Parasomnia Essay

This essay has a total of 1902 words and 9 pages.


Parasomnia refers to a wide variety of disruptive, sleep-related events or,
“disorders of arousal.” These behaviors and experiences occur usually while
sleeping, and most are often infrequent and mild. They may however happen often enough to
become so bothersome that medical attention should be sought out. “Parasomnias are
disorders characterized by abnormal behavior or physiological events occurring in
association with sleep stages, or sleep-wake transitions.”(DSM pg. 435)

Arousal disorders are the most common type of parasomnia. These disorders include:
confusional arousals, sleepwalking, sleep terrors and nightmares. Experts believe that
each is related and share some symptoms. Essentially, they occur because a person is in a
mixed state of being both asleep and awake, generally coming from the deepest stage of
non-dreaming sleep. The individual is awake enough to act out complex behaviors, but
asleep enough not to be aware of or remember them.

Arousal disorders (parasomnia) are common in young children but may occur in adults as
well. These disorders tend to run in families and might be made worse when overly tired
or stressed, a high fever, or when taking certain medications.

Confusional Arousals can occur at any age. “Confusional arousals consist of
confusion during and following arousals from deep sleep in the first part of the
night” Stanford (1972). This disorder often occurs in infants and toddlers, but may
also be seen in adults. These episodes may begin with a person crying and thrashing
around in bed. The individual may appear to be awake, even confused and upset, yet resists
all attempts by others to comfort them. It’s also very difficult to wake someone up
when they are in this state. The episode may last up to thirty minutes to an hour and it
usually ends with the person calming, waking briefly and then wanting to go back to bed.
The individual usually will have no recollection of this event in the morning so it would
be either the parents, or the spouses’ responsibility to bring this to the
individuals attention.

Sleepwalking is commonly seen in older children. It ranges from getting out of bed to
prolonged and complex actions. “Sleepwalking occurs relatively often among
children; one can even cause it intentionally simply by picking up a child or adult in
deep sleep and standing them on their feet” Borbely (1986). In adults,
sleepwalking could indicate a personality disturbance. For instance, a good amount of
adults that sleepwalk are suffering from depression. It is thought that this condition is
hereditary and can be brought on by stress, also by not getting enough sleep or a high

The typical sleepwalking episode begins about three hours after the individual has fallen
deeply asleep and it will usually last about five to twenty minutes. During one of these
episodes the sleepwalker’s eyes are generally open. However, we don’t think
they can see their surroundings because they always seem to be completely unaware of the
environment around them. They manage to show keen ability to navigate through their
surroundings without serious harm. Less often than not you can expectt a sleepwalker to
dress themselves, open doors, make a sandwich, or go to the bathroom without any problems.
Unfortunately there is always the extreme tragedies, for example. “A
fourteen-year- old boy got up, walked to the refrigerator, and then stepped out the
door----of the family camper, which was going fifty miles per hour down the San Diego
freeway” Fritz (1993).

“The etiology of sleepwalking is not clear. It does however seem to be concentrated
in families and to be characterized by the presence of bursts of high voltage delta
activity in delta sleep” Borbely (1986). There is no known drug yet for
sleepwalking however doctors have been prescribing Valium, which suppresses stage four
sleep. The down side to this though is it will only work for a short while and
shouldn’t be taken for more than six months. It can be pretty difficult to
distinguish sleepwalking disorder from sleep terror disorder. In both disorders, the
individual shows movement, difficulty awakening, and amnesia of the entire event.

Sleep Terrors are the most extreme form of arousal disorders and are horrible to witness.
Broughton (1970), Fisher, Byrne, Edwards and Kahn (1970) have each suggested that night
terrors are precipitated by the sudden release of emotional conflicts when the defenses
are at their lowest, in the deepest stages of sleep.” Like sleepwalking sleep
terrors begin during deep sleep, NREM, that is characterized by slow-frequency EEG
activity. “The onset of sleep terror episodes is typically heralded by very high
voltage EEG delta activity, an increase in muscle tone, and a twofold to fourfold increase
in heart rate, often to over 120 beats a minute” (DSM pg. 435). These episodes
usually begin with a scream or shout and cause behavior simulating terror or fear, an
increased heart rate, rapid breathing, sweating and agitation. Some sleep terror cases
report that the terror is attached to a single scene, like being trapped in a cave, or
being burned alive. By themselves, sleep terrors are not dangerous, but what happens
during one can be. A person may jump out of bed and do something he might not normally
do. Then of course there are always the extreme cases that usually result in injury,
violence, excessive eating, or disturbances to others in and around the bed.

Among children, sleep terror disorder is more common in males than in females ands among
adults the sex ratio is equal. Instead of waking and moving into another stage of sleep,
the child or adult get “stuck” in between stages of sleep. “This can
occur in as many as 15% of young children and can be caused by being overly tired, of
having an interrupted sleep cycle, having a high fever can also produce an increase in
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