Sleep disorders can make life very tricky. Here's what parasomnias are — and how to treat them.
Imagine waking up in the morning only to be told that you didn’t spend all night curled up in bed. Instead, you maybe drove a car or ate last night’s leftover pizza. Perhaps you even initiated sex with your spouse — none of which you remember at all now because you were still asleep.
This is a reality for people who suffer from non-REM (rapid eye movement) parasomnias, also known as arousal disorders.
Non-REM sleep encompasses the first three stages of sleep, per Verywell Mind, and is categorized by thoughtlike mental activity and little to no eye movement. According to Cleveland Clinic, these non-REM sleep disorders can include night terrors, when you wake up in a terrified state; sleepwalking, which can include complex activities, including moving furniture, playing a musical instrument and even operating heavy machinery; and sleep-related eating disorders, in which you eat and drink while partially awake.
“One of the characteristics of non-REM parasomnias is that there’s amnesia for the event in the morning, so they usually don’t remember what happened,” Molly Atwood, assistant professor of psychiatry and behavioral sciences at Johns Hopkins University, tells Yahoo Life.
According to Atwood, studies have shown that these disorders typically affect less than 5% of the population and can range in terms of how disruptive they are to one’s life. However, for certain people, living with parasomnia can make life very tricky.
Dr. Rafael Pelayo, professor of sleep medicine at Stanford University, had a patient who was unaware that he was having sex with his girlfriend while he was sleeping — and the girlfriend didn’t notice that he wasn’t conscious. He’s also encountered patients who will eat while sleeping and wake up to find wrappers and other objects around their home, having no clue how they got there.
“The [cases] you hear about are rare, but they may be happening more often than you realize,” he tells Yahoo Life. “People might be experiencing this and be scared to talk about it.”
Interestingly, some researchers believe myths about supernatural creatures may actually be related to these disorders. Pelayo says that sometimes people would blame ghosts when they woke up to furniture being rearranged in their room — when in reality, they did it while sleepwalking.
In the most extreme cases, people with parasomnia can behave violently toward other people.
“Tales of things like werewolves are thought to be descriptions of people who are sleepwalking because when you’re sleepwalking you don’t feel pain the same way — they have altered pain sensations,” he explains. “There are people who had weapons in their hands who would not release the weapon until the tendons in the hands were severed, either by biting or cutting.”
What’s going on?
These sleep issues are caused when there’s an incomplete arousal from deep sleep. In deep sleep, our body can still be active, but our mind is shut down.
“So you can do some pretty complex behaviors, but your mind is not totally aware when you’re not completely aroused from deep sleep,” says Atwood.
When we are sleep-deprived, our body tends to compensate for it by ramping up deep sleep, which is important for health. However, if something is fragmenting your sleep, “then you can have this mixed state where you’re trying to push yourself out of deep sleep, but it’s an incomplete wake-up,” she explains. This leads to parasomnias.
Things that can cause fragmented sleep include disorders like sleep apnea, as well as taking antidepressants, being in a noisy environment and having an irregular sleep schedule. While not much is known about why some people may be more prone to sleep disorders than others, Atwood says there is likely a genetic component. Children are more likely to develop parasomnias than adults.
How can we treat parasomnias?
Atwood says that safety is paramount when it comes to starting treatment for one of these kinds of sleep disorders.
“Make sure that if you are flailing and hitting a bed partner, that you either sleep separately for now or put a pillow between you,” she says.
Atwood also notes that it can be helpful to put locks or barriers on doors, though it’s important to make sure it is still possible to get out in case there is a fire or other emergency.
Bells, to alert someone if a sleepwalker exits the room, can also be helpful, and gates and protective features on sharp objects like furniture can prevent someone from getting hurt while in a sleepwalking state.
Beyond that, a doctor should “take a look at what medications they’re on and see if there’s any medications that are possibly causing the behaviors.”
Participating in a sleep study can also ensure that one does not have sleep apnea, which may contribute to parasomnias, Atwood says.
Pelayo says that medications like melatonin and the muscle relaxant clonazepam may help, while Atwood notes that “benzodiazepine and certain blood pressure medications can help.”
It’s also important to look at one’s lifestyle.
“We want to make sure people aren’t sleep-deprived, that their sleep schedules are regular, their sleep is optimized, that they’re engaging in stress management and that their environment is as conducive to sleep as possible,” says Atwood.
Pelayo adds that alcohol can also be a contributing factor. “I tell people, ‘You can drink at breakfast but not at dinner,’” he says. “Going to sleep drunk may aggravate these conditions.”
