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Last Updated September 23, 2025
Most people think of sleep as a peaceful break from the day, but parasomnias can turn the night into something far less restful. They show up as odd or disruptive behaviors, often catching people off guard and leaving them confused the next morning. These episodes can affect not only the person experiencing them but also anyone nearby who has to witness and deal with the disturbance. In the sections ahead, we’ll look at what these strange sleep events are, why they happen, how they affect overall rest, and what you can do to manage them.
Key Takeaways:
Parasomnias are a group of sleep disorders characterized by unusual actions or reactions that occur during the night. Instead of resting quietly, a person might get up and walk, talk out loud, or even act out parts of a dream without realizing it. These moments occur when the brain transitions between sleep stages, leaving someone in a strange middle ground where they’re neither fully awake nor completely asleep.
Parasomnias can appear in many forms, and their intensity varies from mild to disruptive. Common symptoms include:
What often makes parasomnias puzzling is that the person experiencing them may not remember anything, even though the behavior can be obvious to anyone nearby.
Parasomnias don’t come from a single cause. Instead, they’re usually triggered by a mix of factors that affect how the brain moves between sleep stages. When this process is disrupted, parts of the brain may stay “active” while the rest is still asleep, leading to unusual behaviors.
Some common triggers include:
Emotional stress is one of the most common drivers of parasomnias. Research has shown strong links between parasomnias and conditions such as post-traumatic stress disorder (PTSD), where the brain remains hyper-alert during sleep. A study of university students in Saudi Arabia found parasomnias to be especially common in females and in students reporting high stress, depression, and anxiety.
When the body is deprived of rest, the brain struggles to regulate sleep cycles properly. Sleep deprivation makes sudden or incomplete transitions between sleep stages more likely, which is when parasomnias often occur. Irregular sleep schedules, such as those common among shift workers or students with inconsistent routines, can produce similar effects by throwing off the body’s natural rhythm.
Some medications that affect the nervous system have been linked to parasomnias. We are talking about antidepressants or drugs that alter REM sleep here. Alcohol, recreational drugs, and even caffeine can also destabilize sleep, either by fragmenting it or altering brain chemistry in ways that make parasomnias more likely.
Disorders that fragment or interrupt sleep can create the right conditions for parasomnias to appear. Obstructive sleep apnea, restless legs syndrome, and periodic limb movement disorder are all associated with nighttime arousals that may lead to episodes. For instance, someone with untreated sleep apnea may not only snore and gasp for air but also wake partially in ways that trigger confusional arousals or sleepwalking.
Genetics plays a significant role in parasomnias. Children whose parents experienced sleepwalking or other sleep disorders are more likely to develop them as well. The Saudi student study also reinforced this connection, noting higher parasomnia rates among those with a family history of such disorders. This suggests that heredity shapes how vulnerable the brain is to disrupted arousal states, although lifestyle and environment remain important factors.
While not every episode has an obvious cause, most stem from something that interferes with the brain’s natural rhythm of sleep. Identifying these triggers is often the first step toward managing parasomnia episodes.
Parasomnias are often grouped based on when they occur during the sleep cycle. This helps in understanding their causes, behaviors, and potential risks.
These occur during deep NREM sleep, typically in the first third of the night. During this stage, the brain is largely inactive, but the body is in a state of partial arousal. This can result in behaviors that seem purposeful but are carried out without awareness.
Common NREM Parasomnias:
Sleepwalking is among the most familiar parasomnias. A person might wander through the house, move objects around, or, in some cases, even step outside while still asleep. Episodes can be brief or stretch to half an hour, and the sleeper usually has no memory of what happened.
Sleep terrors are sudden bursts of fear that can leave a person shouting or thrashing around while still asleep. They usually happen in the first part of the night. Unlike a nightmare, the person is hard to wake and often looks overwhelmed, breathing quickly and breaking into a sweat, with a pounding heartbeat. Most cases are seen in children, but adults can go through them as well.
In confusional arousals, a person wakes in a confused, disoriented state. They might sit up and mumble, sometimes even carrying out routine actions without full awareness. This usually happens in the transition from deep sleep to lighter stages. The behavior often fades once the brain settles back into sleep.
REM sleep parasomnias occur during the stage of sleep associated with vivid dreaming. Normally, the body is paralyzed in REM sleep to prevent acting out dreams. When this mechanism fails, unusual or sometimes dangerous behaviors can occur.
Common REM-related Parasomnias:
In RBD, the normal paralysis of REM sleep is incomplete or absent. This leads to the person physically acting out dreams, which can include kicking, shouting, etc. These episodes can result in injury to the sleeper or a bed partner. RBD is more common in older adults and may be linked to neurological disorders such as Parkinson’s disease or Lewy body dementia. Episodes often occur later in the night, during vivid dreaming periods.
Nightmares are intense, frightening dreams that often wake the sleeper. While most people occasionally experience nightmares, frequent nightmares can be considered a parasomnia when they disrupt sleep consistently. Nightmares differ from night terrors because the person usually remembers the content of the dream vividly upon waking.
Sleep paralysis occurs
when a person becomes conscious but is unable to move or speak because the body remains in its REM sleep state of
muscle paralysis. These episodes happen either during sleep onset or upon awakening from REM sleep.
Episodes are usually brief, lasting seconds to a couple of minutes, but they can feel much longer. Many people also report vivid hallucinations, which make the experience far more unsettling.
When sleep paralysis occurs repeatedly without being linked to another disorder like narcolepsy, it is called recurrent isolated sleep paralysis. Although not harmful, the combination of paralysis and hallucinations can make this one of the most frightening parasomnias.
Some parasomnias don’t fit neatly into Non-REM or REM categories but still involve unusual behaviors during sleep.
Common Other Parasomnias:
Sleep talking ranges from single words to full sentences or conversations. It can occur in any stage of sleep, and people usually have no memory of talking. Episodes are generally harmless but can disrupt a partner’s sleep.
People with SRED eat or prepare food while asleep, often without remembering it. This behavior can be risky if it involves handling hot surfaces or consuming unsafe foods. Episodes usually happen during partial arousals from non-REM sleep. SRED should not be confused with nocturnal eating syndrome.
Bruxism involves repeated clenching or grinding of the teeth during sleep. It can cause jaw pain, headaches, worn-down teeth, and sleep disruption.
Enuresis is the involuntary release of urine during sleep, most common in children but sometimes persisting into adolescence or adulthood. It is classified as a parasomnia because it occurs during sleep without conscious awareness.
Despite its alarming name, this condition is not physically dangerous. People with exploding head syndrome hear a sudden loud noise as they are falling asleep or waking up. These sounds are imagined, not real, but can cause distress or fear.
This rare parasomnia involves prolonged groaning or moaning sounds during exhalation in sleep. Unlike snoring, which occurs during inhalation, catathrenia often happens in REM sleep and can last for several seconds to minutes. The groaning may disturb bed partners but is usually not harmful to the sleeper.
These vivid experiences occur as a person is falling asleep (hypnagogic hallucinations) or waking up (hypnopompic hallucinations). They may involve seeing figures, hearing voices, or feeling a presence in the room. While the hallucinations can be frightening, they are not typically dangerous. They often occur alongside sleep paralysis and are more common in people with narcolepsy.
Parasomnias vary widely in impact. Occasional sleep talking may require no intervention, while recurring violent dream enactments call for medical care. Treatment strategies depend on the specific parasomnia and its underlying causes.
A consistent bedtime routine and avoiding stimulants before bed go a long way. Pairing that with a calm, comfortable sleep environment helps prevent the brain from misfiring during transitions between sleep stages.
Because stress is such a common trigger, addressing it directly is essential. Relaxation practices such as deep breathing, mindfulness meditation, or gentle evening stretches can reduce nighttime disturbances. Therapy may also help when parasomnias are tied to mental health.
Frequent or severe parasomnias should be checked by a professional. A doctor may suggest a sleep study, where your brain and body are monitored overnight to track activity, breathing, and movement. The results can reveal whether the episodes are linked to medical disorders such as sleep apnea, restless legs syndrome, or other conditions that disrupt normal sleep. In some cases, medication or targeted therapy may be recommended to help stabilize sleep cycles.
For parasomnias that involve physical activity, safety measures are crucial. Taking precautions like securing windows and doors, removing sharp objects, and using bed barriers can reduce the risk of injury. In households with children, extra steps may be needed to prevent accidents.
Parasomnias can be frustrating, both for the sleeper and those who share their space. A partner may be startled awake by shouting, or a parent may rush to comfort a child in the midst of a night terror. While not always dangerous, parasomnias can cause stress and confusion.
One helpful step is keeping a sleep diary. Tracking when episodes occur, along with details like bedtime routines, stress levels, and diet, can reveal patterns. This information is valuable for both individuals and healthcare providers in identifying triggers.
Though parasomnias can feel isolating, they are far more common than people realize. Millions experience them, often without discussing them openly. Recognizing that these events are part of a broader category of sleep disorders can reduce the stigma and encourage proactive management.
Parasomnias remind us that sleep isn’t just “shut down mode.” The brain stays active, cycling through stages that sometimes overlap or misfire. Most parasomnias are harmless, but some can disrupt rest or even create safety concerns that shouldn’t be ignored. The good news is that many respond well to proper sleep hygiene practices, stress management, and guidance from sleep medicine specialists when needed. Understanding these nighttime events not only helps reduce worry but also highlights just how intricate and fascinating sleep really is.
A well-known example of parasomnia is sleepwalking. During sleepwalking, a person may get out of bed and move around while still asleep, with little to no memory of it the next day. It can range from simple activities, like walking to the bathroom, to more complex behaviors, such as eating or even trying to leave the house. Sleepwalking often happens during deep sleep and can be triggered by stress or certain medications.
Most parasomnias are not harmful on their own, but certain types can become risky. For example, someone with REM sleep behavior disorder may act out dreams violently, while severe sleepwalking could lead to falls, injuries, or wandering into unsafe areas. These situations can endanger both the sleeper and those around them. While many cases are mild, frequent or intense episodes should not be ignored. Taking practical safety steps and getting medical guidance can help reduce risks and protect everyone involved.
In most cases, kids grow out of parasomnias as they mature. Episodes usually become less frequent with age and eventually disappear altogether. However, if the episodes are very disruptive and continue into adolescence, it may be wise to consult a pediatrician or sleep specialist. Early guidance can reassure parents and help manage the situation better.
Yes. Stress is one of the most common triggers, especially when combined with irregular sleep or other risk factors. Managing stress often reduces the frequency of episodes.
It is usually better to guide them gently back to bed rather than waking them abruptly. Forcing sudden wakefulness can cause confusion or agitation.
Diagnosis typically begins with a detailed sleep history. In complex cases, doctors may recommend a sleep study that records brain waves, breathing, and body movements overnight.
For mild cases, lifestyle changes alone can make a big difference. Regular sleep schedules, reduced caffeine or alcohol, and stress-management strategies often reduce episodes.
Parasomnia itself is not classified as a mental disorder. Instead, it can be considered a sleep disorder in which a person may experience unusual activity during sleep, such as acting out dreams or sleepwalking.
However, mental health conditions such as anxiety and post-traumatic stress disorder (PTSD) can increase the risk of parasomnias.
Stress, poor sleep habits, and even some medications can also play a role. Treating underlying causes often helps manage parasomnia episodes, leading to fewer sleep disturbances.
The main difference lies in what they affect. Dyssomnias are sleep disorders that disrupt normal sleep, such as sleep apnea or narcolepsy.
Parasomnias, on the other hand, involve unusual behaviors or experiences during sleep, such as sleepwalking, night terrors, or acting out dreams.
Put simply, dyssomnia is about trouble with sleep quantity or quality, while parasomnia is about strange or disruptive actions during sleep.
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Disclaimer: What is said in this article has been referenced from multiple sources and is intended only for educational and informational purposes. Please note that no content in this article is a substitute for professional advice from a qualified doctor or healthcare provider. Always consult an experienced doctor with any concerns you may have regarding a health condition or treatment, and never disregard any medical suggestions or delay in seeking treatment because of something you read here.
