Colin Snow
Sleep is a complex and fascinating phenomenon, and while we are unconscious, our bodies can sometimes perform surprising and unusual actions. These behaviours are known as parasomnias and can range from sleep talking, or somniloquy, to more complex activities such as sleepwalking, sleep eating, and even sexual behaviours. Parasomnias are sleep disorders that cause abnormal behaviours during any stage of sleep, from the transition to wakefulness to deep sleep. While they can be disruptive and dangerous, parasomnias are usually harmless and can be managed with medical help. So, if you or someone you know exhibits strange behaviours while asleep, it may be worth exploring the fascinating world of parasomnias to understand these mysterious nocturnal activities.
| Characteristics | Values |
|---|---|
| Sleep talking | Somniloquy, is a common physiological phenomenon |
| Sleepwalking | Getting out of bed and moving about with eyes open, but being asleep |
| REM sleep behavior disorder | Shouting, grunting, and acting out dreams, often violently |
| Sleep terrors | Screaming, thrashing, and kicking |
| Sexsomnia | Sexual behaviors during sleep, such as intercourse, masturbation, or sexual assault |
| Sleep-related eating disorder | Eating and drinking while asleep, including inedible items |
| Confusional arousals | Waking up in a state of confusion and disorientation |
| Nightmare disorder | Vivid dreams causing fear, terror, and anxiety |
| Parasomnias | Abnormal behaviors during sleep, including sleep paralysis, hallucinations, and confusional arousals |
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Sleep talking
The exact cause of sleep talking is unclear, but it may be triggered by stress, anxiety, and mental health conditions. Sleep talking is also associated with certain factors, such as fatigue, emotional stress, sleep deprivation, vigorous exercise, and stimulants like caffeine and nicotine. To reduce the occurrence of sleep talking, it is recommended to manage stress, maintain a regular sleep routine, and avoid stimulants and electronics before bed.
While sleep talking is usually not a cause for concern, it can be a nuisance for those who share a bedroom with a sleep talker. Partners of sleep talkers can try earplugs and white noise machines to minimise disruptions. Additionally, maintaining a sleep diary or using a polysomnogram, which records brain waves, breathing, and heart rate, can help specialists analyse sleep behaviour and provide appropriate treatment if needed.
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Sleepwalking
The activities performed while sleepwalking can range from benign behaviours such as talking, sitting up in bed, or walking to the bathroom, to more hazardous activities like cooking, driving, or making violent gestures. Sleepwalkers often have little to no memory of their actions, and their consciousness is altered, making memories difficult to recall. In some cases, sleepwalkers may act out behaviours that align with their dreams, such as urinating in unusual places or engaging in sleep eating. While complex activities while sleepwalking are rare, there have been reports of people driving or cooking while asleep, especially when experiencing sleep deprivation.
Although sleepwalking is usually not a serious condition, it can cause concern for those who experience it or their loved ones. If you or someone you know is affected by sleepwalking, it is recommended to consult a healthcare professional for guidance and support.
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Sleep terrors
During a sleep terror episode, the person may suddenly sit up in bed, scream, thrash around, and appear terrified. Their heart rate may increase, they may sweat profusely, and their breathing may become rapid and shallow. Despite appearing awake, the person is still asleep and may have no memory of the event the next morning. The person's body is aroused, but their mind is still asleep, leading to a state of partial wakefulness where the fear centres of the brain are highly activated. They may scream, cry, mumble incoherently, flail their limbs, and even sleepwalk or run out of the room.
Night terrors can be difficult to distinguish from nightmares, but there are some key differences. Night terrors occur during non-REM sleep, typically in stage 3 or 4 of the sleep cycle, while nightmares occur during REM sleep. During a night terror, the person is not fully awake and is hard to console, but with nightmares, they wake up and remember the dream. Night terrors can be very disruptive to the person's sleep and disturbing for bed partners.
Treatment for night terrors typically involves a combination of therapy, stress reduction, treating any underlying conditions, and, in some cases, medication. Creating a consistent and relaxing bedtime routine, avoiding overtiredness, and establishing a calm sleep environment can help reduce the occurrence of night terrors. A healthcare provider can help manage night terrors and recommend appropriate treatments.
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REM sleep behaviour disorder
Parasomnias are sleep disorders that cause abnormal behaviour while sleeping. They can occur during any stage of sleep, including the transition from wakefulness to sleeping and vice versa. People with parasomnias might move around, talk, or do unusual things during sleep. Parasomnias can be dangerous because the person affected is unaware of their surroundings.
One type of parasomnia is REM sleep behaviour disorder (RBD), a neurological condition that causes a person to make involuntary movements in their sleep. Dreams are most prevalent during the REM phase of sleep, and people with RBD may talk or make vocal sounds in their sleep, fall out of bed, or make sudden, violent arm and leg motions in response to vivid, troubling dreams. These movements could potentially cause people to injure themselves or their sleeping partner. RBD is a complex sleep disorder affecting the brain and is closely related to Lewy body dementia (LBD), Parkinson's disease, and multiple system atrophy (MSA). It is also associated with narcolepsy, another sleep disorder.
RBD can be divided into three categories: idiopathic RBD, drug-induced RBD, and secondary RBD due to a medical condition. The diagnosis requires confirmation by an in-laboratory sleep study (polysomnography) with video recording, which helps assert abnormal behaviours during REM sleep and excludes other sleep disorders. Certain medications, notably newer antidepressants, alcohol and drug abuse, smoking, occupational pesticide exposure, and previous head injuries might also have roles in causing a person to develop RBD. Statistically, men are nine times more likely to develop RBD than women, and the average age of those with the disorder is 61. However, women under 50, young adults, and children are being diagnosed with it more often, typically in association with narcolepsy, antidepressant use, or brain tumours.
Parasomnias can be treated with medication or cognitive behavioural therapy (CBT).
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Sexsomnia
The causes of sexsomnia are not entirely clear, but they may be related to other sleep disorders, such as sleepwalking, sleep talking, and sleep-related epilepsy disorder, as well as external factors like stress, alcohol, and drug use. Sexsomnia can also be triggered by physical contact initiated by a partner or another individual sharing the same bed. Additionally, certain medications, such as the sedative-hypnotic zolpidem (commonly known as Ambien), have been found to increase the risk of sexsomnia.
The symptoms of sexsomnia can vary depending on the person, but they often cause considerable shame and distress for both the person experiencing it and their partners. Treatment for sexsomnia is possible and may include the use of medication and lifestyle changes, such as improving sleep hygiene and reducing stress or triggers.
It is difficult for experts to estimate how many people experience sexsomnia, as it can occur unexpectedly and may go unnoticed unless another person observes the effects. However, a study found that nearly 8% of people at a sleep centre exhibited symptoms of the disorder.
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Frequently asked questions
Sleep talking, or somniloquy, is a common physiological phenomenon and is usually harmless. However, in some cases, it could be a sign of a more serious sleep disorder.
Sleepwalking can be dangerous. Sleepwalkers may perform complex activities such as driving a car, or do things they wouldn't normally do, like urinating in an area without a toilet.
Sleep-related eating disorder (SRED) is a sleep disorder where people eat or drink in their sleep. This can be dangerous as people may eat inedible or toxic foods, and there is also a risk of choking or injuries from preparing food.
This is known as confusional arousal, where a person wakes up in a state of extreme confusion. The episode may last for a few minutes to hours.
This is likely due to a sleep disorder called parasomnia. These are unwanted behaviours that occur during sleep, ranging from small actions like opening your eyes to extreme actions like driving a car.
