Non-REM parasomnias encompass a spectrum of motor behavior and disorders of arousal occurring during the transition from deep sleep to wakefulness. This transition is vulnerable to incomplete sleep transitions, resulting in one sleep stage intruding upon another. These events typically last seconds to minutes, often associated with complete amnesia afterward.
- Diminished cognition
- Confused demeanor and a vacant stare
- Absence or inappropriate reaction to external stimuli
- Difficulty in arousal and failure to return to baseline once awakened
- Febrile illnesses
- Emotional stress
- Sleep deprivation
- Alcohol use
- CNS medications
Confusional Arousal: Progressively waking to a sitting position with disorientation and puzzled behavior. If the individual leaves the bed, it’s considered sleepwalking.
Sleepwalking (Somnambulism): Arising with confusion, disorientation, and possibly leaving the bed. Ranges from automatic, non-goal-oriented behavior to complex, agitated actions.
Sleep-Related Eating Behavior: Involves consuming edible and non-edible substances. Often triggered by certain hypnotic medications like Ambien or Lunesta.
Sexsomnia: Inappropriate, out-of-character sexual behavior directed at a bed partner or bystander during sleep.
Sleep Terrors (Night Terrors): Characterized by sudden piercing screams, increased aggression, and attempts to interrupt behaviors that deepen confusion and agitation.
These disorders originate from arousal during stage 3 sleep, often have genetic inheritance patterns, impaired cognition during events, and no recollection afterward. They are common in children and sometimes considered age-related sleep manifestations. Understanding these disorders helps in managing the associated risks and behaviors during sleep episodes.