Parasomnia

Key takeaways

Parasomnia belongs to science; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Parasomnia to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Parasomnia from memory before moving on to harder problems.

Reference excerpt

Parasomnias are a category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep. Parasomnias are dissociated sleep states which are partial arousals during the transitions between wakefulness, NREM sleep, and REM sleep, and their combinations.

Classification The newest version of the International Classification of Sleep Disorders (ICSD, 3rd. Ed.) uses State Dissociation as the paradigm for parasomnias. Unlike before, where wakefulness, non-rapid eye movement (NREM) sleep, and rapid eye movement (REM) sleep were considered exclusive states, research has shown that combinations of these states are possible and thus may result in unusual unstable states that could eventually manifest as parasomnias or as altered levels of awareness. Although the previous definition is technically correct, it contains flaws. The consideration of the State Dissociation paradigm facilitates the understanding of the sleep disorder and provides a classification of 10 core categories.

Non-rapid eye movement (NREM)-related parasomnias NREM parasomnias are arousal disorders that occur during stage 3 (or 4 by the R&K standardization) of NREM sleep—also known as slow wave sleep (SWS). They are caused by a physiological activation in which the patient's brain leaves SWS and is caught between a sleeping and a waking state. In particular, these disorders involve activation of the autonomic nervous system, motor system, or cognitive processes during sleep or sleep-wake transitions.

Diagnosis Differential diagnosis for NREM-related parasomnias:

Sleep-disordered breathing REM-related parasomnias Nocturnal seizures Psychogenic dissociative disorders

Confusional arousals

Confusional arousal is a condition when an individual awakens from sleep and remains in a confused state. It is characterized by the individual's partial awakening and sitting up to look around. They usually remain in bed and then return to sleep. These episodes last anywhere from seconds to minutes and may not be reactive to stimuli. Confusional arousal is more common in children than in adults. It has a lifetime prevalence of 18.5% in children and a lifetime prevalence of 2.9–4.2% in adults. Infants and toddlers usually experience confusional arousals beginning with large amounts of movement and moaning, which can later progress to occasional thrashings or inconsolable crying. In rare cases, confusional arousals can cause injuries and drowsy driving accidents, thus it can also be considered dangerous. Another sleeping disorder may be present triggering these incomplete arousals.

Sleep-related abnormal sexual behavior

Sleep-related abnormal sexual behavior, Sleep sex, or sexsomnia, is a form of confusional arousal that may overlap with somnambulism. Thereby, a person will engage in sexual acts while still asleep. It can include such acts as masturbation, unexpected fondling themselves or others, having sex with another person; and in more extreme cases, sexual assault. These behaviors are unconscious, occur frequently without dreaming, and bring along clinical, social, and legal implications. It has a lifetime prevalence of 7.1% and an annual prevalence of 2.7%.

Sleepwalking (somnambulism)

Sleepwalking has a prevalence of 1–17% in childhood, with the most frequent occurrences around the age of eleven to twelve. About 4% of adults experience somnambulism. Normal sleep cycles include states varying from drowsiness all the way to deep sleep. Every time an individual sleeps, they go through various sequences of non-REM and REM sleep. Anxiety and fatigue are often connected with sleepwalking. For adults, alcohol, sedatives, medications, medical conditions and mental disorders are all associated with sleepwalking. Sleep walking may involve sitting up and looking awake when the individual is actually asleep, and getting up and walking around, moving items or undressing themselves. They will also be confused when waking up or opening their eyes during sleep. Sleep walking can be associated with sleeptalking.

Sleep terrors (night terrors/pavor nocturnus)

Sleep terror is the most disruptive arousal disorder since it may involve loud screams and panic; in extreme cases, it may result in bodily harm or property damage by running about or hitting walls. All attempts to console the individual are futile and may prolong or intensify their confused state. Usually they experience amnesia after the event but it may not be complete amnesia. Up to 3% of adults have sleep terrors and exhibited behavior of this parasomnia can range from mild to extremely violent. This is very prevalent in those who have violent post-traumatic stress disorder (PTSD). They typically occur in stage 3 sleep.

Sleep-related eating disorder

The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) classifies sleep-related eating disorder (SRED) under sleepwalking, while ICSD classifies it as NREM-related parasomnia. It is conceptualized as a mixture of binge-eating behavior and arousal disorder. Thereby, preferentially high-caloric food is consumed in an uncontrolled manner. However, SRED should not be confused with nocturnal eating syndrome, which is characterized by an excessive consumption of food before or during sleep in full consciousness. Since sleep-related eating disorders are associated with other sleep disorders, successful treatment of the latter can reduce symptoms of this parasomnia.

Rapid eye movement (REM)-related parasomnias

REM sleep behavior disorder

… excerpt ends here. Continue reading the full article.

Worked examples

Example 1 — a first encounter with Parasomnia

Start with the simplest possible case. Write down what Parasomnia claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Parasomnia before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Parasomnia ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Parasomnia

In research: Parasomnia appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Parasomnia in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Parasomnia is common in secondary-school and first-year university syllabi. It links to neighbouring topics Parasomnias, Sleep disorders, so understanding it makes those chapters shorter.
In everyday life: Look for Parasomnia outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

How to study Parasomnia in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Parasomnia means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Parasomnia out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Parasomnia in simple terms?

Parasomnias are a category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep. Parasomnias are dissociated sleep states which are partial arousals during the t…

Why does Parasomnia matter?

Because it connects several science ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Parasomnia?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Parasomnia.