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Types of Sleep Disorders:

Parasomnias and
PTSD-Related Sleep Disorder


Information from "Sleepwalking and Night Terrors" (Ch. 8) in Sleep Soundly Every Night, Feel Fantastic Every Day by Dr. Robert Rosenberg

Sleepwalking, also known as somnambulism, is common in children. However, sleepwalking may persist into or begin in adulthood. Sleepwalkers arise from slow wave sleep (non-REM) and walk, sit up in bed, or do other activities that are usually performed during a state of full consciousness. Sleepwalking usually happens during the first third of the night when most slow wave sleep occurs.

sleepwalking symptoms Symptoms
Common symptoms of sleepwalking include:

  • Sitting up or bolting from bed
  • Being unresponsive to conversation or commands
  • Sleepwalker may be quiet or agitated
  • Sleepwalker’s eyes may be open but glazed over and not seeing as an awake person

sleepwalking dangers Dangers of Sleepwalking
The sleepwalker may be violent if startled awake, although adult sleepwalkers are more likely than children to turn violent. Some sleepwalking actions may place the sleepwalker in dangerous situations such as falling down the stairs. There is also a form of sleepwalking called sleep driving where a person drives in their sleep.

sleepwalking treatments Treatments
For sleepwalking in children, there is an effective treatment called scheduled awakenings. First, the parent should observe approximately what time the sleepwalking usually occurs. Then, they are instructed to gently and briefly awaken the child 30 minutes earlier than when they sleepwalk. This interrupts their sleep in a loving way. Doing this for 25 to 30 days can eliminate sleepwalking for up to six months.

If another disorder such as sleep apnea is the cause, treatment for these disorders is generally effective at eliminating the sleepwalking. By successfully treating these issues, the sleepwalking will diminish and disappear. Some medications may also cause sleepwalking. Discuss potential contributing factors such as sleep deprivation, stress, sleep apnea, restless legs syndrome (RLS), and medication with your health care professional.

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Night Terrors
Information from "Sleepwalking and Night Terrors" (Ch. 8) in Sleep Soundly Every Night, Feel Fantastic Every Day by Dr. Robert Rosenberg

Night terrors, a state of intense fear often accompanied by a piercing scream or cry, sweating, and agitation, also typically occur in the early stages of sleep and may coexist with sleepwalking.

night terrors symptoms Symptoms
Common symptoms of night terrors in children include:

  • Bolting upright, looking fearful or panicked, and crying inconsolably
  • Sweating or trashing their limbs
  • Being unresponsive to attempts to communicate with them, and may not recognize others familiar to them

For adults, common symptoms include:

  • Sitting up, looking terrified, sweating, and perhaps screaming
  • Running out of the house or room

night terrors dangers Dangers of Night Terrors
The person suffering from night terrors will not be fully conscious and will not remember the event. While this condition is not medically dangerous itself, it can cause behavior that may be harmful to the person with night terrors or someone else.

night terrors treatments Treatments
Because the person with night terrors will not remember the event, usually it is an intimate partner or family members who are most terrified and prompt treatment. Adult night terrors often respond to treatments to rectify causes of poor quality or quantity of sleep. If testing reveals no cause, and the condition becomes frequent and potentially dangerous, then clonazepam is recommended. The antidepressant paroxetine may also be effective.

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REM Sleep Behavior Disorder
Information from "Do You Sleep, But Not Too Deeply? REM Sleep Behavior Disorder" (Ch. 11) in Sleep Soundly Every Night, Feel Fantastic Every Day by Dr. Robert Rosenberg

In the late 1980s, a group of researchers reported patients that were exhibiting signs of a new form of parasomnia, an umbrella term for a collection of strange sleep behaviors. Behaviors such as sleepwalking or sleep eating were studied previously and were found to occur during the non-REM stages of sleep. However, these new cases were different because they occurred during REM sleep. In addition to the normal eye movements for REM sleep, these patients vocalized sounds and had a notable lack of the atonia, the muscle paralysis, usually present in REM sleep.

This was the first diagnosis of REM sleep behavioral disorder. We now know it is present in about one out of every 200 people. RSBD usually strikes around the age of 50, and mostly in men, whose wild and often violent dreams contradict their peaceful waking lives. The number of women being diagnosed with RSBD has recently been on the rise; however, their symptoms are usually milder.

REM sleep behavior disorder symptoms Symptoms
Common symptoms of REM sleep behavior disorder include:

  • “Motor attacks,” including twitches, jerks, grimaces, searching movements, defensive and or aggressive actions, and vocal sounds
  • Violent episodes about once per week, but may appear as frequently as four times per night over several consecutive nights
  • Occurrence at least 90 minutes after sleep onset, but most often take place much later when REM sleep increases in duration

An acute, transient form may accompany REM rebound during withdrawal from alcohol and sedative-hypnotic agents. Drug-induced cases have been reported with several antidepressants.

REM sleep behavior disorder dangers Dangers of REM Sleep Behavior Disorder
Because people with REM sleep behavior act out their dreams, often in violent ways, they may cause harm to either themselves or loved ones. Additionally, while not medically dangerous, the thrashing and screaming is often disconcerting and frightening for loved ones.

REM sleep behavior disorder treatments Treatments
In order to prevent injury, people suffering from REM sleep behavior disorder may want to create physical safeguards. These may include adding pads to your floor or barriers to your bed. Medication is another treatment option. A tranquilizer of the benzodiazepine class such as clonazepam, is usually prescribed. Recently, melatonin has also been found to be very effective.

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Post-Traumatic Stress Disorder (PTSD) Related Sleep Disorder
Information from "Sleep for those with Post-Traumatic Stress Disorder" (Ch. 12) in Sleep Soundly Every Night, Feel Fantastic Every Day by Dr. Robert Rosenberg

PTSD is a medically recognized anxiety condition that occurs after witnessing or directly experiencing a life-threatening event. People have certainly been suffering from PTSD since humans walked the earth. However, the syndrome was not formally named until 1980, largely in response to the high numbers of Vietnam veterans who continued to suffer from battle fatigue long after they had returned home.

Although this disorder is most common among those who have experienced military combat, you don't have to be a soldier to have PTSD. People from all walks of life can have PTSD and therefore PTSD-related sleep disorders. Recent studies show high rates of sleep disorders in military personnel, who may receive a co-existing diagnosis of a specific sleep disorder like insomnia or sleep apnea.

PTSD-related sleep disorder symptoms Symptoms
Common symptoms of PTSD-related sleep disorder include:

  • Difficulty falling or staying asleep
  • Inability to go to sleep
  • Frequent awakenings
  • Shorter sleep time
  • Nightmares
  • Anxiety dreams
  • Restless sleep
  • Daytime sleepiness

PTSD-related sleep disorder dangers Dangers of PTSD Related Sleep Disorder
People suffering from PTSD-related sleep disorder are associated with several other disorders, including panic attacks, social anxiety, conduct disorders, dissociation, and eating disorders. Psychological problems such as low-self esteem and self-destructive behavior are also common, as are substance abuse, problems at work, and attempted suicide. PTSD-related sleep disorder often corresponds with chronic physical ailments, including headaches, digestive problems, and pain in the chest or other areas of the body.

If you or a loved one is experiencing PTSD-related sleep disorder, seek professional help immediately.

PTSD-related sleep disorder treatments Treatments
Treating other underlying sleep disorders such as sleep apnea or insomnia may help reduce sleep disruption, nightmares, and waking symptoms of PTSD.

Different therapies have also been helpful for treating this disorder. A technique called imagery rehearsal therapy has been particularly effective. In this therapy, the person with PTSD writes down the nightmare and then rewrites the script to be an unthreatening scenario that he or she rehearses during the day.

Finally, several medications have been used to improve sleep and reduce nightmares. One in particular called prazosin has been effective.

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Sleep Soundly Every Night by Dr. Robert Rosenberg

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If you are concerned that you may have sleepwalking, night terrors, REM sleep behavior disorder, or a PTSD-related sleep disorder, talk to your doctor.

To learn more about these problems and other disorders that might be disrupting your sleep, order Sleep Soundly Every Night, Feel Fantastic Every Day by specialist Dr. Robert Rosenberg.

You can also learn more by reading Dr. Rosenberg’s articles:

Parasomnias and PTSD

General Sleep Hygiene




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