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Parasomnias

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Parasomnias are unusual episodes or behaviours occurring during sleep which disturb the patient or others

  • violent or unusual night-time attacks may arise from deep non-Rapid eye movement (REM) sleep (night terrors and sleepwalking) or from REM sleep [sleep paralysis, severe recurrent nightmares, REM behaviour disorder(RBD)]
  • treatments depend on which disorder is present

Diagnosis of parasomnias

  • assessment of parasomnia may be possible with a detailed history from patient or witness, but in general for adequate diagnosis, referral to a specialist sleep centre for polysomnography and video recording may be necessary especially for RBD where loss of REM atonia is seen

Notes:

  • sleep consists of two strikingly different states:
    • Rapid eye movement sleep (REM) and non-rapid eye movement sleep (NREM), which alternate in a cyclical fashion
      • sleep begins with a “shallow” Stage 1 of NREM and “deepens” to NREM Stages 2, 3, and 4
        • which are followed by the first brief episode of REM in approximately 90 minutes
      • after the first sleep cycle, NREM and REM sleep continue alternating in a cyclical fashion
        • duration of each cycle is approximately 90 minutes
      • stages 3 and 4 of NREM sleep (also known as deep sleep, delta sleep, or slow wave sleep) predominate during the first third of the night
      • REM sleep episodes become longer as the night progresses, and the longest REM periods are found in the last third of the night

Reference:


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