12133 Parasomnias Disruptive Sleep Disorders
Informed by recognized medical guidance
Overview
Parasomnias are sleep disorders that cause unusual behaviors, movements, emotions, or dreams while you are falling asleep, sleeping, or waking up. Examples include sleepwalking, night terrors, and sleep talking. You are still partly asleep while these happen, so you may not be aware of your actions.
Key facts
- They are more common in children and often outgrown by adolescence.
- They can happen at any age and may be triggered by stress, lack of sleep, or other medical conditions.
- Most parasomnias are not dangerous, but some behaviors can lead to injury.
Yes, parasomnias are fairly common. Most people will experience at least one parasomnia episode at some point in their lives, and many are occasional or harmless.
Parasomnias can affect anyone, but they are most common in children. Certain types, like REM sleep behavior disorder, are more likely in older adults.
Symptoms
- Injuring yourself or others while asleep
- Seizure-like movements or stopped breathing during sleep
- Behaviors that put you or someone else in danger, like leaving the house during sleep
- ⚠New or frequent episodes that are getting worse
- ⚠Daytime sleepiness or poor sleep affecting daily life
- ⚠Behaviors that cause concern to family members
Common symptoms
- Sleepwalking – getting up and walking around while still asleep
- Night terrors – sudden waking in fear with screaming or crying, but no awareness of what happened
- Sleep talking – speaking during sleep without remembering it
- Confusional arousals – waking in a confused state, slow to respond
- Sleep paralysis – being unable to move or speak while falling asleep or waking up
- REM sleep behavior disorder – acting out dreams, sometimes with forceful movement
Symptoms in children
- Night terrors (screaming and thrashing during deep sleep)
- Sleepwalking
- Sleep talking
Symptoms in older adults
- REM sleep behavior disorder – acting out vivid dreams, sometimes punching or kicking
- Sleep-related eating disorder – eating while not fully awake
- Confusional arousals
Causes
Main causes
- Disrupted sleep (for example, from sleep apnea or restless legs syndrome)
- Stress or anxiety
- Insufficient sleep
- Alcohol use before bed
- Some medicines (prescribed by a doctor) can trigger parasomnias
- Genetics – a family history of parasomnias
Risk factors
- Being a child
- Sleep deprivation
- Irregular sleep schedule
- Stress or emotional upset
- Certain neurological conditions (in older adults)
When to see a doctor
See a doctor urgently if:
- Symptoms that happen often or cause injuries
- Violent behavior or acting out dreams
- Symptoms that started suddenly, especially with headaches or confusion
Book a routine appointment if:
- Occasional episodes that worry you or your family
- Understanding whether treatment options are needed
- Checking for possible underlying causes like sleep apnea
Diagnosis
Your doctor will ask you about your sleep habits, medical history, and what you do during sleep. They may ask your bed partner or family to describe what they see. You might also be asked to keep a sleep diary.
Tests that may be done
- Sleep diary – recording your sleep patterns, routines, and any episodes
- A sleep study (polysomnography) – you stay overnight at a clinic while brain waves, breathing, heart rate, and movements are monitored
- Sometimes, a video recording during sleep can help with diagnosis
What to expect at your appointment
Your doctor will work with you to understand the pattern. They may refer you to a sleep specialist if needed. Most parasomnias can be diagnosed with a careful history, and a sleep study is only needed in certain cases.
Treatment
Treatment for parasomnias depends on the type, how often it happens, and how much it affects you. In many cases, especially for children, no specific treatment is needed. The focus is on safety and improving sleep quality.
Self-care at home
- Keep a regular sleep schedule – go to bed and wake up at the same time each day
- Make your bedroom safe – remove sharp objects, lock windows, and use a low bed
- Reduce stress before bedtime – try relaxing activities like reading or taking a warm bath
- Avoid alcohol in the evening
- Practice good sleep hygiene – a cool, dark, quiet room
Medical treatments
Medical treatment includes addressing any underlying conditions, such as sleep apnea or restless legs syndrome. Cognitive behavioural therapy (CBT) may be used to reduce stress or anxiety. In some cases, your doctor may prescribe a medicine (such as a sedative or a type of antidepressant) to reduce episodes – but this is only considered if episodes are frequent, dangerous, or affecting your life. Always talk to your doctor before starting any treatment.
When is surgery considered?
Surgery is not used as a treatment for parasomnias itself. However, if an underlying condition like sleep apnea needs surgical treatment, this might reduce parasomnias.
Living with this condition
Living with a parasomnia often means taking simple safety steps. Tell your family or partner what to do if they see you sleepwalk or act out a dream. Gently guide the person back to bed without shouting or waking them fully.
Lifestyle tips
- Create a calm bedtime routine
- Avoid caffeine and alcohol in the evening
- Aim for the same amount of sleep every night
- Get regular physical activity during the day
Diet and exercise
Eating a balanced diet and staying active can improve the quality of your sleep. Avoid heavy meals or vigorous exercise close to bedtime, as both can make sleep more restless.
Mental health and emotional wellbeing
Frequent parasomnias can cause embarrassment, worry, and sleep-related anxiety. You may worry about injuring yourself or others, or you may feel exhausted. These feelings are normal. Talking to your doctor or a therapist can help.
Prevention
Not all parasomnias can be prevented, but many episodes are triggered by poor sleep, stress, or alcohol. Keeping a regular sleep pattern and reducing triggers can help lower the chance of episodes.
Vaccines
There is no vaccine for parasomnias.
Screening programmes
There is no routine screening test for parasomnias. If you have symptoms, your doctor can evaluate you based on your history and, if needed, a sleep study.
Complications
If left untreated
- Injuries from sleepwalking or acting out dreams
- Daytime sleepiness and difficulty concentrating
- Strained relationships with a partner or family
- Disrupted sleep for you and your household
Long-term outlook
The outlook for parasomnias is generally good. Many children outgrow them by their teens. Adults may find that episodes become less frequent when they improve their sleep habits and manage stress. With the right support, most people can keep themselves safe and sleep well.
Find support
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
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Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 31, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.