PARASOMNIAS: FROM SLEEPWALKING TO SLEEPTALKING
Up to now the sleep disorders we have examined are those involving disruptions in the physiological process of falling asleep or maintaining sleep and those involving the daytime consequences of disturbed sleep. At this point let’s turn our attention to phenomena that are not directly related to malfunctions of the sleep process itself but can interfere with, or are exacerbated by, sleep. Such disorders, some of which affect children almost exclusively, are given the name “parasomnias,” a word that translates roughly as “events associated with sleep.” Parasomnias account for nearly one out of ten diagnoses of sleep disorders.
Parasomnias are disorders involving unwanted or abnormal events, including sleepwalking, bed-wetting, and behaviors such as teeth grinding or head banging. (While nightmares and the panic disorder known as night terrors are also forms of parasomnia. A patient with a parasomnia will usually complain about the problem itself— bed-wetting, for example—rather than about the disturbed sleep the problem is causing.
Generally speaking, the cluster of parasomnia disorders tends to occur at the threshold between wakefulness and sleep, or during deep sleep—Stages 3 and 4 of the sleep cycle. And, because the longest periods of deep sleep occur in the first part of the cycle, most parasomnia events tend to take place early in the night, usually about an hour after the onset of sleep. I use the term “cluster” because often more than one form of the disorder afflicts the same person. For example, the same problem that is manifested as sleepwalking may also be the underlying cause of bed-wetting.
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