Parasomnia


by ScatterJaw


“I have woken up twice in the last three months with scratches on my arms that I cannot explain”. Could I be scratching myself in my sleep? Why would I be doing this? ~Lauren

 

It is definitely possible for you to scratch yourself while you are asleep, even without being aware that you are doing it. If this is becoming a persistent problem, you will want to see your primary care doctor for advice. I say this because the most effective way to stop scratching yourself while asleep is to figure out what is making your skin itch and eliminating it.

There are several distinct possibilities. First, it is important to examine the skin for any signs of bug bites. In particular, if you have bed bugs, these may be coming out of the mattress at night and biting you, leading to itching and scratching. Second, it is important to rule out any allergies or skin sensitivities. You could, for example, have a reaction to a new laundry detergent or soap. Similar, you could be allergic to mites or mold, or some other allergen that you are running in to in the bedroom. Finally, atopic dermatitis, or eczema, is a common chronic skin condition leading to itching and dryness. Your primary care doctor will be able to consider all of these possibilities, as well as more rare serious medical causes of itching, and help you with a treatment plan. 

 

This question leads us into another common discussion often attributed to sleep; known as, Parasomnia. 

Parasomnias:

  • are characterized by undesirable physical or verbal behaviors, such as walking or talking during sleep

  • occur in association with sleep, specific stages of sleep or sleep-wake transitions and

  • can be divided into two groups: primary parasomnias and secondary parasomnias.

Primary parasomnias are disorders of sleep states, while secondary parasomnias are disorders of other organ systems that arise during sleep.

Primary parasomnias are marked by a simultaneous occurrence of elements of both wakefulness and sleep. Primary parasomnias are classified according to the stage of sleep in which they occur: rapid eye movement (REM) or non–rapid eye movement (NREM).

Secondary parasomnias are disorders of other organ systems that may take place during sleep. Secondary parasomnias may be quite common, but can be unrecognized, misdiagnosed, or ignored in clinical practice.

Types of Parasomnias

Nightmares
Nightmares are vivid nocturnal events that can cause feelings of fear, terror, and/or anxiety. Usually, the person having a nightmare is abruptly awakened from REM sleep and is able to describe detailed dream content. Usually, the person having a nightmare has difficulty returning to sleep. Nightmares can be caused by many factors including illness, anxiety, the loss of a loved one, or negative reactions to a medication. Call your doctor if nightmares occur more often than once a week or if nightmares prevent you from getting a good nights rest for a prolonged period of time.

Sleep terrors/night terrors
A person experiencing a night terror or sleep terror abruptly awakes from sleep in a terrified state. The person may appear to be awake, but appears confused and is not able to communicate. Night terrors last about 15 minutes, after which time the person usually lies down and appears to fall back asleep. People who have sleep terrors usually don’t remember the events the next morning. Night terrors are similar to nightmares, but night terrors usually occur during stages 3 sleep (deep sleep). People experiencing sleep terrors may pose dangers to themselves or others because of jumping on the bed or running around. Night terrors are fairly common in children aged four to twelve. This sleep disorder, which may run in families, also can occur in up to 3% of adults. Strong emotional tension and/or the use of alcohol can increase the incidence of night terrors among adults.

Sleepwalking (somnambulism)
Sleepwalking occurs when a person appears to be awake and moving around with eyes wide open but is actually asleep. Sleepwalkers have no memory of their actions. Sleepwalking most often occurs during deep non-REM sleep (stage 3), early in the night. These episodes vary widely in complexity and duration. This disorder is most commonly seen in children aged six to twelve; however, sleepwalking can occur among younger children, the elderly, and adults. Sleepwalking appears to run in families. Sleepwalking can sometimes be dangerous because the sleepwalker is unaware of his or her surroundings and can bump into objects or can fall down.

Sleep paralysis
People with sleep paralysis are not able to move the body or limbs when falling asleep or waking up. Brief episodes of partial or complete skeletal muscle paralysis can occur during sleep paralysis. Sometimes sleep paralysis runs in families, but the cause of sleep paralysis is not known. Sleep deprivation and irregular sleep-wake schedules can also cause sleep paralysis. It is also seen in narcolepsy, a disorder characterized by severe excessive daytime sleepiness. This disorder is not harmful, but people experiencing sleep paralysis often are fearful because they do not know what is happening. An episode of sleep paralysis often is terminated by sound or touch. Within minutes, the person with sleep paralysis is able to move again.

REM sleep behavior disorder (RBD)
People with rapid eye movement (REM) sleep behavior disorder act out dramatic and/or violent dreams during REM sleep. REM sleep usually involves a state of paralysis (atonia), but people with this condition move the body or limbs while dreaming. Usually, RBD occurs in men aged 50 and older, but the disorder also can occur in women and in younger people. In the diagnosis and treatment of RBD, potentially serious neurological disorders must be ruled out. Polysomnography (sleep study) and drug treatments are involved in the diagnosis and treatment of this disorder.

This article is for general informational purposes only and is not a substitute for professional medical advice.