Parasomnias are unwanted and, often, distressing behaviors that happen while you’re asleep. They include things like acting out dreams or nightmares, bed-wetting, screaming, waking up confused or panicked, and sleepwalking.
While parasomnias can affect people of all ages, they’re most common in children. Fortunately, most young people who experience parasomnias eventually outgrow them.
There’s no cure for parasomnias, but they can be managed with the right support. This includes working with a sleep specialist, therapy, medication, and improving your sleep hygiene.
Parasomnias are unpleasant or disruptive behaviors that happen when a person is asleep. For example, a person might shout or make sounds, sleepwalk, have intense nightmares or night terrors, or wet the bed. The person might seem wide awake, even though they’re asleep.
Often, parasomnias are noticed by someone other than the person having them. For example, a partner might be woken up by a person shouting in their sleep. Or a parent may realize their child is sleepwalking around the house. On their own, parasomnias aren’t dangerous. But left untreated, they can lead to injuries and a loss of restful sleep.
While parasomnias tend to affect children, they can affect people of all ages. Research suggests that many people experience parasomnia at some point in their lives. Learning more about the signs and symptoms of parasomnia can help you know when to seek support.
Signs and symptoms of parasomnia
Parasomnias can take many different forms. But you might be having one if you or someone else notices that you:
Act out your dreams or nightmares
Speak, shout, or make other audible noises while you’re sleeping
Get up and move around without waking up
Feel wide awake but can’t move your body
Do things you can’t remember, or you wake up confused
Wake up crying or in a state of panic
Wet the bed
See or hear things that aren’t there as you’re falling asleep or waking up
Eat and/or prepare food while you’re asleep
Engage in sexual behavior or make sexual noises while sleeping
Different types of parasomnia
Most people cycle through different stages of sleep each night, including light sleep, deep sleep (also called slow-wave sleep), and REM sleep. REM is when most dreaming happens and is important for processing emotions and memories. It’s not considered deep sleep, but it plays a major role in helping your brain and body reset.
Parasomnias typically fall into two categories based on the sleep stage when they occur:
REM parasomnias: Nightmares, sleep paralysis, vocalizations, aggressive movements, and acting out dreams are examples of REM parasomnias.
Non-REM parasomnias: Waking up terrified and screaming, sleepwalking, and feeling confused and disoriented upon waking (also called confusional arousal) are examples of non-REM parasomnias.
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What causes parasomnia?
We aren’t fully aware of all the causes of parasomnia. But experts have identified a few factors that may increase your risk:
Getting woken up during one of the transitions between sleep stages, often due to noises, temperature changes, restless legs, or sleep apnea (when a person temporarily stops breathing while they’re asleep)
Having a mental health condition like post-traumatic stress disorder (PTSD), depression, or anxiety or a neurological disorder like Parkinson’s disease
Having a family history of similar parasomnias
Long-term effects of parasomnia
Most children who experience parasomnias eventually outgrow them. But for some people, they can persist into adulthood. Left untreated, parasomnias can lead to sleep deprivation.
This can increase a person’s risk of a variety of health challenges, including:
High blood pressure (hypertension)
Diabetes
Obesity
Depression
Heart attack
Stroke
Safety precautions for parasomnias
In some cases, parasomnias can also lead to safety concerns. Adults who experience them are advised to take some precautions to keep themselves and others safe.
These precautions might include:
Locking up any firearms
Removing sharp objects or furniture from the sleeping area
Locking or securing windows and doors
Setting bedroom door alarms (for sleepwalkers)
Using extra padding or pillows on the sides of the bed to prevent falls or injuries
Making sleeping partners aware of the concern and, in some severe cases, having them sleep in a separate bed
Treatment options for parasomnias
The first step in seeking treatment for a parasomnia is getting an evaluation from a sleep specialist. These medical providers have specialized training in sleep disorders. Your parasomnia evaluation may include a sleep test, blood work, imaging tests like an MRI or CT scan, and other assessments.
Once you receive a diagnosis, your care team will help you find the right support for your needs. While there’s no cure for parasomnias, they can be effectively managed. This usually includes a combination of therapy, lifestyle changes, and, in some cases, medication.
While not a replacement for professional help, improving your sleep hygiene can also be an effective way to reduce parasomnias. You can do this by:
Going to sleep and waking up at the same time each day (even on the weekends)
Getting a full night’s sleep each night
Only using sleeping medication only as directed by your provider
Avoiding alcohol and drugs
Making adjustments to your work schedule if you’re a shift worker (if possible)
Making your sleeping area as comfortable, quiet, and dark as possible
Limiting screen time before bed
Creating a consistent bedtime routine
Parasomnias can make you feel tired and anxious. You might worry about going to sleep, which can make it hard to rest well. Talking with a therapist can help you manage these feelings and find ways to feel safer at night.
Brandy Chalmers, LPC
Clinical reviewer
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Anyone can have a bad night’s sleep once in a while. But this is different from experiencing parasomnias. Parasomnias are disturbing behaviors that happen when someone is asleep. They include things like sleepwalking, shouting or screaming, acting out dreams, bed-wetting, and other behaviors. Left untreated, parasomnias can cause sleep deprivation, and this can have serious health consequences. And in some cases, they can lead to safety concerns.
Fortunately, parasomnias can be managed with the right support, and many children who have them eventually outgrow them. With help from a sleep specialist, therapist, psychiatrist, and other providers, you can get the restful sleep you deserve.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
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Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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