Parasomnias represent a group of abnormal activity or behaviors during sleep that are disruptive to the patient or to the bed partner, the family, or even to the neighbors. Parasomnias are very common in childhood and include sleep walking, talking, night terrors, nightmares, grinding teeth, head rolling/banging, and urinating in bed.
In adults, an important parasomnia is REM Behavior Disorder, during which patients act out their violent dreams and at times injure themselves or their bed partners. As mentioned above in the section on Narcolepsy, we are ordinarily paralyzed while dreaming for this very reason: so we will not act out our dreams. Luckily, these patients respond well to medications.
Well-trained sleep experts need to diagnose and manage parasomnias. First of all, parasomnias must be distinguished from seizures or convulsions, or recognized as a secondary phenomenon to another sleep disorder such as sleep apnea. In these cases it is important to treat the seizure or the sleep apnea directly. Often no treatment at all is necessary (especially in children who grow out of the condition), but at other times treatment is mandatory for dangerous and disruptive conditions. At times, patients can engage in offensive acts that can lead to problems with the police and the courts. Diagnosis and treatment can be difficult under these circumstances.