What is a Parasomnia?

The term parasomnia refers to general sleep disruptions from the REM (rapid eye movement) sleep cycle and non-REM sleep cycles. These disruptions can occur on a regular basis, or very rarely depending on the person. The disruptive events by them self may cause the affected person to wake up or partially wake, although during the actual event, one remains asleep. There are several types of sleep disruptions that fall under the umbrella-term parasomnias. The most recognized parasomnias are talking while asleep, sleepwalking, night terrors and nightmares. These events are more common in children, but can occur in adults as well.

  • Chapter 10   Parasomnias by F. Gokben Hizli and Nevzat Tarhan

Confusional Arousals

Confusional arousals are far more common in children than in adults. The affected person may cry out or thrash around in bed. Sometimes this condition is referred to as sleep drunkenness because the affected person reacts very slowly to stimulation or has a hard time understanding what is happening around them. Attempts to calm the person can go unnoticed because it is very hard to wake a person in one of these states. These events can last up to half an hour. After the arousal is over, the affected person wakes very briefly, calms and returns to sleep. Most people who have one of these events have no memory of it the next day.

Sleep Walking

Sleepwalking or somnambulism is probably the most well known arousal disorder. Sleep Walking is most commonly seen in children, although it can be seen in adults and the elderly. Boys are more likely to be sleepwalkers than girls are, and the disorder usually runs its course before the teen years. The rates of the occurrences can vary from person to person, some may only sleep walk once a month, while others may sleep walk nightly. The actions during a sleepwalking event can vary as well. Some people may only sit up in bed, or walk around the room while others may walk around the house or leave the house. Other events during sleepwalking may include open eyes with a blank expression, unintelligible talking, or use of language not typical to the person. While injury from sleepwalking is rare, they affected person can put them self in danger, like going outside in bed cloths during the winter. In most cases, no treatment is necessary for the sleepwalker, as the number of events will decrease as the child ages. As the sleepwalker is unaware of their environment there are some common sense steps one can take to insure safety for the sleepwalker. Be sure there no large objects near the bedside; make sure there is not anything on the floor that could be tripped over. If one is concerned the sleepwalker will try to go outside, close and lock bedroom windows at night and lock doors to the house. Despite popular myths, it is not dangerous to wake a sleepwalker. However, upon waking them, they will probably be confused or disoriented, so it is best to speak to them gently and encourage them to return to bed.

REM Behavior Disorder (RBD)

People who have REM Behavior Disorder, or RBD often act out their dreams during sleep. Typically, during REM sleep ones body will experience atonia, which is paralysis of all voluntary muscles. This sleep paralysis is a normal self-defense mechanism, preventing us from acting out our dreams. Sleep paralysis is nonexistent or insufficient for people who have RBD. This allows them to “act out” their dreams, which can cause them or their bed partners’ injury. When people with RBD experience an episode they often remain in bed, moan, and thrash around as they dream. In extreme cases, some people have actually gotten out of bed. Men over the age of 50 are most at risk for RBD, although it can occur in at any age and in women as well. RBD is different from “sleep terrors” and sleep walking as people with RBD can easily be awakened during an event. The affected person will usually be able to recall their dream, but they had no idea they were moving about during their dream. Many people who have RBD report that intense or violent dreams trigger their episodes. There is treatment available for RBD. Most physicians will want a person to have sleep study done to confirm the diagnosis of RBD. After which treatment will be decided on; most treatments include medication or behavioral therapy.

Sleep Terrors

Sleep terrors are more common in children than in adults, although adults may have them occasionally. Despite their appearance, sleep terrors are not nightmares. Nightmares are vivid dreams that occur during REM sleep, and most people can recall most or all of their nightmares. On the other hand, sleep terrors occur during the deepest stages of sleep when dreaming does not occur. Commonly one who has a sleep terror cannot recall what was so frightening to them. It is typical during a sleep terror for a person to scream, sweat, have a rapid pulse and sit up in bed. The person having a sleep terror may appear to be awake, but are unable to communicate. During a sleep terror the person will not respond to soothing words or comfort, they may try to run away. This event will last 20 minutes or less, at which time the person will lie down and return to sleep. Stress, some medications and possibly sleep apnea are thought to be triggers of sleep terrors. These evens will lesson as a child grows, and usually taper off completely by age 5. Until then, be sure to keep the bedroom a safe place. Make sure there is not anything on the floor that can be tripped over and move any large objects away from the bedside. There is no need to restrain a person having a sleep terror unless they are putting them self in danger.


Nightmares are vivid, frightening dreams that we all experience at one time or another. People have little difficulty recalling their nightmares as they are usually filled with feelings of fear, terror and foreboding. It is not uncommon to have a problem returning to sleep after a nightmare, especially for children. Nightmares occur more often in children than in adults, and it is a normal development process for children to go through. These frightening dreams can start as early as eighteen months of age. Children will benefit from comfort and reassurance after a nightmare as they move through this development stage. Adults have far fewer nightmares than children do. Often nightmares for adults are brought on by emotional stress, anxiety or illness. Some medications disturb REM sleep and these may trigger nightmares as well. When to Seek Treatment Typically, any of the sleep disruptions listed above are not signs of anything physically or psychologically wrong with a child. Most of these behaviors will self correct as a child ages. However, one should contact a health care provider if a child experiences excessive sleepiness during the day, if the child puts them self in danger, or if the events are making it difficult for your family to function. In these cases, it is possible the health care provider will want to evaluate your child or have them see a sleep specialist. The sleep disruptions listed above are not typical for an adult; they actually may be indicators of other sleep related disorders like apnea or periodic limb movement disorder. See a health care provider to find the cause of the sleep disturbances. The health care provider may refer one to a sleep specialist or a sleep center for an evaluation.

Other Parasomnias

Other parasomnias can be just as taxing and frightening as the events listed above. Some of the more common of these are listed below. Teeth Grinding (Bruxism): Grinding ones teeth while sleeping could be an indicator of stress and can be damaging to your teeth. Sleep Talking: This is a very common event, there is no need to worry if one talks during their sleep; it is not a sign of anything physically or mentally amiss. Sleep Starts: Many people often experience the sensation of their body “jerking” or a limb jerking just as they fall asleep. Theses sleep starts can be visual as well, in the form of a bright light inside ones eyes. Another type of sleep start is auditory, it will sound like loud bang or snap that seems to emanate from inside ones head. These occurrences can be startling and annoying, but are harmless.

Nocturnal Seizures

These seizures occur only while asleep, and may resemble a confusional arousal event. One having a nocturnal seizure may cry out, fall out of bed or thrash their limbs. This seizure disorder will need to be properly evaluated by a health care provider. As with most seizure disorders it may be treated with medication. Who to see. Most primary care physicians will be able to evaluate someone who is having sleep disturbances. However, if they conclude the disturbance is complex they may refer a person to sleep specialist or a sleep center for further evaluation.

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36 thoughts on “Parasomnias

  1. Mike E Reply

    Been setting up side of bed for few years now. I’ve had 4spinal surgeries which is really bad with what I do. I fall forward and go head first into the wall. About 3ft away from bed so it’s top of my head taking all the impact. Wife catches me and gets me to lay back down. But if she doesn’t it gets bad. I’m afraid I’m gonna break my neck or take a concussion then go back to sleep. As of typing this she is getting me a twin air mattress to prop against wall. Last night I hit head 3times and sprained wrist. Ugh I wish I knew why I did it. But the mattress will at least possibly safe my life. Crazy

  2. Jeanette Reply

    My s/o touches me on the shoulder to tell me to lay down as I am sitting up sleeping. I go to sleep lying down and when he realizes I’m sitting I have no idea how long I’ve been sitting. What causes this and should I see a doctor? If so what kind? I have an Essential Frontal Tremor which was diagnosed in 1980. Thanks, Jeanette

  3. Angela Kendall Reply

    I wake up and I guess at some point satup but then bent forward and my head is laying on my knees. It is very painful for my lower back. I wake and I’m just sitting sometimes or wake up and I am half on the floor and half in the bed. This is really stressing me out, the pain in my back is killing me. I have no idea how to make this stop.

  4. Rashaan Reply

    I’ve been sleeping like this for some time now I’m 25 and I believe it’s been happening for a couple of years, I’ll sleep laying down then maybe a couple of hours later I’ll wake up and I’ll be sitting on the side of my bed, most of the time I’ll wake up and some rare occasions I’ll half wake up and then fall to my side hitting my head on my side table…. is there a cure or treatment for this??

    • Hope Reply

      I’ve been going through the same thing for 8 years. Got a lot of bumps and bruises, but i can’t seem to figure out why i do that. I’ve also recently started Restless Leg Syndrome behaviors at night. Just wanted to let you know that you’re not alone.

  5. NANCY NAZAR Reply

    For the past 6-8 months I have been falling asleep laying down and waking up sitting up. My husband sometimes notices and lays me back down but when he does not notice I sleep like this almost all night and in the morning my head and neck hurt so much. This is starting to worry me because I am losing sleep and cant seem to stay asleep laying down any suggestions. Thanks!

    • Rhe Reply

      I also do this very often when i was still single and living with my parents. I suddenly sit up in the middle of thenight while asleep. My mom noticed this often and tried to lay me down to sleep. Now after a few years it happened again.

      • Anonymous Reply

        I was once invited, and went on vacation with my uncle and cousin. I had warned them of my sleeping issues, without knowing what it’s called, just knowing what I’ve been told often happens when I sleep by friends and immediate family. After warning them on the drive there, and trying to be adamant they shouldn’t try to aggressively wake me. I realized they thought I was lying and dismissed what I was saying altogether. So, I tried staying up the entire trip (4 days, 3 nights). Terrible idea on my part. Accidentally fell asleep night 3, I was told, screaming and thrashing. My uncle couldn’t wake me up, so he kicked me in the ribs. I was sleeping on the ground)
        , and I got up saying I was going to do unspeakable things to myself and my dad (My dad is my hero and was in a different state because I was on vacation). I then proceeded to lay back down fall asleep and urinate on the hotel floor. I’m not sure if I had gotten kicked in the kidney or it was from fear but I’m glad it happened and I can’t stand anyone who dismisses a disorder they don’t know about and refuse to.

    • Summer Cory Reply

      The same thing with the sitting up and neck and legs and shoulders hurting is happening w my boyfriend I will wake up and keep getting him to Lay down and he won’t he gets angry sounds half awake and will even sometimes lay down but sit back up minutes to hours later if anyone knows what this is pls lmk I wanna help him

      • Amyjo Reply

        I shared a room with my sister for 23 years of my life and she has told me that I’ve been doing this thing every single night since I was 8 years old. Every night I sit up in my sleep cross my legs and rock forward and back while muttering random stuff. Usually it’s just weird stuff like “mothers cabinet… chips” and every time I would do this my sister would have to say “Amyjo go back to sleep” and I would respond back with “okay” “night” or “goodbye” and fall back into my bed limp. I recently moved away and I hadn’t woken up sitting up for almost a whole year but just last night I woke up with all my pillows on the floor sitting at the edge of the bed facing my closet and apparently freaking out my cat as she was crouched and growling. I’ve never made a mess of my bed before and I don’t generally wake up sitting up but without anyone to tell me to go back to bed it’s now starting to affect my sleep and I hope someone has an answer for stopping this cause I want to get a full night without waking up just once more.

  6. Alexis Love Reply

    hello. I’m 15 and I started to do this very rarely when I was about 10 or 11, I randomly sit straight up in my sleep and (usually) stare at my wall. I have also stared at my mom and newly started staring at my camera on my laptop after falling asleep on a call with my boyfriend. I want to know why I do this and it’s really scary.

    • Logan predinchuck Reply

      I live alone so it’s hard for me to have empathy on how scary it can be. Although I do fall asleep and then wake up in my office chair or vice versa every night and am never sure how I get there. I usually just chuckle about it and go along with my day. Asking as I’m not harmed and no one else is I see no issue with it other then waking up with numb limbs lmao. It’ll probably fade and if not your loved ones will have to understand it’s only a condition and it’s ok, that your not scary and it doesn’t mean anything scary. Your just genetically wired to do something different while sleeping. Who knows what triggers it but I try to think of myself as original ahaha. I think about buying a. Camera often to see if I do anything but I try to think of it as a joke. Can’t be afraid of things that aren’t in your control or it’ll take over your life.

  7. rebecca heap Reply

    this is happening to me, i wake up on and off through the whole night sitting up sleeping with my legs crossed as well. i always fall asleep laying down. it scares me and my son, i wish there was a answer

  8. Marcus Stanley Reply

    I laid down on I mom’s couch to sleep once and as soon as I closed my eyes… like emediately after I was having a hard time with a feeling of not being able to get comfortable but then realized I was standing in the dark bathroom and my blanket was wrapped around the bottom of the toilet… please help me find out what happened. I’ve had a weird feeling ever sense that something happened during this time laps.

  9. M Reply

    Hi guys, I’ve bee netting sleep jerks where one part of my body would jerk and wake me as soon as I fall asleep. And this happens throughout the night so I have to use sleeping pills. The jerks also startles me and makes me panic. Any advice or contacts I get get in touch with? 🙁

  10. Cynthia Wisniewski Reply

    My husband has started sitting up while sleeping. If I wake him he is in a very angry state. This is worrying me. Can anyone explain to me why all of the sudden he has started sitting up during sleeping?

  11. Donald Reply

    Ive been sleep sitting for the last year or so. I was worried there was something wrong with me at first. It is good to know there are others out there with the same 39 and never did it before the last year. Im not sure what causes it

  12. Kelly Reply

    Glad to know I am not alone in this, either Jordan. I appreciate your sharing! Read my comment if you would like, I was reading about Buddhist monks doing the same thing. So, I feel we are in good company!!! 🙂

  13. Kelly Reed Reply

    I have been sleeping sitting in an upright position now for some time. My husband usually tells me to just lay back down, I do not know I am sitting up until he wakes me. It is not bothersome, nor do I lack sleep. I’ve read that Buddhist monks meditate and do sleep like this as well, so I guess we are in good company! I usually have to go to the bathroom once I’m woken up, maybe I was well on my way there and just decided to go back to sleep while sitting up. Don’t know, and it does not concern me too much. I find it amusing. My husband does not, he says I keep the covers from keeping him warm! Sorry baby!!!

  14. Sharon E. Ballard Reply

    I need help! I lay down in bed and fall asleep . I generally sleep for one and a half hours and without knowing it I sit up on the edge of the bed. I then sleep sitting upright on the edge of the bed for at least hour and a half WITHOUT KNOWING IT. Many times if I go to the restroom I then fall asleep on the toilet for the hour and a half. I am so tired all the time!!

    • Heni Reply

      Same here! I’m so frustrated with myself as I started doing this these last few months 🙁

  15. Jordan Reply

    I’ve been sitting up in my sleep with my legs crossed since i was a little kid , im now 20 and still do it. Every night. When my friends of family see my doing this all they say is “jordan lay down.” And i lay down . i don’t know why i do this . but im glad im not the only one

    • Emraan Reply

      same here buddy, every night I don’t know for how long till I realize i am sitting down lol

    • Kelly Reply

      Glad to know I am not alone in this, either Jordan. I appreciate your sharing! Read my comment if you would like, I was reading about Buddhist monks doing the same thing. So, I feel we are in good company!!! 🙂

  16. Tonia mahaffey Reply

    I do the same thing my son has woke me up so many times but my neck nor back hurt its driving me crazy and now i have found myself standing up sleeping please trll me what the hell is wrong with me

  17. Brittany Reply

    I lie down every night to sleep just like one normally does… however every single night I find myself sleeping in an upright position with my legs crossed and eyes closed, and only discover I’m doing so when I need to use the restroom, alarm goes off or boyfriend gently shakes me to let me know I’m “sleeping sitting up again***”. It’s so strange to wake up and open my eyes and be sitting there in such a way and I have no idea how long I have been doing this, I only know from when I was told/noticed it happening the first time about two years ago. I don’t feel any pain in my neck, back, etc… but it’s just disturbing and unnerving to not know the cause or possible negative effects of it happening. At least I know I’m not the only one. If anyone had any more info or personal experiences please share, thanks.

    • Kelly Reply

      I do it too! And, I as well usually have to use the restroom once awoken by my hubby. I was reading about Buddhist monks sleeping and meditating like this as well. It does not bother my back or neck, either. I can sleep like this for hours as well. So, you are not alone, and I feel abit better knowing I am not either in this endeavor. Happy New Year! 😉

  18. Anonymous Reply

    I was told I was a sleep sit up in the bed talked Layed back down and resumed sleep. I wish I knew why this happened

  19. Maria Reply

    So my Boyfriend sits up in his sleep with his legs crossed and looks ahead with his eyes closed. I was curious the reason, and if you could explain to me? A doctor told me it’s due to lack of oxygen but I figured I’d ask someone who’s actually researched this..

  20. Sydney Reply

    What is it called when you sit straight up in bed with your eyes open, with a blank expression on your face and moan? However, when anyone has tried to alert you, you are unresponsive. (like you can’t hear them) My friends have mentioned that I have done this on several occasions, and I am very interested in trying to find out what I have. Can anyone help?

    • Anonymous Reply

      i have no idea why but i did the same thing but only i spoke, my mom she told me in the morning

  21. Kerri Reply

    Leslie I do the same thing and have for years but have been doing it more the past few months.

  22. Leslie Reply

    My husband has been sitting up on our bed randomly (coincidently its around 3am). He sits straight up after being asleep and will just look straight ahead, almost as if he’s in some sort of trance. I have tried talking to him or asking him a question during this event and he is unresponsive and seems like he doesn’t hear me. He doesn’t acknowledge me whatsoever. I would do this for about 15-30 mins. After minutes have gone by he will just lay back down as if nothing was wrong, very calmly he will just resume sleeping in the position he was before and continue his sleep. It scares me… and I would like to know if it can potentially lead to something more severe. Or at least know why this happens.

  23. Korin Reply

    I hope this is something that can be answered here. I have an issue where when I’m trying to go to sleep, sometimes it feels like NY thoughts are screamingly loud. I know it’s just in my head, and it’s not screams, it’s…my thoughts words images, IDEAS themselves are yelling instead of inside “voice”. I have to open my eyes, or shift my focal point. A while ago I found Exploding Head Syndrome online. Do you think that could be an explanation? Not asking a diagnosis, just an opinion.

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