| |
Parasomnias - Parasomnias Symptom, Cause, Treatment
Parasomnias are the class of sleep disturbances caused by abnormal (or shall we say paranormal) brain activity during the cycles of night sleep. Parasomnias are often associated with stress and depression , and biological factors may also be involved. Some people also experience sleep paralysis (attempting but being unable to move) or brief hallucinations when they are just falling asleep or awakening. The result is a striking mix of behaviors - crying, walking, talking - while dazed and as difficult to arouse to consciousness as any child in deep sleep. Also called dream anxiety attacks, these are frightening dreams that occur during REM sleep and are associated with tachycardia, tachypnea, diaphoresis, and arousal. A person who talks during sleep typically has no recollection of the actions. Sleep talking can be caused by external factors including fever, emotional stress or other sleep disorders Patients with sleepwalking disorder show complex automatic behaviors, such as wandering aimlessly, carrying objects without any purpose, going outdoors, and performing other activities of varying complexity and duration (even driving). Such dream- related behavior may be violent and result in injury to the victim or bed partner. This idea of disordered sleep cycling is supported by the observation that these disturbances never occur before the age when the adult type sleep cycle appears at around 7 months, give or take. Nearly all persons with restless legs syndrome have periodic limb movements, and only few persons with periodic limb movement disorder also have restless legs syndrome.
Symptoms of Parasomnias
Some are common symptoms of Parasomnias :
- Arousal during the dream is common.
- The person has an increased heart rate, an increase in the respiratory rate, flushing, sweating, and increased muscle tone.
- Upon awakening, the person most often is confused and does not remember the event.
- In persons with REM sleep behavior disorder, arousals from sleep to alertness and orientation occur rapidly, and they usually vividly recall their dreams.
- Restless legs syndrome and periodic limb movement disorder may occur even during childhood and present as attention deficit disorder with hyperactivity or as growing pains.
- Commonly, the person cries out or screams as he or she is aroused.
- Restless legs syndrome and periodic limb movement disorder affect 20-40% of persons with chronic renal (kidney) failure who are on dialysis .
Causes of Parasomnias
The common causes of Parasomnias :
- Causes of Parasomnias
- CNS depressant medications
- Thioridazine, fluphenazine, perphenazine, desipramine, chloral hydrate, and lithium
- Has been associated with dementia, subarachnoid hemorrhage, ischemic cerebrovascular disease, olivopontocerebellar degeneration, multiple sclerosis, and brain stem neoplasms
- Pregnancy, menstruation, and menopause
- Internal stimuli, such as a full urinary bladder
- One possible cause of hypersomnia is restless legs syndrome. Restless legs syndrome is the name given to cramps and twitches a person may experience in the calves of the legs during sleep.
Treatment of Parasomnias
- The treatment of parasomnias is aimed at lessening the frequency and/or intensity of the events.
- Imipramine, which has serotonergic effects, has been used in the treatment of REM behavior disorder, but the effects are unpredictable.
- Avoid vigorous activity prior to bedtime, though a brief period of aerobic activity 4 hours before bedtime may be helpful.
- Have the person sleep in a bedroom on the ground floor if possible.
- Pharmacologic treatments are rarely necessary except in REM sleep behavior disorders; they are most often needed for short term.
- Tricyclic antidepressants are occasionally used in the treatment of REM sleep behavior disorder.
- Some patients who do not respond to benzodiazepines alone, levodopa alone, or a combination of both may be treated with opiates.
|
|
|
