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Parasomnias
Medical expert of the article
Last reviewed: 08.07.2025
Parasomnias are various episodic events that occur during sleep. They are numerous, varied in their clinical manifestations and can be expressed in different stages and phases of sleep, as well as at the stages of transition from wakefulness to sleep and vice versa.
Parasomnias can cause insomnia or drowsiness, psychosocial stress, harm to oneself and others. In some cases, parasomnias are a “mask” of a neurological, psychiatric or somatic disease.
The 2005 classification distinguishes the following groups of parasomnia: disorders of awakening (from FMS); parasomnias usually associated with FBS; other parasomnias.
[ Parasomnias in children
In children, parasomnia is often a marker of insufficient brain maturation and, as a rule, goes away with age even without special therapy, but in adults, parasomnia can be associated with organic brain damage (or emotional instability), which necessitates a thorough examination.
Diagnosis of parasomnia
Diagnostics and differential diagnostics of parasomnia are impossible without polysomnography with parallel video monitoring. The most important thing in differential diagnostics of parasomnia causes is to clarify the epileptic nature of this phenomenon.
In general, with all the variety of parasomnia manifestations, the cardinal issue of diagnosis is the confirmation (or exclusion) of their epileptic origin. Three variants of the relationship between epileptic activity and parasomnia are discussed:
- Parasomnias occur against the background of typical epileptiform activity.
- Parasomnias and epileptiform activity are separated in time.
- Parasomnias not accompanied by epileptiform activity.
Particular attention should be paid to parasomnias if they first occur in adulthood.
Treatment of parasomnia
If parasomnias do not interfere with social adaptation, patients do not require therapy. However, sometimes it is necessary to use both drug (mainly GABA-ergic drugs such as clonazepam, carbamazepine, etc., as well as antidepressants and anxiolytics) and non-drug therapy (psychotherapy, behavioral therapy, acupuncture, phototherapy, special devices against tooth decay in patients with bruxism, etc.). As a rule, arousal disorders do not require special treatment and are limited to organizational measures. For example, in 90% of cases, it is enough to put a wet rag near the bed of a patient with sleepwalking so that he wakes up at the moment of getting out of bed and sleepwalking does not occur. In the event of or frequent episodes of arousal disorders in adults, a comprehensive (including psychiatric) examination is required to clarify the etiology of the disorder.