Abstract

Parasomnias are unpleasant experiential or undesirable behavioral phenomena that occur during entry into sleep, during any stage of nonrapid eye movement (NREM) or rapid eye movement (REM) sleep, or on termination of sleep. All of sleep is vulnerable to parasomnias, which can occur spontaneously or linked with other sleep disorders, such as sleep apnea and restless legs syndrome. Our basic instincts can emerge pathologically with the parasomnias, including eating, sex, locomotion, and aggression. Parasomnias can affect people across the entire life span. Most parasomnias are diagnosable and treatable. Most are not the manifestation of psychopathology or psychiatric disorders. Parasomnias can be categorized as primary (disorders of the sleep states per se) and secondary (disorders of other organ systems that manifest themselves during sleep). The primary sleep parasomnias can be classified according to the sleep state of origin: REM sleep, NREM sleep, or miscellaneous (those not respecting sleep state). The secondary sleep parasomnias can be further classified by the organ system involved. The major primary parasomnias include disorders of arousal from NREM sleep (confusional arousals, including the variant sexsomnia, sleepwalking, and sleep terrors), REM sleep behavior disorder, and sleep-related eating disorder.

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