Parasomnias: Disruptive Sleep-Related Disorders

Nightmares

If you’ve ever had a traumatic or harrowing dream that is full of emotion, then you’ve experienced a nightmare. They’re common to both adults and children, and their memories can linger for decades. Children tend to have nightmares most often between the ages of 3 to 4 and 7 to 8. Nightmares are less common for adults, although it’s estimated that 5-10% have them once a month or more.

 

What causes nightmares? Sometimes, these vivid and disturbing dreams are brought on by medications, drugs, illness, or high fevers. Other times, these are initiated by trauma or subconscious fears and struggles in life. Occurrences such as wartime combat, death of a loved one, surgery, pregnancy, financial anxiety, job loss, divorce, and other stresses can materialize as nightmares. At other times, nightmares can be completely unrelated to any events in waking life.

When a child has a nightmare, be sure to listen to what they have to say and avoid reacting in a terrified manner. Instead, encourage the child to talk about the scary characters, and try to help them feel safer. Most of the time children do not require treatment for nightmares. If these dreams are persistent and affecting the child in a traumatic way, then do seek a therapist who can ease the intensity of terror for them.

 

In adults, the inspiration for most nightmares can be understood upon awakening. Reflecting on the occurrences in the dream can bring awareness to the symbology of the events and the ability to decode and decipher the nightmare.

 

Night  Terrors

Not to be mistaken for nightmares, night terrors are completely different. They occur during different phases of the sleep cycle. Nightmares occur after several hours of sleep and the dreamer is usually quiet, motionless, and can recall their dream upon awakening. With night terrors, the dream occurs within the first 1-2 hours of sleep and there is often bodily flailing and loud shouting along with it. Waking up someone having a night terror is difficult, and there is limited recall of the dream upon awakening. No one is sure of the reason behind night terrors, but it is found that most children outgrow these by the time they’re teens. As with nightmares, if these experiences are traumatically disturbing, seek the advice of a therapist.

 

Sleepwalking

Sleepwalking, also called somnambulism, occurs most frequently early in the night, but can also occur close to morning. The cause is unknown, but in children it’s thought to be related to fatigue or anxiety. Sleepwalking is most common to children age 6-12. Although sleepwalking can occur at any age, most children outgrow it as their nervous systems mature. In adults, it can be caused by medication, drugs, alcohol, stress or certain medical conditions. It has been found that adult sleepwalking may be hereditary. Episodes of sleepwalking can be as short as a few seconds to a half hour or more. The activities done during sleepwalking can be as simple as sitting up, to doing things around the house or going outdoors. Contrary to popular belief, it is not dangerous to awaken a sleepwalker. Sleepwalkers are rarely violent and pose no complications for those who go back to sleep after being awakened during an episode.

 

Bed-Wetting

Seventy-five percent of children under the age of three are not able to stay dry during the night. Bed-wetting, or nocturnal enuresis, is very common in children who are younger than 6 or 7 years old. The act of bed-wetting is not done on purpose. Never punish a child for wetting their bed, or assume it’s because they’re lazy or disobedient. It’s thought that bed-wetting the result of emerging bladder control, which develops as children grow. The chief causes are that the child is not able to hold urine for an entire night or does not wake when their bladder is full. Only 1% of bed-wetting is the result of a medical condition. The physical causes of involuntary incontinence can be a bladder infection or an internal abnormality of organs, muscles or nerves. Neurological or emotional stress can upset a child to the point of bed-wetting.

 

Although most children outgrow bed-wetting, there are over-the-counter remedies such as alarms that signal at the first sign of wetness. This is designed to condition the child into waking up when their bladder is full. It can take weeks for these to work, but success is reported in the majority of cases. Hypnosis is sometimes recommended as an effective treatment as is homeopathy. Some physicians prescribe medication, but this is a subject of controversy since the relapse rate is quite high when the drug is discontinued.