Parasomnias
Last reviewed: 23.04.2024
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Parasomnias are various episodic events that arise in a dream. They are numerous, diverse 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 themselves and others. In some cases, parasomnia is a "mask" of a neurological, psychiatric or somatic disease.
In the 2005 classification, the following groups of parasomnia are distinguished: wake-up disorders (from FMS); parasomnia, usually associated with PBS; other parasomnias.
[Parasomnia in children
At the child parasomnia more often represents a mark of insufficient maturation of a brain and, as a rule, with age passes even without special therapy, however in an adult parasomnia can be connected with an organic lesion of a brain (or with emotional instability), that causes a necessity of careful inspection.
Diagnosis of parasomnia
Diagnosis and differential diagnosis of parasomnia is impossible without polysomnography with parallel video monitoring. The most important in the differential diagnosis of the causes of parasomnia is the clarification of the epileptic nature of this phenomenon.
In general, with all the diversity of parasomnia manifestations, the cardinal issue of diagnosis is confirmation (or elimination) of their epileptic origin. Discuss three variants of the ratio of epileptic activity and parasomnia:
- 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 parasomnia if they first appear in adulthood.
Treatment of parasomnia
If parasomnias do not violate social adaptation, patients do not need 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, disorders of awakening do not require special treatment and are limited to organizational measures. So, for example, in 90% of cases it is enough to put a wet rag around the bed of a patient with sleepiness, so that he woke up at the moment of getting out of bed and the dream did not take place. If there are or frequent episodes of awakening disorders in adults, a comprehensive (including psychiatric) examination is needed to clarify the etiology of the disorder.