Parasomnias: causes, symptoms, diagnosis, treatment

Parasomnias are behavioral phenomena arising in connection with sleep. Parasomnias are characteristic of the childhood and adolescence and often disappear as they grow older. The diagnosis is clinical. Treatment medication in combination with psychotherapy.

Nighttime fears are characterized by episodes of fear, screaming, often accompanied by confusions. Distributed among children and observed only with incomplete awakening from the III and IV stages of slow (without BDG) sleep, i.e. Are not nightmares. In adults, nighttime fears are often associated with mental disorders or chronic alcoholism. As a rule, medium or long-acting benzodiazepines are effective (eg, clonazepam 1-2 mg orally, diazepam 2-5 mg orally) before bedtime.

Nightmares (frightening dreams) occur in children more often than in adults, are observed during sleep with BDG, at elevated temperature or overfatigue, and after drinking alcohol. Treatment consists in the elimination of mental (emotional) disorders.

Violation of behavior during the phase of fast sleep (with BDG) is characterized by a concussion and often violent movements (for example, waving hands, punches, kicks) into the fast (BDG) sleep phase. This behavior can be a dream realization provided there is no muscle atony characteristic of the sleep phase with the BDG. This disorder is more common among the elderly, especially with degenerative diseases of the central nervous system (eg Parkinson's disease or Alzheimer's disease, vascular dementia, olivopontocerebellar degeneration, multiple systemic atrophy, progressive supranuclear palsy). Similar phenomena occur in narcolepsy and the use of norepinephrine reuptake inhibitors (eg, atomoxetine, reboxetine).

Polysomnography can reveal increased motor activity during REM sleep, and audiovisual monitoring fixes pathological body movements and concussion. For correction appoint clonazepam for 0.5-2 mg orally before bedtime. Spouses should be warned about the possibility of damage.

Night terrors are also noted in the 3-4th phases of sleep. The subject wakes up with a feeling of intense fear and anxiety, with signs of excitation of the autonomic nervous system. Such a person may rush to flee somewhere and may cause damage to other persons.

Night cramps, or cramps in the muscles of the lower leg or feet during sleep, are observed in healthy young and elderly persons. The diagnosis is based on the history and absence of pathology according to the results of a physical examination. For prevention, it is recommended to stretch the muscles involved for several minutes before bedtime. Stretching is also an emergency treatment method and stops the convulsions that have begun, therefore it is preferable to pharmacotherapy. For the treatment of krampi, a wide variety of drugs have been tried (for example, quinine, calcium and magnesium preparations, diphenylhydramine, benzodiazepines, mexiletine), but none of them has proven effective in the abundance of serious side effects (especially quinine and mexiletine). Refusal of caffeine and other sympathomimetics can also give an effect.

[1], [2], [3]