PARASOMNIAS - AROUSAL DISORDERS INFORMATION

Updated June 16, 1999

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| Confusional Arousals | Sleepwalking | Sleep Terrors in Adults |

What are Parasomnias?

The Parasomnias are disorders that intrude into the sleep process and create disruptive sleep-related events. These behaviors and experiences occur usually while sleeping, and are most often infrequent and mild. They may happen often enough or become so bothersome that medical attention is required.

The parasomnias are divided into four groups:

Learn more about parasomnias by visiting the new Stanford Sleep and Dreams website, and by browsing more below.

What are Arousal Disorders?

Arousal disorders are parasomnia disorders presumed to be due to an abnormal arousal mechanism. Forced arousal from sleep can induce episodes. The "classical" arousal disorders are sleepwalking(somnambulism), sleep terrors and confusional arousals. Experts believe the various types of arousal disorders are related and share some characteristics. These arousals occur when a person is in a mixed state of being both asleep and awake, generally coming from the deepest stage of nondreaming sleep. This means a person is awake enough to act out complex behaviors but still asleep and not aware or able to remember these actions.

What are the causes arousal disorders?

These disorders tend to run in families and are more common in children. Being over tired, having a fever or taking certain medications may make it worse. Because disorders of arousal are less common in adults, having an evaluation is important. In some cases, these disorders are triggered by other conditions, such as sleep apnea, heartburn, or periodic limb movement during sleep. A sleep specialist should evaluate the person's behaviors and medical history.

How are arousal disorders treated?

If it is a severe case that leads to injury or involves violence, excessive eating, or disturbs the bedpartner or family, treatment by a sleep specialist may be necessary. Treatment might involve medical intervention with perscription drugs or behavior modification through hypnosis or relaxation/mental imagery.


Diagnostic Classification Steering Committee, Thorpy MJ, Chairman. International Classification of Sleep Disorders: Diagnostic and Coding Manual. Rochester, Minnesota: American Sleep Disorders Association, 1990.

Kryger, Meir H., Roth, Thomas, Dement, William C. Principles and Practice of Sleep Medicine, 2nd Edition. Philadelphia, Pennsylvania: W.B. Saunders Company, 1994.

Parasomnias: Things That Go Bump in the Night, A patient-education brochure. American Sleep Disorders Association, 1992

Confusional Arousals - Sleep Inertia

Confusional arousals consist of confusion during and following arousals from sleep, most typically from deep sleep in the first part of the night.

Sleep Inertia: Is There A Worse Time to Wake Up?

Sleep Research Zurich Papers - Abstracts 1995

Sleep Inertia - Circadian Rhythms, Sleep and Sleep Disorders

Sleepwalking (Somnambulism)

What is Sleepwalking (Somnambulism)?

Sleepwalking (Somnambulism) is a series of complex behaviors that are initiated during slow wave sleep and result in walking during sleep.

Learn more about sleepwalking (somnambulism) from the students of Stanford Sleep and Dreams.

What are the symptoms of Sleepwalking (Somnambulism)?

Ambulation (walking or moving about) that occurs during sleep. The onset typically occurs in prepubertal children.

Associated features include:

How Common is Sleepwalking?

Medical reports show that about 18% of the population are prone to sleepwalking. It is more common in children than in adolescents and adults. Boys are more likely to sleepwalk than girls. The highest prevelance of sleepwalking was 16.7% at age 11 to 12 years of age.  Sleepwalking can have a genetic tendency. If a child begins to sleepwalk at the age of 9, it often lasts into adulthood.

How serious is Sleepwalking?

For some, the episodes of sleepwalking occur less than once per month and do not result in harm to the patient or others. Others experince episodes more than once per month, but not nightly, and do not result in harm to the patient or others. In its most severe form, the episodes occur almost nightly or are associated with physical injury.  The sleepwalker may feel embarrassment, shame, guilt, anxiety and confusion when they are told about their sleepwalking behavior.

It is very important that if the sleepwalker exits the house, or is having frequent episodes and injuries are occurring -- DO NOT delay, it is time to seek professional help from a sleep disorder center in your area. There have been some tragedies with sleepwalkers, don't let it happen to your loved one!

In a few instances, sleepwalking can result in violent behavior. It is very important that a chronic sleepwalker seek professional help and follow the suggestions listed below to prevent having any violent episodes.

There is murder trial that is going on in Arizona where Scott Falater is accused of stabbing his wife 44 times and drowning her while sleepwalking. If you would like to read about it, the Arizona Republic is carrying daily articles about the trial. Several sleep specialists are acting as expert witnesses for Scott. For background information on the case, the Phoenix New Times did a very good story on it. (6/15/99)

What can be done about sleepwalking?

There are some things a sleepwalker can do: