Before we proceed towards discussing parasomnia treatment, let us first understand the complete implications of this term. The term parasomnia includes within its scope a number of different symptoms, that together comprise a group of eight sleep disorders which are classified under two separate categories - REM (Rapid Eye Movement stage of sleep) parasomnias and NREM (Non Rapid Eye Movement stage of sleep) parasomnias. A parasomnia is symptomized by a set of unusual movements, actions, dream patterns and perceptions, just before falling asleep, while sleeping, or just before waking up. Also, these symptoms can occur anywhere between the sleep stages themselves such as between REM and NREM, between N1 and N2 or N2 and N3 or between N3 and SWS (Slow Wave Sleep, which is the last stage just before arousal from sleep).
Let's take a more detailed look at the various symptoms and occurrences/events that take place between falling asleep and waking up, to better understand what the treatment of this disorder is aimed at and how it works. As mentioned above, there are eight different indications and events that comprise the entire scope of parasomnia.
These include REM sleep behavior disorder (which is characterized by the subject indulging in physical action in accordance with vivid dreams while in the REM stage of sleep such as holding on to the bed or trashing around), Recurrent Isolated Sleep Paralysis (which is characterized by feeling awake in one's dreams and finding oneself unable to move for a few moments after a perceived arousal from sleep), Catathrenia (characterized by holding one's breath during sleep and emitting a groan while breathing out), Somnambulism (sleepwalking), night terrors, Bruxism (grinding one's teeth while in deep sleep), and Restless Legs Syndrome and Confusional arousals (characterized by random waking spells accompanied by violent thrashings or inconsolable sobbing and weeping, especially in case of children).
Treatment of Parasomnia and Related Symptoms
Parasomnia treatment measures are directed towards providing relief from all those symptoms mentioned in the preceding segment, from which the subject suffers. Since most of these symptoms have to do with abnormal activities or behavior that are recurrent in nature, a significant part of treating parasomnia involves lessening the frequency of these behaviors and events. Most REM Parasomnias (REM sleep behavior disorder, Recurrent Isolated Sleep Paralysis and Catathrenia) are treated by administering tricyclic anti depressant medications.
NREM Parasomnia symptoms like Restless Legs Syndrome and Periodic Limb Movements can be arrested by administering drugs used in the treatment of Parkinson's disease such as levodopa/carbidopa, pramipexole, etc. Psychoactive drugs in the Benzodiazepines group such as diazepam, lorazepam, etc., are also used for providing relief from night terrors and confusional arousals.
Certain drugs belonging to the Opiates group such as codeine, methadone, etc., are also administered for providing relief from sleep disturbances, and for lessening the frequency and intensity of sleep paralysis and similar states. Since parasomnia occurs as a set of combinations of the above mentioned symptoms, rather than as a single isolated symptom, the treatment plan usually includes a combination of the aforementioned drugs and medications to tackle the different aspects of this disorder.
Besides medications, hypnotherapy and relaxation techniques are also found to be effective in the long term treatment of parasomnia. In fact, when accompanied by these two therapeutic methods, the comprehensive treatment plan assumes greater efficiency, and cases have been noted where the parasomnia disorder has been completely cured over a span of a few years! Practicing yoga, meditation and regular exercise, have proved to be effective in inducing undisturbed sleep rhythms over time, by correcting the various chemical and elemental imbalances in the body and mind, by improving blood circulation and lowering stress blood pressure to normally desired levels.