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Sleepwalking and Other Parasomnias


Parasomnias are sleep-related disorders, such as sleepwalking, nightmares and sleep terrors. In many sleep-related experiences may be just mildly annoying, such as talking in your sleep or a child’s occasional nightmare, but these conditions can also be very disruptive, disturbing and even dangerous.

Parasomnias can occur at different stages of sleep—during rapid eye movement (REM) sleep, during non-REM sleep and in transition between sleep and wakefulness. They are more common in children than adults, but can occur in people any age. Parasomnias often run in families.

One group of parasomnias, called non-REM sleep arousal disorders, occur during sleep-wake transition and involve sleepwalking or sleep terrors. When people sleepwalk they typically have their eyes open with a blank stare and do not respond to others. They often wake up confused and do not remember the episode when they wake up.


Sleep walking usually involves routine, uncomplicated activities and can involve eating (sleep-related eating disorder). Sleep terrors are extreme nightmares that wake a person from sleep, often with a scream. The person usually doesn’t remember the dream or only remembers a little.

This type of parasomnia is common among children—between 10 and 30 percent of children have at least one episode of sleep walking—though only 1 to 5 percent sleepwalk often and are distressed. About 3 to 4 percent of adults experience sleepwalking each year.

Nightmare disorder involves recurring intense, disturbing dreams that occur during REM sleep. The person recalls the dream in detail, unlike sleep terrors which are usually not remembered. Nightmares can be caused by some medications, including antidepressants and hypertension medication. About 6 percent of adults have nightmares at least once a month and 1-3 percent have them frequently. Women are more likely than men to have nightmares. Nightmares are common in people with posttraumatic stress disorder (PTSD).

Another parasomnia, REM sleep behavior disorder, involves people actually acting out their dreams during sleep. It can involve violent actions and can be dangerous for the person experiencing the violent dream and for his/her bed partner. The person wakes fully alert and may be able to recall the dream. REM sleep behavior disorder is rare, affecting less than one percent of adults, most commonly older men. It can be a side effect of antidepressants or other medications.

What can you do?

Most children with parasomnias don’t need treatment and the episodes will become less frequent over time. For adults, good sleep habits, such as keeping a regular sleep schedule and routine, not becoming sleep-deprived, and managing stress can help improve symptoms. In some instances, therapy and medication can help.

Environmental changes can help keep people safe. Creating a safe environment for those with parasomnias can include sleeping on the lowest floor or not near a window, sleeping with a mattress on the floor, keeping nearby furniture to a minimum, or using child-proof door knobs or door alarms. Household members should be aware of a person with parasomnias and what to do. Sometimes trying to wake someone up in the middle of a parasomnia event can cause a violent reaction.

If you or someone you know has sleep-related activities that are potentially harmful or very disturbing or occur frequently, consider seeking help from a sleep specialist.

Parasomnias often appear as some mix of being asleep and being awake. The Diagnostic and Statistical Manual of Mental Disorders* notes that these conditions “serve as a reminder that sleep and wakefulness are not mutually exclusive and that sleep is not necessarily a global, whole-brain phenomenon.”

Help for Patients & Families

Learn about common mental disorders, including symptoms, risk factors and treatment options. Find answers to your questions written by leading psychiatrists, stories from people living with mental illness and links to additional resources.

Learn More

*American Psychiatric Association. 2013. Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) used to diagnose mental illnesses.


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