Parasomnia is a term that covers a wide range of sleep disorders ranging from bed wetting to night terrors, and although such problems are commonly associated with children, they can also affect adults, so what are the parasomnia treatment options for adults and children?
The treatment for parasomnias will depend on the exact nature of the sleep disorder. Primary parasomnias usually have no underlying cause, but are categorized according to which stage of sleep is affected. Secondary parasomnias are usually caused by physical or psychiatric problems such as heart problems or seizures. Nightmares and sleepwalking are referred to as arousal parasomnias; other types of parasomnias are teeth grinding, and a more recently reported parasomnia called sexsomnia.
In all cases of parasomnias, the first step in any course of treatment is to try and identify, and then cure, any underlying physical causes of the sleep problem. Once these have been eliminated, the next stage will depend on whether the patient is an adult or a child.
Parasomnias in Children
In children, parasomnias typically include night terrors, nightmares, and sleepwalking. The first stage of the treatment process will depend on the age of the child. For younger children it is important to ensure a good bedtime routine is established, which includes going to bed at the same time every night and getting up at the same time each morning. Older children should avoid school work, computers, video games, etc, immediately prior to bedtime. Similar advice will also be applicable to adults suffering from parasomnias as a regular bedtime routine is extremely important when trying to resolve sleep disorders.
Treatment Options for Children and Adults
Sleepwalking in children and adults can be managed in the first instance by making sure all external doors and windows are locked to prevent accidents. If necessary, alarms can be installed on exits. The next step is to try a program of anticipatory waking, which is intended to disrupt or prevent the neurophysiology underlying the disorder. In more severe cases, medications, in particular benzodiazepines, can eliminate instances of sleepwalking.
Infrequent night terrors do not normally require any treatment, but if the problem is regular or intense, long acting benzodiazepines can be used to suppress the symptoms of confusional arousals. If these do not work, the next course of treatment would be to try tricyclic antidepressants, although these should only be used when all else has failed due to the issue of potential side effects.
In the case of REM parasomnia problems, the first stage of treatment is to minimize the risk to the patient and other people in the household. Once the sleeping environment has been modified, the next step is to prescribe medication to reduce the symptoms. Clonazepam, a benzodiazepine, has been found to be very effective in treating REM parasomnia problems in adults. Research has also indicated that melatonin is an effective treatment. When persistent sleep paralysis is the problem, taking antidepressants before sleep can resolve the problem.
Cognitive behavioral therapies, relaxation therapies, and desensitization to external stimuli care also recommended in the treatment and management of parasomnias.