Parasomnias pp 17-24 | Cite as

Classification of Parasomnias

  • Erick N. Viorritto
  • Aatif M. Husain


Parasomnias are undesirable events or experiences occurring in sleep or during transitions to and from sleep. This category of disorders includes a varied set of disorders that can be classified based upon the sleep stage in which they predominantly occur. The non-REM parasomnias include disorders of arousal and sleep–wake transition. These are confusional arousals, sleepwalking (including sleep sex), and sleep terrors. Parasomnias occurring predominantly during REM sleep include REM sleep behavior disorder, recurrent isolated sleep paralysis, and nightmare disorder. The third category, parasomnias that occur independent of sleep stage, includes sleep related dissociative disorder, sleep related groaning (catathrenia), exploding head syndrome, sleep related hallucinations, sleep related eating disorder, and sleep enuresis, as well as parasomnias due to drugs or substances and parasomnias due to a medical condition. As further research clarifies the pathophysiology of these highly varied disorders, it is likely this scheme for classifying parasomnias will continue to evolve.


Parasomnia Arousal disorders NREM sleep REM sleep 


  1. 1.
    American Academy of Sleep Medicine. International Classification of Sleep Disorders, 2nd edition: Diagnostic and Coding Manual. Westchester, IL: American Academy of Sleep Medicine; 2006.Google Scholar
  2. 2.
    American Academy of Sleep Medicine. International Classification of Sleep Disorders, Revised: Diagnostic and Coding Manual. Rochester, MN: American Academy of Sleep Medicine; 2004.Google Scholar
  3. 3.
    Farid M, Kushida CA. Non-rapid eye movement parasomnias. Curr Treatment Options Neurol. 2004;6:331–7.CrossRefGoogle Scholar
  4. 4.
    Pressman MR. Factors that predisponse, prime and precipitate NREM parasomnias in adults: clinical and forensic implications. Sleep Med Rev. 2007;11:5–30.PubMedCrossRefGoogle Scholar
  5. 5.
    Boursalian LJ, Schenck CH, Mahowald MW, Lagrange AH. Differentiating parasomnias from nocturnal seizures. J Clin Sleep Med. 2012;15:108–12.Google Scholar
  6. 6.
    Derry CP, Duncan JS, Berkovic SF. Paroxysmal motor disorders of sleep: the clinical spectrum and differentiation from epilepsy. Epilepsia. 2006;47:1775–91.PubMedCrossRefGoogle Scholar
  7. 7.
    Broughton R, Billings R, Cartwright R, Doucette D, Edmeads J, Edwardh M, et al. Homicidal somnambulism: a case report. Sleep. 1994;17:253–64.PubMedGoogle Scholar
  8. 8.
    Rosenfeld DS, Elhajjar AJ. Sleepsex: a variant of sleepwalking. ArchSexual Behav. 1998;27:269–78.CrossRefGoogle Scholar
  9. 9.
    Iranzo A, Santamaria J, Rye DB, Valldeoriola F, Marti MJ, Munoz E, et al. Characteristics of idiopathic REM sleep behavior disorder and that associated with MSA and PD. Neurology. 2005;65:247–52.PubMedCrossRefGoogle Scholar
  10. 10.
    Husain A, Miller P, Carwile S. REM sleep behavior disorder: potential relationship to post-traumatic stress disorder. J Clin Neurophys. 2001;18:148–57.CrossRefGoogle Scholar
  11. 11.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th edition, text revision). Washington, DC: American Psychiatric Association; 2000.CrossRefGoogle Scholar
  12. 12.
    Schenck CH, Milner DM, Hurwitz TD, Bundlie SR, Scott R, Mahowald MW. Dissociative disorders presenting as somnambulism: polygraphic, video and clinical documentation (8 cases). Dissociation. 1989;2:194–204.Google Scholar
  13. 13.
    Vetrugno R, Lugaresi E, Plazzi G, et al. Catathrenia (nocturnal groaning): an abnormal respiratory pattern during sleep. Eur J Neurol. 2007;14:1236–43.PubMedCrossRefGoogle Scholar
  14. 14.
    Vetrugno R, Provini F, Plazzi G, Vignatelli L, Lugaresi E, Montagna P. Catathrenia (nocturnal groaning): a new type of parasomnia. Neurology. 2001;56:681–3.Google Scholar
  15. 15.
    Ohayon MM. Prevalence of hallucinations and their pathological associations in the general population. Psychiatry Res. 2000;97:153–64.PubMedCrossRefGoogle Scholar
  16. 16.
    Silber MH, Krahn LE, Slocumb N. Clinical and polysomnographic findings in narcolepsy with and without cataplexy: a population-based study [abstract]. Sleep. 2003;26:A282–A3.Google Scholar
  17. 17.
    Silber MH, Hansen MR, Girish M. Complex visual hallucinations: clinical and neurobiological insights. Brain Res. 1998;6:363–6.Google Scholar
  18. 18.
    Winkelman JW. Clinical and polysomnographic features of sleep-related eating disorder. J Clin Psychiatry. 1998;59:14–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Medicine (Neurology)Duke University Medical CenterDurhamUSA
  2. 2.Duke University Medical CenterDurhamUSA

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