Parasomnias
Unusual events during sleep can be confusing, especially when someone else notices them first. Explore the different kinds of events and how to ask for an appropriate assessment.
A family of sleep events.
Parasomnias are unusual experiences or behaviours around falling asleep, during sleep or when waking. The term includes different events rather than one disorder with one test.
A description from you or someone who witnessed an event can help a clinician. You do not need to provoke an episode, stay awake to watch someone, or obtain a video before asking for care.
Based on MSD Manual Professional
Describe the event before naming it.
- The observation
What you or another person noticed
- The memory
What you recall afterwards
- Your sleep context
Timing and other relevant concerns
- Assessment & safety
Medical review and potential injury risk
Sleepwalking, terrors and dream enactment differ.
Sleepwalking and sleep terrors usually arise from non-REM sleep; the person may have little memory afterwards. Nightmares more often involve waking with a memory of a distressing dream.
REM sleep behaviour disorder involves acting out dreams during REM sleep and can lead to injury. Similar-looking events still need professional evaluation. Reading about dream enactment does not establish this diagnosis or predict a future neurological condition.
Based on MSD Manual Professional · NHS
What someone may notice.
These are descriptions to bring to a professional, rather than a way to identify a sleep stage or diagnose an event at home.
Sleep activity
Walking or other activity during sleep, with limited later memory.
Apparent fear
Episodes of apparent fear or agitation while still asleep.
Dream-related movement
Movements or sounds that seem connected to a dream.
Your safety
Events that disrupt sleep or raise concerns about injury.
Based on MSD Manual Professional · NHS
A sleep history comes before an explanation.
A professional can consider what happened, its timing, medicines and other sleep or health concerns. Some situations need a specialist sleep study; the investigations depend on the event.
New, repeated or potentially injurious episodes deserve medical attention. Ask what needs assessment and how to reduce injury risk while waiting. An online questionnaire cannot determine the sleep stage or cause.
Based on MSD Manual Professional
- 1The observation
What you or someone else noticed, in ordinary words.
- 2What is known
Timing, memory afterwards and other relevant sleep concerns.
- 3Your safety question
Ask what needs urgent attention and how the event will be assessed.
A description helps a clinician decide what needs investigation.
Parasomnias are a family of events around sleep, with different possible patterns. Explain what was noticed, any injury or safety concern, and relevant health or medicine changes. A witness can contribute if you choose to involve them.
Movement or sound during sleep does not identify a sleep stage or rule out another medical explanation. A professional may consider sleep testing or other assessment. Do not deliberately provoke an event to observe it.
Based on MSD Manual · NHS
Your event and your safety guide the discussion.
Explore the options and ask what fits your circumstances and needs.
Based on MSD Manual Professional
Ask for safety advice that fits the actual event.
Care can include reducing injury risk and addressing the assessed condition or relevant contributors. Ask what precautions are appropriate in your circumstances and whom to contact if events change.
The existing event distinctions are educational, not a promise that every episode is harmless. A description alone should not be used to predict a future neurological condition. Raise new or concerning events with a healthcare professional.
Event
What does the description suggest needs assessment?
Safety
What changes would make the situation safer?
Follow-up
What should prompt another medical conversation?
Based on MSD Manual
Find support. Prepare your next step.
Find care or prepare a conversation. You can ask for help before you have a diagnosis.
Your first sentence does not need to be perfect.
You can contact your medical service with a brief description and any concern about injury. If an event is occurring with immediate danger or serious injury, seek emergency medical help first.
Based on MSD Manual Professional
“There have been unusual events during sleep. Could we assess what they might be and discuss how to keep the sleep setting safe?”Make it sound like you
Your questions, with room for nuance.
You can read just the answer you need.
Can I identify the sleep stage from a movement or sound?
No. A description alone cannot reliably establish the stage or diagnosis. A clinician considers history and, when appropriate, sleep investigations.
Based on MSD Manual
Where this information comes from.
Use this hub to learn and prepare questions. It does not diagnose you or recommend a personal treatment plan. By Selfmora editorial; sources checked . Updated .
Additional explanations and examples: sources consulted . Examples illustrate ideas; they do not assess your personal health. Your questions
- Parasomnias: sleepwalking, terrors and REM sleep behaviour
- Night terrors and nightmares: differences and getting help