Strange sleep behaviors? Here's what might really be going on
If you or someone you love moves, talks, screams, or acts strangely during sleep—but has no memory of it afterward—you might be dealing with a parasomnia.
These aren’t just quirks or bad dreams. They’re real, treatable sleep disorders that occur when the brain doesn’t transition smoothly between sleep stages.
At Whitney Sleep Center, we often hear from people who feel confused, isolated, or even alarmed by these nighttime episodes. Understanding what parasomnias are—and what to do about them—can offer real relief and a path toward safer, more peaceful sleep.
What are parasomnias?
Parasomnias are sleep disorders involving unusual behaviors or experiences during sleep or the transitions into and out of it. They differ from insomnia (trouble sleeping) or narcolepsy (trouble staying awake) because they’re about what happens during sleep—not how much or when you get it.
Key characteristic: the brain is partially asleep and partially awake, leading to behaviors that happen without full awareness or memory.
What are parasomnias?
Parasomnias are sleep disorders involving unusual behaviors or experiences during sleep or the transitions into and out of it. They differ from insomnia (trouble sleeping) or narcolepsy (trouble staying awake) because they’re about what happens during sleep—not how much or when you get it.
Key characteristic: the brain is partially asleep and partially awake, leading to behaviors that happen without full awareness or memory.
The different types and what they look like
What triggers these events?
Parasomnias are not signs of mental illness or personal weakness—they’re neurological events tied to how the brain cycles through sleep. Common triggers include:
- Sleep deprivation or fragmented sleep
- Stress or anxiety
- Alcohol or recreational drugs
- Certain medications (e.g., antidepressants, sleep aids)
- Family history of parasomnias
Neurological conditions, especially in REM-related cases like RBD
How they affect your life (and others')
While some parasomnias are harmless or temporary, others can cause:
- Sleep fragmentation and daytime fatigue
- Emotional distress or sleep avoidance
- Safety risks (e.g., falling, injury to self or partner)
- Relationship strain due to fear or confusion
If the episodes are frequent, disruptive, or physically risky, they deserve professional evaluation.
What you can do–starting tonight
Safety first:
- Remove sharp objects or fragile items from the room
- Use bed railings, padding, or motion alarms as needed
- Sleep in separate beds temporarily if safety is a concern (especially with RBD)
Improve sleep hygiene:
- Stick to regular sleep/wake times
- Prioritize enough sleep to avoid overtiredness
- Avoid alcohol and stimulants in the evening
Build in stress-relief routines (e.g., meditation, light stretching)
When to seek professional help
Talk to a sleep specialist if:
- Episodes are frequent, violent, or emotionally distressing
- There’s risk of injury
- You suspect REM behavior disorder, especially in older adults
- There are signs of an underlying neurological issue
Diagnostic steps may include a sleep diary, overnight sleep study (with video), or even EEG/MRI if seizures are suspected.
Treatment options that work
Many parasomnias improve with lifestyle changes alone, but treatment may also include:
- Melatonin: Common for RBD, with low side effects
- Clonazepam: Effective but used cautiously, especially in older adults
- Prazosin: For PTSD-related nightmares
- Behavioral therapy: Including CBT, imagery rehearsal, and scheduled awakenings
You're not alone–and you're not broken
Parasomnias may feel strange or even frightening, but they are medically recognized conditions with effective strategies for management. At Whitney Sleep Center, we help patients turn confusion into clarity—and restore safety and confidence around sleep.
You can reclaim restful nights. And we can help you get there.