Non-Rapid Eye Movement Sleep Arousal (NREM Disorder in Adults

Although parasomnias can take several forms, an individual is typically diagnosed with a NREM sleep arousal disorder when he or she experiences one of the following on a regular basis:

• Sleepwalking, in which the individual rises from bed and moves around while still asleep.  Individuals who are sleepwalking typically cannot communicate and are awakened only with significant difficulty.
• Night terrors, in which the individual awakes abruptly from sleep in a panicked, intensely fearful state.  

Individuals who experience sleepwalking or night terrors remember little or nothing of these episodes, including any dreams that may have occurred.

Occasional parasomnias are fairly common, occurring in approximately 30% of adults at some point in their lives.  Therefore, NREM sleep arousal disorders are diagnosed only when the parasomnias occur repeatedly and cause clinically significant distress or impairment.

NREM sleep arousal disorders can also lead to sleep avoidance or impaired concentration or efficiency during the day.  NREM sleep arousal disorders often occur in isolation, but can co-occur with other psychological disorders, including major depressive disorder and obsessive-compulsive disorder.

NREM sleep arousal disorders are thought to stem from abnormalities in sleep architecture, including deeper sleep, greater occurrence and fragmentation of slow-wave sleep, and alterations in delta activity during sleep, which give rise to the disorder.  Parasomnias are thought to increase in frequency following the consumption of alcohol and other substances, in response to lights or noises, and when the individual is experiencing stress.  Parasomnias appear to have a genetic component, although having a genetic predisposition toward parasomnias does not necessarily mean that the individual will develop a parasomnia.

However, clinical research suggests that the following treatments have shown some promise for reducing the occurrence of one or more parasomnias:

• Benzodiazepines, specifically diazepam and clonazepam, have shown promise in very small clinical trials and several case series.  Triazolam and flurazepam have also been reported to be used with success.
• Continuous positive airway pressure (CPAP) showed promise for individuals with somnambulism and disordered breathing in an open trial.
• Antidepressant medications, specifically paroxetine and imipramine, have shown some benefit in case studies.
• Hypnosis has shown some positive effects in several case series.

You can learn more about treatments for NREM sleep arousal disorders here.