Another type of sleep disorder is parasomnia. Parasomnia is any abnormal activity that happens to us when we are sleeping. For instance things like sleep talking, sleep walking, sexsomnia, and sleep eating. Also night terrors, where people are terrified of something they feel they have seen. They may not even remember it and it can be exhausting. Whilst these kind of conditions seem to be much more rare than insomnia is, I see it quite a bit in clinic. I often wonder whether people see it as a condition or even know that it’s happening. That’s why we don’t think it’s as common as something like insomnia.
I worked on a Channel 4 sleep series called The Secrets of Sleep. We were given about 12 complex cases of different sleep disorders. This included insomnia, sleep apnoea, narcolepsy, and parasomnias. So people suffering from something like night terrors or sleepwalking and talking. I remember a specific lady who had serious night terrors and it was terrifying for her. It was really distressing and happening regularly. These were all people with complex sleep disorders that had already been treated. So they had already gone through diagnosis, sleep studies, and treatment and they were still struggling.
I was working with Dr Guy Leschziner who has a lot of experience in sleep medicine. Between us we tried to use our skills and everything we knew and learned through other patients to adapt a program that would work for these patients. The interesting thing is we adapted a personalized program which was very similar to cognitive behavioural therapy for insomnia (CBT-I). CBT-I is what I use to treat my insomnia patients and we developed it into something that could help. We used elements of it to help with all these other sleep disorders. CBT-I is about building the sleep quality and duration, and alleviating some of those fears, worries, and ideologies around sleep that aren’t quite accurate. We found that it actually improved their conditions – especially those with parasomnias.
Parasomnias can be exacerbated by things like poor sleep, excess alcohol or caffeine, or a stressful time in our lives. I often reflect and look at these factors when I’m dealing with somebody that has night terrors. Indeed I’ve had night terrors in the past. What I sort of see it as now is that life issues, whatever they are, can act as a trigger and cause sleep issues. But some people are more predisposed to having a night terror over, for example, insomnia. I see it as sort of your body’s way of showing that you may have a problem. When you improve the sleep quality and duration in most cases you can also improve and reduce the frequency of these abnormal activities happening at night.