Parasomnias and Mental Health: Understanding Strange Sleep Behaviors
A recent comprehensive analysis of 372,000 sleep clinic patients revealed that parasomnias—unusual sleep behaviors like sleepwalking and night terrors—have a significant association with psychiatric conditions, with depression patients being nearly three times more likely to experience these sleep disturbances. This large-scale study provides compelling evidence that parasomnias may be underrecognized clinical indicators of mental health disorders, suggesting the need for increased attention to sleep behaviors during psychiatric evaluations.
What Are Parasomnias?
Parasomnias are unusual behaviors or experiences that happen while sleeping or when falling asleep or waking up. In this study, they looked at several types:
- Sleep talking (somniloquy): saying words or making sounds while asleep
- Hallucinations when falling asleep (hypnagogic hallucinations): seeing or hearing things that aren’t there
- Eating while asleep (sleep-related eating disorder): getting up to eat without being fully awake
- Sleep paralysis: being unable to move or speak while waking up or falling asleep
- Sleepwalking (somnambulism): getting up and walking around while still asleep
How The Research Was Conducted
The study collected information from 240 sleep centers across 30 U.S. states between 2004 and 2019. They looked at data from almost 372,000 people who answered questions about unusual sleep behaviors. They compared people who reported having parasomnias “often” or “always” with those who experienced them only “a few times” or “never.”
The Results
About 16% of people (about 1 in 6) reported having at least one type of parasomnia regularly. The most common was sleep talking (8.8%), followed by sleep hallucinations (6%), sleep-related eating (4.8%), sleep paralysis (2.1%), and sleepwalking (1.7%).
The most important finding was that people with parasomnias were much more likely to have depression. In fact, those with parasomnias were 2.72 times more likely to have diagnosed depression compared to those without these sleep behaviors.
Other patterns they discovered:
- Parasomnias were more common in younger people and females
- People with parasomnias often had symptoms of anxiety, insomnia, restless legs syndrome, pain, and daytime sleepiness
- Certain medications affected parasomnia risk:
- Benzodiazepines (anti-anxiety medications), antipsychotics, and opioid pain medications increased the risk
- Antihistamines (allergy medications) and melatonin reduced the risk
- Z-drugs (sleep medications like Ambien) increased the risk of sleep-related eating disorder
Real-Life Takeaways
- Mental health connection: If you or someone you know experiences frequent parasomnias, it might be worth discussing mental health with a doctor. These sleep behaviors could be a sign of depression or anxiety that needs treatment.
- Medication awareness: Certain medications can make parasomnias more likely. If you’re taking medications and develop unusual sleep behaviors, talk to your doctor about possible connections.
- Multiple health factors: Parasomnias rarely happen in isolation. They’re often part of a bigger picture involving sleep quality, mental health, physical pain, and other medical conditions.
- Underrecognized problem: The researchers point out that parasomnias might be important symptoms that aren’t getting enough attention in mental health care. Doctors might want to ask about these sleep behaviors when treating depression and anxiety.
- Need for further research: The study couldn’t determine which comes first—the parasomnia or the mental health condition. More research is needed to understand if one causes the other, or if they share common underlying factors.
This research suggests that when we see unusual sleep behaviors, we should consider them potential signs of mental health conditions that might benefit from treatment, rather than just strange sleep quirks.
Read the full article here.