Sleep Disorders: Parasomnias

Impaired sleep-related penile erections

This disorder occurs among men who are unable to sustain a penile erection during sleep that would be sufficiently rigid enough to engage in sexual intercourse. Men usually experience erections as a part of REM sleep, and impaired sleep-related erections may indicate erectile dysfunction.

Sleep-related painful erections

Erections are a normal component of REM sleep for men. In rare cases, however, erections become painful and cause a man to wake up. The treatment of sleep-related painful erections may involve drugs that suppress REM sleep (some antidepressants, for example).

REM sleep cardiac arrhythmias

A cardiac arrhythmia is a change from the normal rate or control of the hearts contractions. People who have coronary artery disease and whose blood oxygen is lowered by sleep-disordered breathing may be at risk for arrhythmias, which take place during REM sleep. Continuous positive airway pressure (CPAP) treatment may reduce this risk.

REM sleep behavior disorder (RBD)

People with rapid eye movement (REM) sleep behavior disorder act out dramatic and/or violent dreams during REM sleep. REM sleep usually involves a state of sleep paralysis (atonia), but people with this condition move the body or limbs while dreaming. Usually, RBD occurs in men aged 50 and older, but the disorder also can occur in women and in younger people. It differs from sleep walking and sleep terrors in that the sleeper can be easily awakened and can recall vivid details of the dream. In the diagnosis and treatment of RBD, potentially serious neurological disorders must be ruled out. Polysomnography (sleep tests) and drug treatments also can be involved in the diagnosis and treatment of this disorder.

Sleep bruxism

Sleep bruxism involves the involuntary, unconscious, excessive grinding or clenching of teeth during sleep. It may occur along with other sleep disorders. Sleep bruxism may lead to problems including abnormal wear of the teeth and jaw muscle discomfort. The severity of bruxism can range from mild cases to severe cases that involve evidence of dental injury. In some cases, bruxism can be prevented with the use of a mouth guard. The mouth guard, supplied by a dentist, can fit over the teeth to prevent teeth from grinding against each other.

Sleep enuresis (bedwetting)

In this condition, the affected person is unable to maintain urinary control when asleep. There are two kinds of enuresis -- primary and secondary. In primary enuresis, a person has been unable to have urinary control from infancy onward. Primary bedwetting appears to run in families. Children are more likely to have it if their parents or siblings had it as children. In secondary enuresis, a person has a relapse after previously having been able to have urinary control. Enuresis can be caused by medical conditions (including diabetes, urinary tract infection, or sleep apnea) or by psychiatric disorders. Some treatments for bedwetting include behavior modification, alarm devices, and medications.