Parasomnias
topic
Parasomnias are sleep disorders characterized by abnormal behavioral, experiential, or physiological events during sleep or sleep-wake transitions — including NREM parasomnias (sleepwalking, sleep terrors, confusional arousals occurring during deep NREM), REM parasomnias (REM Sleep Behavior Disorder: physically acting out dreams due to absent muscle atonia, a strong early marker of Parkinson's disease and other synucleinopathies), and sleep paralysis.
Role
Parasomnias are frequently misunderstood and mismanaged — with sleepwalking treated as comical rather than as a safety risk requiring environmental modification, and REM Sleep Behavior Disorder (RBD) being particularly significant as an early biomarker of neurodegenerative disease. RBD — in which dreamers physically act out their dreams because REM atonia has failed — precedes Parkinson's disease diagnosis by an average of 12 years in affected individuals, representing the longest-known preclinical window for neurodegeneration prevention research. Most affected individuals and their healthcare providers do not make this connection, missing a potential 12-year window for neuroprotective intervention.
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