How can I address being an "over-active" sleeper?

Dear Active Sleeper, 

Sleep is supposed to be relaxing! Physical and vocal activity disturbing your sleep (and that of your partner) may suggest that you might be experiencing abnormal sleep behavior. There are many forms of sleep disorders and figuring out what you’re experiencing isn’t something you can do on your own. Getting diagnosed is best accomplished by meeting with a health care provider. They can follow up with testing and treatment, if necessary. Read on for more information about various disordered sleep behaviors and options you may have for treatment. 

What’s parasomnia?  

Based on what you’ve described, it’s possible you may be experiencing what’s called parasomnia, or disordered sleeping behaviors. This is an umbrella term, meaning there are several types of parasomnias that can occur during different stages of sleep. Some occur during the first half of the night, during non-rapid eye movement (non-REM) sleep, while others happen during vivid dreaming in the second part of the night, during rapid eye movement (REM) sleep.  

Non-REM parasomnias include:   

• Night terrors: these can increase feelings of panic and fear. You might sweat, scream, cry, hyperventilate, thrash, and have a racing heart rate. It’s recommended that no one wakes you up during a terror, as this can be difficult and even prolong the episode. You won’t remember the dream that caused these terrors, however.  
• Sleepwalking: this may lead you to perform activities you normally do in waking hours—like walking, driving, and peeing—while you’re asleep. 
• Confusional arousals: often these involve waking up disoriented and confused. 

REM parasomnias include: 

• REM sleep behavior disorder: this can cause the sleeping person to punch, shout, kick, and talk while dreaming. It can be induced by certain medications, evolve from an underlying illness, or develop on its own. While you’ll likely wake up fine without any confusion, you likely won’t be aware of or remember your sleep behaviors.  
• Nightmare disorders: these involve having intense dreams that create fear and anxiety. As opposed to sleep terrors, you can remember the dream upon waking. 
• Recurrent isolated sleep paralysis: this is when you wake up but can’t move your body. 

There are also some other parasomnias that don’t fit neatly in these categories including: 

• Bedwetting,  
• Sleep-related groaning, 
• Exploding head syndrome, 
• Sleep-related eating disorder, and 
• Sexsomnia.  

What are treatment options?  

Getting diagnosed for any of these disorders—which can be the first step towards treatment—can involve tests like a sleep study and an electroencephalogram (EEG).  

You mention a specific interest in herbal remedies, but there unfortunately aren’t any that treat parasomnia. Similarly, medication is usually not the first line of defense—though this may be an option you and a health care provider could discuss after trying other things first. Instead, therapeutic interventions are generally recommended, including cognitive behavioral therapy (CBT), hypnosis, and relaxation and mindfulness training.  

Additionally, some parasomnias, including night terrors, point to psychological distress, including post-traumatic stress disorder (PTSD) and anxiety disorders. In these cases, getting proper mental health treatment to address the root cause might be the most effective treatment for your nighttime outbursts. 

Are there other things I can do to reduce the likelihood of experiencing parasomnia? 

Some general recommendations you might try to reduce the likelihood of experiencing parasomnia or at least reduce the frequency of it include: 

• Reducing alcohol and caffeine consumption, as these are common triggers for parasomnia. 
• Maintaining a regular sleep schedule since getting enough sleep is an important tool against disordered sleep behaviors.  
• Aiming to reduce overall stress—stress is another common trigger! 

Because you’re physically active during the night, it’s also recommended to implement safety measures, so you don’t injure yourself or your sleeping partner. These safety measures could include: 

• Reorganizing: moving things away from the bed prevents you falling onto them if you fall out of bed. 
• Going down a level: avoiding sleeping on the top bunk of a bunk bed or loft means falling from a lower height and (hopefully) avoiding more severe injuries. 
• Locking it up: keeping household weapons or sharp objects out of reach prevents your sleeping self from getting into any accidents. 
• Sounding the alarms: installing alarms on windows and doors can help prevent you from leaving your home. 

With the help of a health care provider, or a referral to a sleep specialist, you can learn how to manage your sleep conditions. Hopefully this helps get you on your way to sharing a bed with your fiancé in peaceful slumber.  

Slumber peacefully,