Sleep enuresis, a.k.a. bedwetting

Bedwetting, or nocturnal enuresis, happens to a lot of children. Boys are more likely to suffer from enuresis than girls, and the condition often runs in families. A large study in Quebec found that 25% of children experience enuresis. Another study in Western Canada concluded enuresis affects 2% of seniors and 30% of elementary school-age children  Although bedwetting is a cause of embarrassment and frustration, it usually isn’t a serious problem in children. Adults who wet their beds often have more serious underlying conditions.

There are two kinds of enuresis -- primary and secondary. In primary enuresis, a person has been unable to have urinary control from infancy onward. This usually indicates that the child's bladder control is developing a little slower than normal. In secondary enuresis, a person has a relapse after previously having been able to have urinary control. Emotional factors, including stress, insecurity or even depression may play a role, but more often a specific cause cannot be pinpointed. Children with enuresis have more fragmented sleep and more daytime sleepiness than other children.

In adults, 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. Limiting liquids before bedtime and encouraging urination before bed is usually the course of action for children.

Confusional arousals

Confusional arousals often occur in infants and toddlers, and less often in adults. These episodes may begin with the person crying and thrashing around in bed. The individual may appear awake, confused and upset, yet resists attempts by others to comfort or console. The episodes may last up to half an hour and usually end with the person calming, waking briefly, and then returning to sleep.

It is estimated that confusional disorders affect 2.9% of the population. Because disorders of arousal are uncommon in older people, adults suffering from these disorders should seek evaluation. In some cases these events are triggered by other conditions such as sleep apnea, heartburn, or periodic limb movements during sleep. A sleep specialist should evaluate the person’s behavior and medical history.

Nocturnal Eating Syndrome

NES or Night Eating Syndrome leads people to wake up and eat. SRES or Sleep Related Eating Syndrome refers to those who eat in their sleep. SRES is a type of somnambulism and a can be dangerous if the sufferer chokes or suffers an injury while cooking. It is more common in women than men. NES is not so immediately dangerous, because the person is rational when up. It can lead to weight gain and sleep disruptions, which may have long-term negative effects. People with NES often skip breakfast, eating nothing in the morning. Both NES and SRES are grouped under the classification Nocturnal Eating Syndrome, also called Sleep-Related Eating.

Sleep Hyperhidrosis

Hyperhidrosis is excessive sweating during sleep. This is not an accepted disorder by the sleep medicine community, but some experts consider it a disorder. Sleep hyperhidrosis is referred to colloquially as night sweats.

Sweating may be a consequence of a bedroom that is too warm or excessive bed coverings or clothing.  But the person should be able to figure out this cause fairly easily.  (Indeed, a comfortable sleep environment is one of the hallmarks of sleep hygiene.)

Night sweats that persist after attempts to cool off may be worth mentioning to a doctor, but they usually are more uncomfortable than serious and there is not much medicine can do about them.

A common cause of night sweats is menopause, which has a frequent symptom of hot flashes.  Hot flashes can happen during the day or night.

Tuberculosis famously causes night sweats, and so can other infections as well as diseases like cancer. Anti-fever medicine (even aspirin) is sometimes linked with hyperhidrosis.

Some hyperhidrosis is idiopathic, is a condition in which the body chronically produces too much sweat without any apparent cause.

Daytime idiopathic hyperhidrosis affects about 2% of adults, and usually shows as sweat from the armpits. Anticholinergic medicines and antiperspirants can be used.

The key thing is that the sweating happens when the person is asleep much more than when awake. Night sweats are typically not dangerous or necessarily a sign of an underlying condition. People of all ages can get hyperhidrosis although it is most common among young adults.


Catathrenia is when people groan in their sleep on a regular basis. It happens more often in REM sleep although it can occur in any stage. While snoring is a sound produced during inhalation, catathrenia happens during exhalation. It is unknown why it happens, but it has been established that the groaning is not a signal or pain or unhappy dreams. Although the groaning can be loud and disturb others in the house, the person with catathrenia does not wake up because of it. In the polysomnogram test used to diagnose sleep disorders, it is often confused for central sleep apnea. CPAP has been tried on people with catathrenia but hasn't yet become a standard treatment. Unlike apnea, catathrenia is not considered dangerous, so the impetus for treatment has not been as strong.

Abnormal Swallowing Syndrome

In sleep this is not typically serious unless it is associated with dangerous apnea.  Saliva builds up in the mouth and is not swallowed.  The person ends up choking or coughing on the saliva and wake up or shift to a shallower stage of sleep.  This syndrome is most common in older people.  It can be confused with gastroesophageal reflux, laryngospasm, and apnea.

Sleep-related Laryngospasm

A spasm is an uncontrolled sudden contraction of muscles, and a laryngospasm is a spasm in the vocal cords.  The person frequently makes a wheezing sound and other may think he is choking.  People who get laryngospasm while asleep suddenly awaken with the feeling they are suffocating. This condition is also called vocal cord dysfunction.

Nocturnal paroxysmal dystonia

Dystonia is a general term for muscle spasms – or more precisely unusual tone (“dys” “tone”) - and the convulsions that twist the body into unusual and sometimes painful postures.  There are often repetitive motions.   "Paroxysmal" means sudden or quick.  Nocturnal means at night.

Nocturnal paroxysmal dystonia is a disorder where the person behaves as if he or she has had an epileptic fit during sleep. Such attacks may take place seven to eight times during one night and each attack last from fifteen to sixty seconds. These attacks typically take place during the non-REM period of sleep. The patient may also wake up from sleep after such a seizure. The behavior pattern of people who suffer from this affliction may also include somnambulism or what is more commonly known as night walking.

Some researchers believe that this disorder is similar to frontal lobe epilepsy but the clinical evidence is not conclusive. The most common form of treatment of this disorder follows the same route as that taken for treating an epilepsy patient. anticonvulsant drug carbamazepine has been used to treat people who experience short outbursts.

Exploding Head Syndrome

Despite the name people with Exploding Head Syndrome do not experience pain and the condition is considered benign, but it can be very upsetting to sufferers. The main symptom is an aural hallucinogen - the person apparently hears a loud sound, often described as similar to a bomb. Some also experience flashes of light. These episodes occur at the border between deep sleep and other stages. When the brain goes from stage 2 to stage 3, the apparent bangs can occur, waking the person up. Exploding Head Syndrome is most common in middle-age and older people - more often in women than men.


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