Welcome my name is Anthony Lucas and today our topic is nightmares and parasomnia to tell us more

we're joined by registered psychologist and sleep health foundation board member Dr. Moira Junge. Dr.
Moira Junge has over 25 years experience in the health healthcare sector and has worked in the sleep
disorders field since 1994. Dr. Moira Junge i'm so extremely glad you're here thanks so much for joining
us so let's get straight into it shall we

many of us maybe not have heard of parasomnia so can you, what is it?

yes well it's a collective term for that covers all sorts of sleep disorders that happen during sleep so
parasom so in the middle of sleep when you're you think you're asleep well you are asleep but there's all
sorts of strange things going on so things like um sleepwalking sleep talking bedwetting teeth grinding,
you know you name it there's a range of things we could keep people driving their car in their sleep
people cooking meals in their sleep

wow

people um having sexual phenomena in their sleep so there's all sorts of things which is called a sex
omnia

wow, okay um so it's kind of like the brain still awake is it

interesting yeah interesting to say that well so yeah so during sleep it's meant it's actually experiencing
uhm phenomena that is um yeah abnormal to what we normally would expect in sleep but having said
that a lot of things that happen like sleep walkings like sleeptalking yes they're abnormal but they're but
sometimes not very common not not every night and they may not be very debilitating to that person
because in fact most of this stuff we're talking about um and including nightmares it's probably the most
common parasomnia is having a nightmare but mostly it doesn't necessarily affect people to the point
where it's affecting their occupational functioning and or social functioning like in other things we've
spoken about

wow okay so what are the different types of insomnia you've said that those things like uh you know
sleepwalking and stuff is that what so that's obviously what can happen but type the different types i
guess

yeah well I suppose um well they're all under the same

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title of a pair of parasomnia um but

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let's let

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maybe we could just pick out one for

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instance like someone who perhaps is

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having nightmares which is the most

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common

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um and and everyone knows i think

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everyone's had at least one nightmare

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like most people

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watching this would think yeah i

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understand what a nightmare is

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but not everyone understands what what

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other things are like

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you know driving not many people

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hopefully driving their car

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in their sleep so well i would have

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thought like nightmares are associated

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with you know being scared and you know

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watching scary movies

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yeah well sometimes that's one of the

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triggers yeah um

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often nightmares could be from that and

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post-traumatically nightmares are a big

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feature that they are

a diagnostic feature in fact of people

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who have

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um a post-traumatic stress disorder

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often there's this and it's it's thought

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to be like an

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and it's intrusive people are replaying

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things over and over

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so you know in a way obviously we don't

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most of the nightmares

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are distressing and and it affects your

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sleep in that way

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because you're still you're asleep so

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we've talked through things like

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insomnia hyposomnia but

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a parasomnia is like it's during the

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sleep so people don't

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know that they're having this and what

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happens is if you're

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actually thrashing about in bed or you

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know having these disruptive nightmares

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you will in fact feel very tired

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the next day but you may not know why

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okay so

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so it's a it's an important it's an

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interesting part
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of of the sleep field and one that we

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don't talk about much at all

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i guess that kind of leads me to my next

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question what causes

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it like is it genetic is it what is it

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yeah it can be

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it can be um post trauma it can be

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obviously post um drugs like people like

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drugging out substance use it can be

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very

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interestingly ironically in a way that

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it can be severe sleep deprivation

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that can cause people to have this these

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parasomnias and

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and and interested so cruelly really

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like the

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so the more unwell you are the more

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tired you are

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the more sleep deprived you are the more

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likely you are to have a parasomnia so

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the young child for instance who might

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be a sleepwalker they might be a

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bedwetter

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they might be asleep but they don't do

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it all the time yeah they're very very

likely to have

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that parent this parasomnia or a lot of

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them in the one night on a friday night

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in on a hot night um after school camp

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for instance so they've had a full week

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of being sleep deprived

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um and then and also being a bit

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stressed a bit out of sorts a bit hot

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so these things are so being being

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stressed being over stimulated

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being overheating like being just so

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sleeping too hot

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like building food you know people might

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have sunlight pajamas and

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a duna and other thing and they're more

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likely to have as

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disturbance like they're more likely to

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have nightmares okay interestingly

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we've talked previously about sleep

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apnea and

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with sleep apnea it's very common that

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people might have associated nightmares

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too like

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as they're having the api and their

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oxygen saturation levels drop

it's very common to have nightmares so

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sometimes treatment of nightmares

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in a sleep disorder setting can be

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actually treating but

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once people get their sleep happening

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are sorted out the nightmares can go

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away

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that can happen which is interesting wow

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so so the yeah so the person

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generally what i find someone who has a

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parasomnia

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um and they're they're they're worried

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about it they're

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worried enough to actually seek

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treatment for it and that someone's

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alerted them to it because some people

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don't know if they're screaming out in

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their sleep

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yeah they say for example night terrors

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when a child or an adult has a night

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terror

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which is different to a nightmare like

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nightmares are often in remnant sleep

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and the night terrors are in non-rem

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sleep so not in the dreaming type stage

of sleep

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the night terror when the person is

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screaming i'm not sure if you've ever

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heard someone have a night terror it's

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it's

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shrill screaming like it actually just

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chills you to the bone you think

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wow they must be sounds like someone's

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being murdered like it's it's you could

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hear it probably next door

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yeah it's really full on so you come

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running in and the child or the adult

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is dead to the world they have no and

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they don't wake up from it

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and they have no memory of it in the

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morning or if they do happen to wake up

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shortly after that

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so that's so mostly they don't know well

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yeah that's just a type yeah night

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terror is a type of parasol well that

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kind of

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leads me to like is it something that

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gets diagnosed and if it is

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how does it kind of get treated yeah so

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yeah if it
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exactly so if it's diagnosed if

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someone's it's problematic for them they

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end up seeking treatment and getting a

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diagnosis

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it's not often diagnosed sometimes over

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with a sleep study but you have to be

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filming them having a set up where you

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actually might be able to capture it on

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film

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because otherwise you don't really know

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what's going on if you don't have that

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visual capturing of it

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yeah so it's often just diagnosed on

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just on report like if you told me this

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is what happens then i believe you don't

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have to go off into a lab and find

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out and get it diagnosed but the

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treatments would be

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really um like looking finding out like

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whether

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what the underlying cause is what's

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going to lead to the treatment

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so making sure that people um like

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getting you sort of drugs and alcohol

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sorted um not being through sleep

deprived so making sure that you're

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you know getting adequate sleep every

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night like a minimum six hours even

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like you're doing lots of shifts or

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you're doing lots of as busy as anything

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to

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really get your minimum six or seven

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preferably you know eight or

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seven or nine but but just because we

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people are

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routinely getting less than six hours

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they've got a much higher risk of having

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this parasomnia

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wow so my interesting situation is when

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i was when i used to be a nurse

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years and years and years ago doing we

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should do like long shifts like 10 hours

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of shift of night shift so coming home

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from a night shift and then sleeping

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during the day i would actually

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apparently i was

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having parasomnias like getting up

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walking around

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thinking the overhead bed lamp was an iv

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pole and trying to fill up the iv like

what i was doing

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so and you didn't realize didn't realise

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and it's usually it was because i was in

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severely sleep deprived state so we need

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to make sure that people aren't in this

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league to private statement

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make sure that they're not just tidy up

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their diet alcohol stress

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not be too hot at night all those sorts

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of things just reducing stimulation

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yeah well does that count for the same

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as children because i can imagine like

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obviously children aren't going to

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most likely hopefully not going to be on

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you know the alcohol and substance

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kind of field like is it the same

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treatment for them

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yeah for the children to making sure for

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sure like making sure they're not too

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stressed making sure they're

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not overheating um interestingly

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sometimes if you're just getting a bit

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of a cold or a bit of a virus

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that's the first part of that when your

body temperature is a bit higher you've

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got a little bit of a temperature

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you're more likely to have the the

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parasomnia then so

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making sure that sort of stuff is

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checked out like that their body

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temperature is kept low during

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during a fever um so

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it's it's really a multi-factorial

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approach around

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mostly educating people that a lot of

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the time it's not very dangerous some

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people

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say sleep walking can be can be very

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very upsetting for

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for people but a lot of people who have

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sleep walking never get treatment

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their whole life yeah because they just

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sort of they're not worried about it but

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once someone's had a dreadful situation

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where they've slipped walks and they

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found them out on the highway

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yeah that's a that's something that you

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think well i need to get that sorted

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that's really dangerous so

so medication so a combination of

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medical

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and psychological um approaches where

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sometimes people might be put onto some

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certain medications that sort of keep

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them quite still during the night just

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literally they can't really

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thrash around too much and then yeah and

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their sleep quality is deeper so they're

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not likely to have it

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um so from my point of view people who

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like who want to reduce their likelihood

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of their teeth grinding or they're

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having nightmares and it's it's really

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around you know stress management and

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reduction of just too much arousal

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in their in their world as well well is

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there anyone that's like

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who is more kind of who is more likely

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to experience

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uh parasomnia yeah those people who uh

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so

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you're more likely you're more

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susceptible to a parasomnia if you have

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had trauma yeah or you've got some like

some

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um or if you're using um or abusing

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substances yeah and would you say it's

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like more kind of men women children or

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yeah across the board across the board

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like men women children and across

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all the life span job for ages so gender

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and age

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all across there's not that much

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difference with susceptibility

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but but more so with the person who's

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just carrying

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um too much stress or the person who's

00:11:06.399

asleep

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like sleep depriving themselves and

00:11:08.399

shooting themselves in the foot like you

00:11:09.600

can be so sleep deprived

00:11:11.200

that you end up having this sort of um

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psycho almost psychotic like you have

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hallucinations it's like feeling

00:11:16.399

like you're not quite sure about reality

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anymore so the

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um yeah the population it's really

00:11:24.000

making sure that people are aware that

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in in
00:11:27.600

what they are and that in general not a

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lot of treatment is needed

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but when treatment is needed that you

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would go to a sleep

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disorders center a sleep disorders

00:11:38.880

particular

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sleep disorder physician someone who's

00:11:42.160

actually had training

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in sleep yeah and would understand um

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a if treatment is needed um and

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education around that

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and be like just be a combination of um

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some medications that can work

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yeah or actually just these lifestyle

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changes these non-drug strategies

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similar to the ones that we have for

00:12:01.680

insomnia just making sure that you're

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you know bringing down the stresses

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etc yeah just not being too concerned

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about it yeah well

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i think it's it's something that a lot

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of people kind of need to become aware

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of

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would you say in you know just just

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quickly
00:12:18.639

if you're kind of living alone do you

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know that you're having an insomnia

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i'm kind of busy i'm just preparing

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no that's the thing and mostly mostly

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you're not aware if you yeah if you

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don't have a bed partner or someone to

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to you know tell you what's going on

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yeah you just don't

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know about it it's really interesting

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well thanks again for joining us it's

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been absolutely amazing to have you

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uh we hoped you gained some insight into

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our topic today