**1. Introduction**

148 Sleep Disorders

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Sleep is a vital physiological process with important restorative functions. Parasomnias are characterized by undesirable physical or verbal behaviors, such as walking or talking during sleep and occur in association with sleep, specific stages of sleep or sleep-wake transitions. The category of parasomnias comprises some of the most exceptional behavior disorders because complex and apparently purposeful, goal-directed behavior is associated with a deep sleeping brain. Parasomnias occur during REM sleep, any of the four stages of non-REM sleep, and during transitions between sleep and wakefulness. Sleepwalking, sleep terrors, and confusional arousals are associated with non-REM sleep, nightmares and sleep paralysis are associated with REM sleep, while sleep starts and sleep talking are associated with sleep-wake transitions. Sleep enuresis has been observed with all sleep types.

The International Classification of Sleep Disorders subdivides parasomnias into the following four groups (Table 1): Arousal disorders, sleep-wake transition disorders, rapid eye movement (REM) stage sleep parasomnias, and other parasomnias (American academy of Sleep Medicine, 2004).

When accompanied with excessive motor activity and other complex motor behaviors, these parasomnias may significantly affect the patient's quality of life and that of the bed partner. Motor behaviors may or may not be restricted to bed but can become dangerous when the subject ambulates or is agitated. The behaviors are inappropriate for the time of occurrence but may seem purposeful or goal directed. Therefore, appropriate diagnostic and therapeutic strategies are needed (Young, 2008).
