Researchers from Northwestern University in the United States have identified that psychotherapy or hypnosis may ease episodes of sexsomnia and other sleep-related disorders. The study detailing these findings appeared in Sleep Medicine.
Across parasomnias, there is no one-size-fits-all treatment approach. A review of 72 scientific papers published between 1909 and 2023 shows a wide variation in how these conditions are managed. Parasomnias encompass a range of behaviors that occur during sleep, from sleepwalking and sleep-related sexual activity to night eating and even nocturnal driving in rare cases. The lack of universal guidelines reflects the complex nature of these conditions and the individual differences in how they manifest and respond to treatment.
Evidence from several investigations suggests that cognitive behavioral therapy, hypnotherapy, improved sleep hygiene practices, and scheduled awakenings just before the typical time a parasomnia event occurs can reduce the frequency or intensity of incidents for some patients. These approaches often work best when tailored to the person, considering factors such as the specific parasomnia type, coexisting sleep disorders, and overall health. For instance, establishing a consistent sleep schedule, reducing alcohol and caffeine intake near bedtime, and creating a safe sleeping environment can complement therapeutic strategies and may lessen sleep disturbances.
People who experience parasomnias frequently recall little or nothing about events that occur during their sleep. When memories do surface, they are often fragmentary, leaving gaps about what happened during an episode. This partial recall can complicate diagnosis and treatment, because the individual may not fully understand the triggers or the consequences of their nocturnal behaviors.
As one study author noted, nighttime actions can carry real risks. Incidents reported in clinical settings have included injuries from banging into objects, lacerations from sharp edges, or other harm that occurs while the person is unrestfully engaged in a parasomnic episode. In some cases, individuals may even use medications during sleep, or experience a rebound of behavior after waking, which can lead to morning discomfort or distress. Real-world examples illustrate the potential severity of parasomnias and the importance of accurate assessment and management by clinicians familiar with these conditions.
Researchers emphasize the need for randomized controlled trials to establish clearer evidence about which treatments are most effective for different parasomnia types and patient profiles. High-quality trials would help create consistent guidelines, improve safety, and support clinicians in delivering care that is both scientifically grounded and practically applicable for patients in North America and beyond.
Overall, the current evidence base supports a multimodal approach to parasomnias. This includes behavioral interventions, environmental adjustments, and, when appropriate, targeted therapies that address underlying sleep disorders. By combining patient education with individualized treatment plans, clinicians aim to reduce nocturnal episodes, minimize risks, and improve daytime functioning for those living with these perplexing sleep disorders.
Continued research, collaboration across sleep medicine specialties, and careful monitoring of treatment outcomes will be essential to advance understanding and management of parasomnias in the years ahead. In the meantime, patients are encouraged to work with their healthcare providers to explore safe, evidence-informed options that align with their symptoms and daily life.