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Ep 227 – Parasomnia

October 8, 2026 · 14 min

Show notes

In this episode, Dr Roger Henderson explores a fascinating and sometimes unsettling area of clinical practice: parasomnias. Sleep is something everyone experiences, but for some patients it is far from quiet or predictable: they may walk, shout, experience vivid nightmares or even physically act out their dreams, leaving both them and their partners confused, frightened or concerned about what these behaviours might mean. For GPs, recognising the pattern is crucial. Is the episode occurring early or late in the night? Is the patient confused or fully alert afterwards? Do they remember what happened, and could medication, another sleep disorder or an underlying neurological condition be contributing? Here, we cover the key clinical features of non-rapid eye movement (NREM) parasomnias, nightmare disorder and rapid eye movement (REM) sleep behaviour disorder, and discuss practical approaches to their assessment, differential diagnosis and management.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/neurology/ep-227-parasomnia

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