Def: REM parasomnia with inability to move limbs, head, trunk or speak, with full consciousness
Episodes last seconds to minutes
Occur at sleep onset or on waking
Usually resolve spontaneously
Triggers: stress, sleep deprivation, irregular sleep-wake schedule

Epidemiology
Isolated events common in general population
Lifetime prevalence 5-60% depending on population
Recurrent episodes more common with other sleep d/o, e.g. 60% of narcolepsy pts

Pathophysiology
Dissociated state with REM elements persisting into wakefulness

Treatment
If no features of another sleep d/o: reassurance and sleep hygiene
Address sleep deprivation and irregular schedules
TCAs or SSRIs for persistent cases