Sleep apnea and parasomnias can affect the same person, but they are different kinds of sleep conditions. Sleep apnea is a breathing disorder that a physician evaluates; parasomnias are unusual behaviors or experiences that happen during sleep or while waking. One does not automatically prove the other, and an unusual nighttime event cannot diagnose sleep apnea. If you notice both breathing concerns and unusual sleep behaviors, share the full picture with a sleep physician so each concern can be assessed.
What are sleep apnea and parasomnias?
Obstructive sleep apnea (OSA) involves repeated narrowing or blockage of the upper airway during sleep. A person may have loud snoring, pauses in breathing noticed by someone else, or other symptoms that warrant medical evaluation. These signs can have different explanations, so only a qualified clinician can determine whether OSA is present. Spark Sleep Solutions provides dental sleep medicine care and coordinates with sleep physicians for diagnosis.
Parasomnias are unwanted behaviors, movements, emotions, or experiences associated with sleep. Examples include sleepwalking, sleep talking, night terrors, and some dream-related behaviors. The term describes a group of events, not one diagnosis. Their timing, what a witness observes, a person’s medical history, and other details help a clinician decide what evaluation is appropriate. The overview of parasomnias describes this broad range of sleep-related behaviors and experiences.
For an accessible introduction to breathing-related sleep disorders, see what sleep apnea is. The distinction matters: an episode of sleepwalking does not establish that someone has apnea, and snoring by itself does not identify a parasomnia.
Can sleep apnea and parasomnias happen together?
Yes, both can occur in one person. But the presence of one does not show that the other caused it. Sleep behaviors can have several possible influences, including disrupted sleep, medications, and other health factors. A clinician needs the context before drawing conclusions.
Research has examined whether parasomnias are more common among people with obstructive sleep apnea. One study reported no overall increase in parasomnias in patients with OSA compared with people without OSA, while noting a finding related to sleepwalking. That result does not settle what is causing an individual person’s symptoms; it is a reminder not to assume that apnea explains every nighttime event. Read the study, “Prevalence of Parasomnias in Patients With Obstructive Sleep Apnea”, for its findings and limitations.
A publication on non-REM parasomnias notes that sleep deprivation, some medications, and untreated OSA are among factors that may provoke parasomnias, particularly in people with a predisposition. This is a possible relationship, not a way to diagnose the cause in a particular person. The review of non-REM sleep parasomnias provides more context. Tell your clinician about medication changes or changes in sleep; do not stop a prescribed medicine without discussing it with the prescriber.
What details should you note about nighttime events?
A brief record can help you describe what is happening. It does not replace an evaluation or confirm a diagnosis. If a bed partner or caregiver witnesses an event, their observations may be useful because the person experiencing it may not remember it.
- When it happens: Note the approximate time, whether it is early or late in the night, and how often it occurs.
- What someone sees or hears: Record movement, speech, apparent awakening, snoring, pauses in breathing, or gasping. Avoid interpreting what the behavior means.
- What happens afterward: Note whether the person wakes fully, recalls a dream or event, feels confused, or feels tired the next day.
- Recent changes: Mention changes in sleep schedule, illness, stress, alcohol use, or medications when relevant. Share medication questions with the prescribing clinician.
- Safety concerns: Describe falls, leaving the bed or home, injury, or behavior that could put the person or another person at risk.
People who sleep alone may not know whether they snore, gasp, or move during the night. A partner’s observations can help, but their absence does not rule out a sleep condition. You can also discuss ongoing daytime fatigue or other symptoms with a physician. Spark’s guide to sleep apnea symptoms in adults covers signs that may be worth bringing up.
How can you distinguish the concerns?
There is no simple home checklist that can tell whether a nighttime event is a parasomnia, sleep apnea, or something else. The examples below can help organize a conversation with a clinician, but they are not diagnostic criteria.
| What you notice | What it may relate to | A useful next step |
|---|---|---|
| Repeated loud snoring, witnessed breathing pauses, or gasping | Possible sleep-related breathing concern, among other explanations | Discuss the pattern with a physician, who can determine whether sleep apnea evaluation is appropriate. |
| Walking, talking, or unusual movements during sleep | A parasomnia or another sleep-related event; the details matter | Record timing and behavior and tell a clinician, especially if events recur or create safety concerns. |
| Both breathing observations and unusual sleep behaviors | Two concerns may coexist; one should not be assumed to explain the other | Share both sets of observations with a sleep physician and ask how each should be assessed. |
| New, severe, or potentially dangerous nighttime behavior | A reason to seek timely medical guidance | Contact a healthcare professional. Seek urgent help if someone is in immediate danger or has a serious injury. |
A physician may consider the history and decide whether testing or referral is appropriate. Sleep testing evaluates breathing and other sleep measures; it is not a substitute for describing unusual behaviors. For more on the diagnostic process, read Spark’s guide to why a sleep study may be recommended and its overview of what to expect during care.
How can you prepare for a conversation with your care team?
It can be hard to remember details after a disrupted night. Before an appointment, write down the main concern in plain terms: what happened, roughly when it happened, and how often it has occurred. Include what you personally experienced and what another person observed. A short, factual description is more useful than trying to label the event yourself.
- Bring the timeline: Note when the behavior or breathing concern began, whether it is becoming more frequent, and whether it happens every night or only occasionally.
- List current care: Bring the names of clinicians involved in your sleep care, any known diagnosis, and the treatment plan you currently follow. If you have a sleep-study report or relevant records, ask the office whether to bring or send them.
- Review medicines with the prescriber: Make a current medication list, including recent changes. Ask the prescribing clinician whether a medicine could be relevant. Do not adjust a dose or stop treatment on your own.
- Ask about the right next step: Find out whether your concern needs evaluation by a sleep physician, another clinician, or more than one member of the care team. Ask how results and recommendations will be shared.
If someone witnesses an episode, ask them to describe what they saw without guessing at a cause. For example, “I heard repeated snoring and then a pause, followed by a gasp” gives a clinician a clearer observation than “I think you stopped breathing.” Likewise, note what the person did, how long it seemed to last, and whether they woke or remembered it. Exact measurements are not necessary; an approximate description is still useful.
Different concerns may require different expertise. A sleep physician evaluates sleep-related breathing and coordinates diagnosis. A clinician assessing parasomnia-like behaviors may ask about timing, recall, safety, and other health factors. If oral appliance treatment becomes part of a diagnosed OSA plan, the dental sleep clinician can coordinate with the physician. Ask who will follow up on each issue so an investigation of one concern does not leave the other unaddressed.
Care coordination can also help prevent mixed messages. Keep a copy of the recommendations you receive, note who to contact with new or worsening symptoms, and ask what changes should prompt earlier follow-up. If you see more than one clinician, make sure each knows about relevant diagnoses and treatment changes. You can request that records be shared through the appropriate office process. These simple steps help the team understand the full picture without turning your notes into a self-diagnosis.
What should you do if both concerns are present?
Start by describing both concerns to a sleep physician. Explain what the breathing looks or sounds like, what the behavior involves, how often it occurs, and whether anyone has been injured. Ask whether the concerns should be evaluated together or through separate steps. If a clinician has already diagnosed OSA, let them know about new or recurring sleep behaviors rather than assuming they are part of apnea.
Keep following the plan prescribed by your treating clinician while you ask questions. Do not change or stop prescribed sleep apnea treatment on your own. If you have an OSA diagnosis and are considering a different treatment approach, discuss the options with your sleep physician. A dental sleep medicine clinician can coordinate with the physician when oral appliance therapy is being considered.
Custom oral appliance therapy is one treatment option for selected patients with obstructive sleep apnea or snoring. A dental sleep medicine practitioner assesses whether an oral device may be appropriate, and the sleep physician remains involved in diagnosis and care coordination. It is not a universal solution, and an appliance should not be treated as a way to diagnose or manage a parasomnia.
Spark Sleep Solutions focuses on dental sleep medicine rather than general dentistry. Dr. Srujal Shah holds dual board certifications, DABDSM and DASBA. The practice coordinates with sleep physicians and can discuss whether a custom oral device may fit an individual’s diagnosed sleep-related breathing condition. Explore oral appliance therapy for sleep apnea or the broader sleep treatment options to learn more.
When you ask about treatment, confirm how the care team coordinates with your diagnosing physician and what follow-up is involved. Ask about medical insurance coverage for your circumstances; coverage depends on the plan and individual eligibility. Treatment is handled through medical insurance rather than dental insurance.
When should you seek medical help?
Arrange a conversation with a healthcare professional when unusual sleep behaviors recur, disrupt sleep, cause injury, or create a safety concern. Also bring up persistent snoring, observed breathing pauses, gasping, or ongoing daytime symptoms with a physician. These observations do not prove sleep apnea, but they can help a clinician decide what evaluation is needed.
Seek urgent medical help if a person is in immediate danger, has a serious injury, or is difficult to wake and has a concerning breathing problem. For less urgent questions, contact the person’s treating clinician and describe what happened. If you are unsure how quickly to seek care, ask a medical professional for guidance.
Frequently asked questions
Does sleep apnea cause sleepwalking?
Not necessarily. Research does not support assuming that OSA causes every parasomnia. Some medical literature identifies untreated OSA as one possible factor that may provoke parasomnias in susceptible people, but unusual behavior needs individual assessment. Share the pattern with a sleep physician.
Can a parasomnia be a sign of sleep apnea?
A parasomnia by itself does not diagnose sleep apnea. Snoring, witnessed breathing pauses, and gasping are separate observations to discuss with a physician. Tell the clinician about both the breathing pattern and the behavior rather than relying on one sign to explain the other.
Should I record an event?
A written record of timing, frequency, and what a witness observed can be useful. If considering a recording, protect the person’s privacy and ask the clinician whether it would help. Do not delay care to collect more information when someone is injured or unsafe.
Can an oral appliance treat parasomnias?
Oral appliances are used for selected cases of obstructive sleep apnea or snoring, not as a general treatment for parasomnias. A sleep physician should evaluate unusual sleep behaviors. If OSA has been diagnosed, the physician and dental sleep medicine clinician can discuss whether oral appliance therapy is appropriate for that breathing disorder.
If you have questions about snoring or diagnosed obstructive sleep apnea, Spark Sleep Solutions can discuss dental sleep treatment and coordinate with your sleep physician, while unusual sleep behaviors should be reviewed with a healthcare professional.