Parasomnias may be easily confused with psychiatric disorders when bizarre motor and/or emotional behavior is mistakenly interpreted as symptomatic of waking aberrance, reports Psychiatric Times.

Underlying the various parasomnias is the fact that NREM sleep, REM sleep, and wakefulness are not mutually exclusive. Behavioral and electrophysiological components of each may separate and recombine in aberrant ways. For example, when concurrent components of NREM sleep and wakefulness occur, there may be variable juxtapositions or oscillations of consciousness, memory, motor, and/or autonomic activation that result in sleepwalking and sleep terrors. Similarly, complex dream enactment behavior can be liberated during spells of RBD in persons with skeletal muscle atonia.