Section 11: Information that Indicates Non-Rapid Eye Movement Sleep Arousal Disorders

DSM-5-TR Code: F51.5   Sleep walking type

Prevalence = 3.6%

DSM-5-TR Code: F51.4   Sleep terror type

Prevalence = 2% - Adults     6% - Children


Common Specifiers:

Can this disorder legitimately be diagnosed by a Master’s level clinician?      No. This disorder, when suspected, calls for a referral to a sleep specialist for diagnosis and treatment. 

These two disorders are concerned with disruptions in the sleep-wake cycle during non-REM stages of sleep: stage 2, 3 or 4 of the sleep cycle. In these deeper stages of sleep, people are difficult to wake and, if awoken, are often confused and groggy. Most people, when in these stages of sleep, may move about in bed in order to shift positions, but will for the most part simply lie there deep asleep. 

A small number of people, however, may move into somewhat strange states of partial waking. They may get out of bed, move about, prepare and eat food, or engage in sexual behaviors. When awakened from these actions, they will not have any memory of their actions, and may be surprised the next morning by the physical evidence of their activities.

This disorder is more common in children (up to 40% - National Sleep Foundation), tends to subside for most people as they move out of childhood, and tends to run in families. Up to 3% of adults may experience this condition, so it is not unlikely that a mental health clinician may treat clients with this disorder.

Because this condition tends to run in families, there appear to be some underlying genetic factors that predispose people to this problem. This condition may separately be triggered by a high fever, alcohol use, and the use of some medications. It may also be triggered by a chronic lack of adequate sleep, so it may accompany sleep apnea. It does not appear to be related to any other kind of underlying mental health condition.

Sleep terrors represent another kind of non-REM sleep problem. The person experiencing this condition has emotional responsiveness similar to a person having a nightmare, accompanied by symptoms of intense autonomic arousal – rapid breathing, increased heart rate, sweating. However, unlike Nightmare Disorder, the person remains asleep, and does not awaken from the nightmare.  The presence of certain neurochemicals that hold people in deeper stages of sleep will still be present. As a consequence, persons who attempt to console and comfort the person will not be responded to until the person is brought into a state of full awakening.