if you are simultaneously attempting to carry out the dream? l have you ever hurt yourself or your bed partner during sleep? do you sleepwalk or have sleep terrors with loud screaming? do your legs feel restless or begin to twitch a lot or jump around when you are drowsy or sleepy, either at bedtime or during the day? do you eat food or drink fluids without full awareness during the night? do you wake up in the morning feeling bloated and with no desire to eat breakfast? in potentially harmful or disturbing cases a specialist in sleep disorders should be approached. video polysomnographic documentation is necessary only in rem sleep behavior disorder (rbd), since it is an essential diagnostic criteria in the icsd to demonstrate the absence of muscle atonia and to exclude comorbid sleep disorders. for most of the other parasomnias, polysomnographic monitoring is a costly, but still supportive tool in the clinical diagnosis. the use of actigraphy can be promising in the diagnostical assessment of nrem-related parasomnias, for example to rule out sleep deprivation or other sleep disorders, like circadian sleep-wake rhythm disorder which often develops among shift workers. however, there is currently no generally accepted standardized technique available of identifying and quantifying periodic limb movements in sleep (plms) that distinguishes movements resulting from parasomnias, nocturnal seizures, and other dyskinesias. eventually, using actigraphy for parasomnias in general is disputed. treatment parasomnias can be considered as potentially harmful to oneself as well as to bed partners, and are associated with other disorders. children with parasomnias do not undergo medical intervention, because they tend to recover the nrem-related disorder with the process of growth. in those cases, the parents receive education on sleep hygiene to reduce and eventually eliminate precipitating factors. in adults psychoeducation about a proper sleep hygiene can reduce the risk to develop parasomnia. case studies have shown that pharmacological interventions can improve symptoms of parasomnia, however mostly they are accompanied by side-effects. behavioral treatments, i.e., relaxation therapy, biofeedback, hypnosis, and stress reduction, may also be helpful, but are not considered as universally effective. prognosis nrem-related parasomnias which are common in childhood show a good prognosis, since severity decreases with age, the symptoms tend to resolve during puberty. adults with nrem-related parasomnias, however, are faced with a stronger persistence of the symptoms, therefore, full remission is quite unlikely and is also associated with violent complications, including homicide. the variant sleep-related eating disorders is chronic, without remission, but treatable. rem sleep behavior disorder (rbd) can mostly be handled well with the use of melatonin or clonazepam. however, there is high comorbidity with neurodegenerative disorders, that is in up to 93% of cases. the underlying psychopathology of nightmare disorder complicates a clear prognosis. the prognosis for other parasomnias seems promising. while exploding head syndrome usually resolves spontaneously, the symptoms for sleep-related hallucinations tend to diminish over time.