Parasomnias are a group of sleep-related disorders of arousal that typically occur around or during sleep. They are categorized by sleep stage (i.e., REM vs. non-REM). Common triggers include sleep deprivation, certain medications, increased stress or anxiety, and other sleep disorders such as obstructive sleep apnea and restless leg syndrome. Parasomnias are usually diagnosed based on clinical history, but REM behavior disorder requires an additional polysomnographic study to confirm the loss of muscle atonia during REM sleep. Ruling out other medical conditions that may contribute to the symptoms is also necessary for a definitive diagnosis. Management involves optimizing comorbid conditions, removing offending triggers, ensuring environmental safety, improving sleep hygiene, and, in severe cases, utilizing pharmacologic interventions.