Sleep Disorder Treatment
“Why do I have nightmares that feel terrifyingly real?” “What is sleep paralysis—and why do I feel like I can’t move sometimes?” “Why do I act out my dreams?” “Am I the only person experiencing strange things while sleeping?”
If you experience sleep-related conditions beyond insomnia such as nightmare disorder, sleep paralysis, exploding head syndrome, sleep-related hallucinations, or other parasomnias, you’re not alone. Many people experience unusual sleep phenomena that can be distressing, frightening, and disruptive. I specialize in assessing and treating these rare and complex sleep disorders using evidence-based approaches tailored to your specific condition, symptoms, and goals.
About Dr. Sharpless
I am a licensed clinical psychologist with over 20 years of experience assessing and treating sleep disorders ranging from common conditions like insomnia to rarer and unusual parasomnias. I received my Ph.D. in clinical psychology from Pennsylvania State University and completed post-doctoral clinical and research fellowships at the University of Pennsylvania.
I have published extensively on sleep-related conditions. For instance, I published Sleep Paralysis: HIstorical, Psychological, and Medical Perspectives with Dr. Karl Doghramji for Oxford University Press (2015) which contains a cognitive-behavioral therapy manual developed specifically for this condition (CBT-ISP). I have published on exploding head syndrome as well and edited Unusual and Rare Psychological Disorders (2017, Oxford University Press). Along with my research and clinical practice, I provide ongoing consultation to other mental health professionals and conduct workshops on the assessment and treatment of sleep conditions. I also occasionally serve as an expert witness for cases involving certain parasomnias.
What Conditions do I Work With?
I work with individuals who experience:
- Nightmare Disorder — recurrent, distressing nightmares that disrupt sleep and daytime functioning
- Recurrent Isolated Sleep Paralysis — temporary inability to move or speak while falling asleep or waking, often accompanied by hallucinations or a sense of threat
- Exploding Head Syndrome — sudden, loud imaginary noises (explosions, gunshots, crashes) upon falling asleep or waking, without pain, but which may include visual phenomena
- Sexsomnia — sexual behaviors, vocalizations, or arousal that occur during sleep without conscious awareness
- Sleep-Related Hallucinations / Complex Nocturnal Visual Hallucinations — vivid perceptual experiences (visual, tactile, or auditory) that occur while falling asleep, during sleep, or upon waking
- Other Parasomnias (e.g., REM Sleep Behavior Disorder)
NOTE: For individuals whose primary concern is insomnia, please see the Insomnia Treatment page.
What to Expect
The first step is a thorough assessment to understand your specific sleep pattern, the onset and course of your symptoms, any triggers, and how the condition affects your daily life. Because many parasomnias are rare and often misdiagnosed, a careful evaluation is essential to ensure you receive appropriate, evidence-based treatment. I conduct these assessments using the International Classification of Sleep Disorders (ICSD-3) diagnostic criteria.
For sleep paralysis, I use Cognitive-Behavioral Therapy for Isolated Sleep Paralysis (CBT-ISP), a short-term treatment that combines cognitive techniques, relaxation training, and behavioral strategies to reduce fear, prevent episodes, and manage symptoms when they occur. For nightmare disorder, treatment primarily uses an Imagery Rehearsal Therapy model. For other parasomnias, treatment is tailored to the specific condition and may involve behavioral modifications, sleep environment changes, and cognitive or, in certain cases, psychodynamic interventions.
Many people find that targeted, evidence-based treatment produces meaningful improvements in sleep quality, daytime functioning, and overall well-being—even when previous treatment attempts have not been successful. Therapy sessions are available via secure teletherapy across many states (check the status of your home state here), with limited in-person availability in Frederick, MD.
Frequently Asked Questions
Are parasomnias treatable? Yes. While parasomnias can be distressing and often poorly understood, evidence-based psychological and behavioral interventions can significantly reduce symptom severity, frequency, and the distress they cause in many cases.
Is my condition rare? Some parasomnias are more common than you might think but they are often underdiagnosed or misdiagnosed. For example, sleep paralysis is experienced by 8% of the population at least once in their life, but far fewer people are troubled by it or find that it significantly interferes with their life. For other conditions (e.g., sexsomnia), good data on prevalence rates do not yet exist.
Do you diagnose parasomnias as part of treatment? Yes. If a formal diagnostic evaluation would be helpful (for example, to clarify what you are experiencing or to rule out other sleep or psychiatric conditions), I offer dedicated sleep disorder assessment services.
How frequent are the sessions? Most people benefit from weekly sessions.
How long does treatment typically take? This varies depending on the specific condition, severity, your personal motivation, and treatment goals. Some conditions respond more quickly than others. We will discuss realistic timelines during your initial assessment.
Can I reduce or stop sleep medication? This depends on your individual situation. For some people, psychological treatment reduces the need for medication; for others, a combination of medication and therapy works best. It is always important to coordinate carefully with your prescribing physician.
Contact Dr. Sharpless
If you are interested in an evaluation and/or treatment, please contact me here or click the Contact button at the top or bottom of this page.