I have had two first trimester pregnant patients in the last week with what sound like parasomnias. The first presented with recurrent nightmares which began at around 4 wks gestation, wake her from sleep and prevent her from falling back asleep. Daytime naps are not affected; she reports no meds other than prenatal vitamins and denies the use of drugs, alcohol, nicotine or caffeine. The second woman presented to the ER at 6 wks complaining of severe pains in her upper body when waking from sleep, causing her to thrash and scream, and only relieved by pouring hot water over herself and liberal use of marijuana. These states take several hours to pass and have destroyed her rest, as she is now terrified to fall asleep. The symptoms are less vivid after daytime naps. Neither woman admits to a history of mental illness, seizure disorder, trauma or prior sleep problems. Pregnancy can lend itself to sleep disorders and may increase the amount of time spent in REM sleep; the increased amount of B vitamins may also play a role. I am open to any and all suggestions for both etiology and treatment, as prazosin is not well studied in early pregnancy.