Sleepwalking and other parasomnias in children
- Suresh Kotagal, MD
Suresh Kotagal, MD
- Professor of Neurology, Mayo Clinic
- Consultant in Neurology, Pediatrics, and Sleep Medicine
Parasomnias are episodic behaviors that intrude onto sleep. Sleep quality generally remains unaffected, but the events lead to significant worry for the parents or the patient. The events are most common in preschool-aged children, and they gradually decrease in frequency over the first decade of life . The events may mimic sleep-related epileptic seizures; thus, it is important to understand their clinical and sleep laboratory diagnostic features. Sometimes parasomnias are isolated symptoms in an otherwise healthy child, while on other occasions they coexist with neurologic, psychiatric, or medical disorders. This article provides an overview of common parasomnias of childhood.
Parasomnias involve relatively complex behaviors. Simpler and stereotyped movements are categorized as sleep-related movement disorders. These include restless legs syndrome, periodic limb movements of sleep, sleep-related bruxism, and sleep-related rhythmic movement disorder, and are discussed in separate topic reviews. (See "Sleep-related movement disorders in childhood" and "Restless legs syndrome/Willis-Ekbom disease and periodic limb movement disorder in children".)
Most studies of parasomnias in childhood have provided cross-sectional data. There are few longitudinal studies.
Young children (aged 2.5 to 6 years) were evaluated in a large study in Quebec, Canada . Parasomnias were ubiquitous: 88 percent of the cohort manifested at least one parasomnia during the study period. Parasomnias or other sleep-related movements were noted at the following frequencies:
●Sleep terrors – 40 percent
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- DISORDERS OF AROUSAL FROM NON-RAPID EYE MOVEMENT (NREM) SLEEP
- Clinical features
- - Confusional arousals
- - Sleep terrors
- - Sleepwalking
- Differential diagnosis
- - Investigations
- - General strategies
- - Medical/surgical strategies
- - Behavioral measures
- PARASOMNIAS USUALLY ASSOCIATED WITH RAPID EYE MOVEMENT (REM) SLEEP
- - Management
- REM sleep behavior disorder (RBD)
- - Parasomnia overlap disorder
- Sleep paralysis
- OTHER PARASOMNIAS
- Sleep enuresis
- SLEEP-RELATED MOVEMENT DISORDERS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS