Dyssomnias and Parasomnias in Early Childhood

Abstract

OBJECTIVES. Our aim for this study was to determine the prevalence of dyssomnias and various parasomnias in early childhood and to describe their temporal evolution, gender differences, and correlates.METHODS. This research is part of a longitudinal study of child development. A randomized, 3-level, stratified survey design was used to study a representative sample of infants who were born in 1997-1998 in the province of Quebec (Canada). When the children were 2.5 years of age, 1997 families agreed to be interviewed. The presence of dyssomnias or parasomnias was obtained from a self-administered questionnaire that was completed by the mother at each round of measures.RESULTS. The percentage of children with frequent night wakings decreased steadily from 36.3% at age 2.5 to 13.2% at age 6. Similarly, the percentage of children who had difficulty falling asleep at night decreased significantly from 16.0% at ages 3.5 and 4 to 10% at age 5 and to 7.4% at age 6. The overall prevalence of each parasomnia for the period studied was as follows: somnambulism, 14.5%; sleep terrors, 39.8%; somniloquy, 84.4%; enuresis, 25.0%; bruxism, 45.6%; and rhythmic movements, 9.2%. Persistent somnambulism at age 6 was significantly correlated with sleep terrors and somniloquy. Persistent sleep terrors at age 6 were also correlated with somniloquy. Finally, persistent sleep terrors at age 6 were correlated with frequent night wakings. Separation anxiety was associated with persistent night wakings and with somnambulism, bruxism, sleep terrors, and somniloquy.CONCLUSIONS. There is a high prevalence of night wakings and sleep-onset difficulties in preschool children. Parasomnias are highly prevalent in early childhood and are associated with separation anxiety. However, they have little impact on sleep duration.www.pediatrics.org/cgi

Comments on "sleep terror disorder: a case report"

“…Infection with hepatitis C virus (HCV) is a chronic blood-born disease, with an estimated general prevalence of 1-2.4% 3 . Moreover, this infection affects 10% to 15% of bipolar disorder patients 4 .…”

“…Interferon-alpha treatment is used in combination with ribavirin in order to eradicate HCV infection promoting viral clearance rates of 54% to 56% 4 . Despite these clinical benefit, antiviral treatment of chronic hepatitis C with interferon-alpha is associated with several neuropsychiatric side-effects such as psychosis, major depression, and neuropsychological dysfunction 5 .…”

“…Although current or previous bipolar disorder is still considered a controversial issue for antiviral treatment with interferon-alpha, the ability of these severely mentally ill patients to tolerate side-effects and adhere to HCV treatment has been shown 4 . It has been demonstrated that several factors would influence patient selection for HCV treatment: the clinical course of the bipolar illness, compliance with medications, frequency of previous hospitalizations, and the presence of a functional emotional and psychosocial support system 4 .…”

“…Although current or previous bipolar disorder is still considered a controversial issue for antiviral treatment with interferon-alpha, the ability of these severely mentally ill patients to tolerate side-effects and adhere to HCV treatment has been shown 4 . It has been demonstrated that several factors would influence patient selection for HCV treatment: the clinical course of the bipolar illness, compliance with medications, frequency of previous hospitalizations, and the presence of a functional emotional and psychosocial support system 4 . In addition, some important topics must be continually reinforced by the psychiatric team when treating patients with severe mental illness: 1) the need for education about the potential to achieve the cure of hepatitis; 2) avoidance of liver toxins, including drug abuse; 3) information about the potential occurrence of neuropsychiatric side-effects, including the fact that these can be treatable and reversible.…”

“…The Brazilian Health Ministry Protocol requires that psychiatric patients with chronic hepatitis C should only be treated with interferon if they are in a stable condition, having regular specialist care, and receiving a psychiatric report allowing the treatment 8 . We have to emphasize that not all bipolar patients can be treated for their chronic hepatitis C; only those who are highly motivated and engaged in an intensive psychiatric care program are prepared for antiviral therapy 3,4 . It cannot be forgotten that further prospective, controlled studies, randomized by age, gender, genotype, and psychiatric group are needed to better investigate the presented issues.…”