Non-Rapid Eye Movement Arousal Parasomnias in Children

Abstract

Parasomnia is a common pediatric sleep disorder that can cause parents or caregivers distress when experienced by their children. Based on the International Classification of Sleep Disorders , parasomnias can be divided into two subgroups: non-rapid eye movement (NREM) parasomnias and rapid eye movement (REM) parasomnias. REM sleep parasomnias include nightmares, REM behavior disorder, and sleep paralysis, whereas NREM sleep parasomnias include disorders of arousal such as confusional arousals, sleepwalking, sleep talking, night terrors, and sleep-related eating disorder. This review focuses on the epidemiology, clinical presentation, diagnosis, and treatment of the most common form of parasomnias—NREM arousal parasomnias. Additionally, this review aims to help clinicians distinguish NREM parasomnias from nocturnal frontal lobe seizures, as this distinction is important to avoid diagnostic delays and inappropriate medication exposure. [ Pediatr Ann . 2017;46(9):e327–e331.]

Triggers and Diagnosis of Parasomnias in Children –A Review

“…Parasomnias are categorised into two subgroups based on the International Classification of Sleep Disorders: non-rapid eye movement (NREM) parasomnias and rapid eye movement (REM) parasomnias. Nightmares, REM behaviour disorder, and sleep paralysis are examples of REM sleep parasomnias, whereas NREM sleep parasomnias include arousal disorders such as confusional arousals, sleepwalking, sleep talking, night terrors, and sleep-related eating problem [32].…”

Комплексна Корекція Розладів Засинання Та Сну У Дітей В Умовах Воєнного Стану

“…Перш за все депривація сну негативно впливає на матерів -у них відмічається підвищений рівень тривожності та депресії. Ключ до розв'язання цієї проблеми -навчити дитину засинати самостійно [6][7][8].…”

Diagnosis and Management of NREM Sleep Parasomnias in Children and Adults

“…During SW, patients leap out of bed and wander about the room or the house, or more rarely, may even walk outside. SW patients may perform routine activities like dressing, washing, preparing for school, urinating (sometimes at inappropriate locations), but can also engage in more dangerous actions like moving the furniture, manipulating sharp objects, or jumping out a window [ 1 , 11 , 12 , 13 , 14 , 15 ]. Prolonged cases associated with sleep driving have been described [ 16 ].…”

“…DoA treatment remains based on the following general mainstays: reassurance regarding the absence of other associated severe neuropsychiatric conditions and the possible spontaneous resolution with age [ 15 , 91 ]; instruction to parents/bed partners to refrain from interacting with/trying to awake the patient (to avoid worsening or lengthening the episodes or violent reactions by patients) [ 9 ]; education on sleep hygiene (e.g., regular sleep-wake routine, quiet and dark bedroom environment, avoidance of sleep deprivation, or of excessive alcohol intake) [ 31 , 92 ]; specific instructions for environmental safety (removal of firearms or other weapons from home, removal of any bedside object or furniture that could cause injuries, installation of bedroom door/window/stairway alarms or locks, sleeping on the ground floor) [ 93 ]; treatment of sleep comorbidities, especially sleep apneas—even when very mild [ 94 ]—and periodic leg movements [ 95 ]; identification and removal of presumed inducing pharmacological agents (meaning almost all psychotropic medications, as well as many other drug classes, introduced in temporal association with the beginning of DoA symptoms [ 31 ]). …”