Highlights & Basics
- Parasomnias in children are common and may consist of abnormal movements, behaviors, emotions, and autonomic activity during transitions between sleep states, from sleep to wakefulness, or during arousals from sleep.
- Non-rapid eye movement (NREM) parasomnias include sleepwalking, night terrors, and confusional arousals, that occur most commonly in the first half of the night.
- Rapid eye movement (REM) parasomnias occur later during the night and consist of experiences such as nightmares, recurrent isolated sleep paralysis, and REM behavior disorder (RBD). The latter is extremely rare in children.
- The three most common modifiable triggers for parasomnias in children include sleep deprivation, restless legs syndrome, and obstructive sleep apnea. Treatment of these disorders may significantly reduce or resolve parasomnias in affected children.
- Parasomnias are diagnosed on clinical grounds, based on descriptions from an observer, such as a parent or sibling who may share the bedroom. Ordinarily, a sleep study (diagnostic polysomnogram) is not necessary to establish the diagnosis. However, this test may be ordered when other comorbid primary sleep disorders, such as sleep apnea, are suspected, and it is required for the diagnosis of RBD.
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