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Highlights & Basics
- Parasomnias in children are common and may consist of abnormal movements, behaviors, emotions, dream perception, and autonomic activity during transitions between sleep states. They occur from sleep to wakefulness, or during arousals from sleep.
- Non-rapid eye movement (NREM) parasomnias occur most commonly in the first half of the night and include sleepwalking, night terrors, and confusional arousals.
- Rapid eye movement (REM) parasomnias occur later during the night and consist of nightmare disorder, recurrent isolated sleep paralysis, and REM behavior disorder (RBD). The latter is extremely rare in children.
- The most common modifiable triggers for parasomnias in children include sleep deprivation and comorbid sleep disorders. 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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