Parasomnias of childhood.
OBJECTIVE
To enhance the ability of the practitioner to diagnose and manage children with parasomnias in the office setting.


RESULTS
Over 80% of preschool-age children experience parasomnia events. Instability in the regulation of sleep continuity might underlie sleep walking, sleep terrors, and confusional arousals. Catathernia or nocturnal groaning is a parasomnia that is recognized in adults but frequently has onset during childhood.


CONCLUSIONS
Common childhood parasomnias such as hypnic starts, rhythmic movement disorder, sleep paralysis, confusional arousals, sleepwalking, sleep terrors, enuresis, and nightmares are discussed. These events may lead to significant concern and worry for the parents. Most parasomnias are recognizable by history alone, but some may require nocturnal polysomnography for accurate diagnosis and determining an underlying trigger factor. Findings on nocturnal polysomnography are described. Sleep terrors, confusional arousals and sleepwalking may mimic seizures; distinguishing seizures from parasomnias is discussed. There is a genetic predisposition to many childhood parasomnias. Management techniques, including behavioral therapy, are reviewed. Unfortunately, evidence-based recommendations are as yet unavailable. The management of sleep enuresis continues to remain a significant challenge.
Kotagal
Suresh
S
Division of Child Neurology and the Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota, USA. kotagal.suresh@mayo.edu
D001521:Behavior Therapy / Q000379:methods; D002675:Child, Preschool; D020022:Genetic Predisposition to Disease; D006801:Humans; D020447:Parasomnias / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy*; D017286:Polysomnography / Q000379:methods