title: Childhood parasomnia--a disorder of sleep maturation?
abstract: BACKGROUND
  Childhood parasomnias are believed to be a benign disorder due to immaturity of some neural circuits, synapses and receptors. The aim of our study was to explore a possible connection with other neurological developmental disorders.
  
  
  METHODS
  72 children (mean age 9.9 ± 5.0 years, 47 boys) were clinically examined and 88 nocturnal v-PSG and 22 v-EEG recordings were evaluated. The most frequent diagnostic findings were: sleepwalking in 24 children, confusional arousal in 21, sleep terror in 8, groaning and enuresis each in 7, non-specific arousal disorder in 4 patients, and REM-related parasomnia in only one child. For statistical evaluation chi-square test, the two-sample t-test and Mann-Whitney rank test were used.
  
  
  RESULTS
  Perinatal risk history was found in 38% of the cohort. Developmental disorders were diagnosed in 30 children (41.7%), more frequently in combinations with: attention-hyperactivity disorder (30.6%), dyslexia and dysgraphia (13.9%), developmental dysphasia (9.7%), mild motor and/or intellectual dysfunction (6.9%). Abnormal movements in sleep, some of them also regarded as developmental, were diagnosed in 37 children (51.4%). Sleep-related breathing disorders were found in 29 patients (40.3%) -snoring (29.2%) and/or sleep apnea (11.1%). Only 16.7% had no comorbidity. Most of the children (60%) showed 2 or 3, exceptionally up to 5 comorbidities. Children, in whom no parasomnia was found in close relatives, had a mild but non-significant earlier onset of the disease (4.4 ± 4.0 against 6.3 ± 4.3 years).
  
  
  CONCLUSIONS
  Childhood parasomnias are frequently associated with perinatal risk factors and developmental comorbidities, and can be regarded as a disorder of sleep maturation.
authors.affiliation: Department of Neurology, Charles University, 1st Faculty of Medicine and General Teaching Hospital, Katerinska 30, 128 00 Prague 2, Czech Republic. Electronic address: snevsi@LF1.cuni.cz.
authors.forename: Sona
authors.initials: S
authors.lastname: Nevsimalova
authors.forename: Iva
authors.initials: I
authors.lastname: Prihodova
authors.forename: David
authors.initials: D
authors.lastname: Kemlink
authors.forename: Jelena
authors.initials: J
authors.lastname: Skibova
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D020447:Parasomnias / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors
keywords: Childhood parasomnias; Developmental and sleep comorbidities; Etiology; Perinatal risk factors