Parasomnias:
sleepwalking and night terrors
Sleep pathology in children

Parasomnias are involuntary, abnormal and annoying events that occur during sleep.

They are not diseases themselves but facts, phenomena, that appear in dreams and reduce their quality. They are more common in childhood, but also extend into adulthood.

Although parasomnias are considered benign, their recognition is important especially when they cause difficult, dangerous or embarrassing situations, both for the person who suffers from it and for those around them.

The behavior is usually simple, without getting out of bed, with simple movements such as sitting, opening the eyes and looking around, with occasional vocalization. There is disorientation and impairment of consciousness. The duration is usually 5 minutes, although they can be longer.

It is a very common disorder between 2-5 years old. The duration of the episode is usually between 5-20 minutes. A typical episode consists of a partial awakening within the first 2-3 hours of sleep, with disorientation in time and space. Children appear confused, may have their eyes open or closed, and may engage in inappropriate behavior.

These are episodes of wandering that are described as routine but inappropriate both at the time they occur and because of their condition, with potential danger, violence and agitation. The eyes are usually open during the episode. There is persistence of impaired consciousness and impaired judgment, making it difficult to awaken the patient during the episode. They generally end up returning to bed or may continue sleeping anywhere.

It is a frequent phenomenon with a peak of maximum incidence between 4-8 years. Es un fenómeno frecuente con un pico de incidencia máxima entre los 4-8 años.

They consist of episodes of intense fear that begin with sudden crying or screaming, accompanied by an intense autonomic component with irregular heart rate, tachycardia, increased respiratory rate and excessive sweating.

It affects approximately 3-15% of children between 4 and 12 years old. They have a maximum peak of appearance between 5 and 7 years, although cases are described before 2 years; Its typical resolution phase is preadolescence. They have a maximum peak of appearance between 5 and 7 years, although cases are described before 2 years; Its typical resolution phase is preadolescence.

It is a sleep disorder in which children consume food and drinks during the night while they are asleep. This may include eating inedible foods, such as chalk or paper, or foods kept in the room, such as candy or snacks.

This disorder can be dangerous as children can choke or suffer digestive problems. It can also cause sleep interruptions and daytime sleepiness.

Nocturnal sleep eating disorder in children usually resolves on its own over time, but may require treatment if it persists for a long period of time or causes health or behavioral problems.

Isolated recurrent sleep paralysis in children is a sleep disorder characterized by the temporary inability to move or speak while sleeping or waking up. This paralysis can last a few seconds or several minutes and is usually accompanied by visual or auditory hallucinations and a feeling of tightness in the chest.

Unlike isolated sleep paralysis, this recurring form occurs frequently and can be very disturbing for the child.

Treatment may include cognitive behavioral therapy and specific sleep medications.

They are dreams that are characterized by being unpleasant or terrifying. An important characteristic of nightmares is that, when the subject wakes up, they are completely oriented and alert, and they have memory of the content of the dream, which is perceived as unreal.

They are very frequent in children (60-75%) as occasional events, they increase in frequency during adolescence. As a defined disorder, it affects approximately 2-6% of pre-adolescent children. The content of the dream and its elaboration depends on the age of the child.

Nightmares can be a natural way of processing normal fears and anxieties in your emotional development. In many cases, these nightmares disappear over time and do not require treatment. However, if nightmares are recurrent and significantly impact the child’s sleep quality and emotional well-being, it is important to seek the opinion of a mental health professional to determine if additional treatment is needed.

It consists of the spontaneous emission of urine during sleep. It is considered normal in children under 5 years of age, with a prevalence of 15 to 25% at this age and 4% at 10 years of age. This shows that it is a normal maturation process of the bladder.

During sleep, a contraction of the masseter, internal pterygoid and temporal muscles frequently occurs, causing an energetic closure of the upper and lower jaw. If it is very intense, the tapping of the teeth can produce a noise or grinding, known as bruxism. This can cause wear of the tooth enamel, dental or jaw pain, alterations of the temporomandibular joint and headache. It is common in childhood, where its prevalence is 14-17%, reducing with age.

They are repeated episodes of sudden, rapid and involuntary movements of the extremities. They usually occur in sequences of 4 or more movements, separated by an interval of 20-40 seconds. They usually affect the lower extremities, and consist of an extension of the first toe, in combination with a partial flexion of the ankle, knee and, sometimes, also the hip. It can also affect the upper limbs.

They usually begin before the ninth month of life and rarely after 2 years of age. They are usually benign and are not associated with any neurological or psychiatric problem. Therefore, parents should not be overly alarmed, but rather informed and reassured. In some cases, steps can be taken to prevent the child from being injured during these movements. If the movements persist beyond 5 years, a neurological and psychiatric evaluation is recommended to rule out other possible causes.