Parasomnias in children

Abstract

The International Classification of Sleep Disorders (ICSD-3) defines parasomnias as “undesirable physical events or experiences that occur during entry into sleep, within sleep, or during arousal from sleep.” The term parasomnia derives from the Greek word para meaning around and the Latin somnus meaning sleep. Parasomnias in childhood are common, more often benign, self-limited and typically resolving in adolescence; they occur either in slow sleep (non-REM) or in paradoxical sleep (REM). To make a diagnosis, it is necessary to clearly identify their characteristics, first by a history as precise as possible and then, if necessary, by a video-polysomnography. Indeed, the differential diagnosis with other events, including epilepsy, is essential. Polysomnography is not always sufficient for the diagnosis and video polysomnography may be indicated to assist in the definition of parasomnias or other sleep disruption, especially when it is not possible for the clinician to identify the etiology of the motor activity in sleep. Misdiagnosis should be avoided and appropriate treatment chosen, if necessary. In this article, we will only review the most common NREM and REM sleep parasomnias in pediatrics; other parasomnias, such as enuresis, will not be discussed. We will attempt to describe their characteristics, pathophysiology and triggering factors, as well as their management.