Understanding Parasomnia: Managing Unwanted Sleep Behaviors in Children

Parasomnia, a sleep disorder, usually refers to unwanted events or behaviors that occur around or during sleep. Parasomnia events include sleepwalking, sleep terrors, confusional arousals, and nightmares.

These are "disorders of arousal" that happen when some parts of the brain are asleep while other parts are awake. They often happen during slow wave sleep, a deep sleep that occurs during the night when the brain is not dreaming. There is more slow-wave sleep earlier in the night, so episodes of parasomnia usually happen in the first third to the first half of the night. The episodes are often short, but can last as long as 30 to 40 minutes. Children's eyes are usually open, but glazed over. They seem confused and are hard to awaken. Children usually do not remember these events or have control over them.

These types of parasomnia are common in childhood. Experiencing parasomnia does not usually mean your child has a psychiatric or psychological concern. Parasomnia can run in families and can be triggered by stress, sleep deprivation (getting less sleep than recommended for a child's age), certain medications, or medical conditions like obstructive sleep apnea.

Types of Parasomnia in Children

Confusional Arousals

During confusional arousals, children will usually sit up in bed and seem confused. They may moan or call out briefly but do not appear fully awake. Up to 17% of children have confusional arousals, and they are most common between the ages of 2 and 5 years.

Sleepwalking

Sleepwalking often starts as a confusional arousal, but when the child gets out of bed, it becomes sleepwalking. Children can have odd behaviors like urinating in a trashcan or complex behaviors like opening the front door and leaving the house. You may find the child back in bed after sleepwalking or in another location. About 18% of people will have sleepwalking at some point in their life. Sleepwalking typically improves as children get older.

Sleep Terrors

Sleep terrors, also known as night terrors, can be very frightening to witness. Children often scream or cry out and look scared. Sometimes children can look flushed and experience sweating, dilated pupils, quicker heartbeat, and breathing. Even though your child may appear scared, they often will not respond when someone tries to comfort them. Sleep terrors are most common between the ages of 4 and 12 years.

Nightmares

Nightmares are intense, frightening dreams that can cause the child to wake up in distress. Unlike sleep terrors, children who experience nightmares are usually able to recall the frightening dream and are fully awake. Nightmares are more common in children than sleep terrors and often occur during the REM (rapid eye movement) stage of sleep, which is when most dreaming occurs.

The key difference between sleep terrors and nightmares is that sleep terrors occur during the deep, non-REM stages of sleep, while nightmares happen during the lighter, REM stages of sleep. Additionally, children with sleep terrors are not fully conscious and cannot be easily comforted, while children with nightmares are usually able to recall the dream and be consoled.

Treatment of Parasomnias

While most parasomnias are not harmful and do not require specific treatment, the following strategies can help manage and reduce episodes:

Ensure Quality Sleep: Maintain a consistent sleep schedule and bedtime routine to improve sleep quality.

Address Underlying Triggers: Identify and address any sources of stress, sleep deprivation, or medical conditions contributing to the behavior.

Create a Safe Sleep Environment: Ensure the child’s sleeping area is free of hazards to prevent injuries during sleepwalking episodes.

Avoid Waking During Episodes: Do not wake the child during a parasomnia episode, as this can prolong their confusion.

Provide Comfort After Episodes: Offer gentle reassurance after an episode without engaging with the content of the parasomnia.

In some rare cases, medication may be prescribed if the parasomnia significantly affects the child’s daily life.

At The Restful Sleep Place, we offer specialized support for children with parasomnias. Our team evaluates children for underlying triggers and provides comprehensive strategies to manage these sleep disruptions.

Schedule an Appointment Today

If your child is struggling with parasomnia or other sleep challenges, we are here to help. Contact The Restful Sleep Place to schedule an appointment and receive personalized guidance. Together, we can ensure restful nights for your family.

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