Things That Go Bump in the Night
Many parents have been startled from pleasant dreams to a child who appears emotionally distressed and inconsolable. Others parents can tell stories of a little one getting up from sleep to take a stroll about the house. So, just what is going on?
The above described scenarios represent two relatively common parasomnias, sleep terrors and sleep-walking. Parasomnias are sleep disorders that involve an undesirable behavior or event which occurs during sleep that involves abnormal movements, behaviors, emotions and/or dreams.
The onset age of these disorders is generally from 2-6 years of age, but may be later. Frequently there is a family history of similar episodes in a parent or sibling. Recent studies suggest that, at least in one family, a specific genetic abnormality may be the root of sleep walking.
These sleep related behaviors usually occur in the first third of the night during what has been referred to as slow wave sleep. The initial sign may be a loud scream or moaning. The child may get out of bed and appear to observers to be terrified. Physical signs include rapid heart rate and breathing, dilated pupils and even sweating.
Factors which may trigger an episode of sleep walking or sleep terrors include insufficient or disrupted sleep, stress, some medications or an inter-current illness, especially with fever. Disorders which may be disguised as sleep terrors or sleep walking include nightmare disorder, sleep-related epilepsy, panic disorder or obstructive sleep apnea.
Most cases of sleep terrors and sleep walking require no specific treatment. Children with sleep walking and sleep terrors are generally physically and developmentally normal.
We advise you to take your child to a pediatrician or sleep specialist if these events occur more than a few times a month, become disruptive to the household, involve dangerous or potentially dangerous behavior and/or become associated with daytime sleepiness and abnormal daytime behaviors.