Terrifying Parasomnias of Childhood Sleep

No parent wants to hear their child at night. It is often a more frightening for the adult than the child, and if it is due to a parasomnia, in most cases the child will not be aware of the event. Parasomnias are common in preschoolers and decrease in young adolescents. Most parasomnias occur in healthy children, but the difference can include neurological, psychiatric, and mental disorders, so careful observation and a good medical history and physical examination are important.

Parasomnias can be divided into those that occur during non-REM (NREM) sleep and rapid eye movement (REM) sleep. NREM parasomnias include sleep horror and sleepwalking. These usually occur during the first trimester of sleep, when the child is in stages of NREM sleep. They are known as partial or confusing arousal because they occur as you transition from deeper stages to lighter stages of NREM sleep. Children who sleepwalk often have parents who did the same thing when they were little. Other sleep disorders such as obstructive sleep apnea and restless legs syndrome can be triggers, as can gastroesophageal reflux, fever, and lack of sleep. Nocturnal seizures can mimic sleep horror and sleepwalking, so particular attention must be paid to parents’ concerns.

Parasomnias that occur during REM sleep include nightmares, sleep paralysis, and REM sleep behavior disorder (RBD). Sleep paralysis is usually seen in young adults and is common in with narcolepsy. RBD is usually seen in older adults over 60 years of age, but can rarely be seen in children.

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Here is a table that might help you distinguish one parasomnia from another:

If these parasomnias are excessive or a seizure is suspected, a sleep expert or neurologist should be consulted. Most of these resolve with time and parental approval. Sleep deprivation in children and teenagers can trigger parasomnias, so make sure the children get enough sleep.


  1. Principles and Practice of Sleep , Sixth Edition.
  2. Kotagal, Suresh. Up to date. Sleepwalking and other parasomnias in children.


Pediatrics insomnia sleep

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