II. Definitions

  1. Parasomnia
    1. Abnormally disrupted sleep
    2. Causes include Sleep Walking, Sleep Talking, Nightmares, Bedwetting, Sleep Apnea or nighttime Seizures

III. Epidemiology

  1. Prevalence: 50% in childhood
    1. Persists into adulthood in 4% of cases

V. Types

  1. Sleep Onset Disorders (or on awakening)
    1. Sleep Paralysis
    2. Restless Legs Syndrome in Children
    3. Hypnagogic Hallucinations
    4. Hypnagogic jerks ("Sleep Starts")
      1. Involuntary Muscle Twitch, jerk or contraction that occurs near sleep onset
      2. Common, normal, physiologic phenomenon
  2. Light Non-REM Sleep Disorders
    1. Bruxism
    2. Periodic Limb Movement Disorder
  3. Deep Non-REM Sleep Disorders in first half of sleep (Sleep-wake transition disorders)
    1. Characteristics
      1. Complex, almost purposeful activity, but detached from environment
      2. Examples: Sits up in bed, appears confused, screams
      3. Difficult to arouse during episode and often returns to sleep without memory of the event
    2. Disorders
      1. Confusional Arousal (Sleep Drunkenness)
      2. Night Terrors (Pavor Nocturnus)
      3. Somnambulism (Sleepwalking)
  4. Parasomnias of REM Sleep in second half of sleep
    1. Characteristics: Child can recall the Nightmare on awakening
    2. Disorders
      1. Nightmares
      2. REM Sleep Behavior Disorder
  5. Nonspecific Parasomnias (may occur at any time of sleep cycle)
    1. Sleep Talking (Somniloquy)
    2. Nocturnal Enuresis

VI. Differential Diagnosis

  1. Nocturnal Seizure

VII. Diagnostics

  1. Polysomnogram Indications
    1. Atypical presentation or significant complications from Parasomnia (e.g. injury)
    2. Suspected specific conditions
      1. Nocturnal Seizures
      2. REM Sleep Behavior Disorder
      3. Obstructive Sleep Apnea in Children
      4. Periodic Limb Movement Disorder

VIII. Management

  1. Consider sleep medicine referral
  2. Reassurance that events are typically self limited and most resolve by teen years
  3. Sleep Hygiene
  4. Manage precipitating conditions
    1. Obstructive Sleep Apnea in Children
    2. Restless Legs Syndrome in Children
    3. Pediatric Reflux
  5. Prevent injury
    1. Lock doors and windows at night
    2. Activate motion alarms
    3. Remove access to knives, firearms and other weapons
    4. Put mattress on the floor
    5. Remove toys and other clutter from the floor before bed

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Related Studies

Ontology: Parasomnia (C0030508)

Definition (NCI_NCI-GLOSS) An abnormal disruption of sleep, such as sleep walking, sleep talking, nightmares, bedwetting, sleep apnea (problems with breathing that cause loud snoring), or nighttime seizures.
Definition (NCI) A group of sleep disorders causing disruption of sleep. Representative examples include nightmare disorders, sleep terror disorders, sleepwalking, and restless leg syndrome.
Definition (MSH) Movements or behaviors associated with sleep, sleep stages, or partial arousals from sleep that may impair sleep maintenance. Parasomnias are generally divided into four groups: arousal disorders, sleep-wake transition disorders, parasomnias of REM sleep, and nonspecific parasomnias. (From Thorpy, Sleep Disorders Medicine, 1994, p191)
Concepts Disease or Syndrome (T047)
MSH D020447
ICD10 G47.5 , G47.50
SnomedCT 58690002
DSM4 307.47
English Parasomnia NOS, Parasomnias, Parasomnia, unspecified, Parasomnias [Disease/Finding], parasomnias, Parasomnia, Parasomnia (sleep disorder), sleep disorder parasomnia, parasomnia (diagnosis), parasomnia, Parasomnia (disorder), Parasomnia, NOS
Italian Parasonnia, Parasonnie, Parasonnia NAS, Parasomnia
Dutch parasomnia NAO, parasomnia, parasomnie, Parasomnia, Parasomnia's
French Parasomnie SAI, Parasomnie, Parasomnies
German Parasomnie NNB, Parasomnien, Parasomnie
Portuguese Parassónia NE, Parassónias, Parassónia, Parassonias
Spanish Parasomnia NEOM, parasomnia (trastorno), parasomnia, Parasomnia, Parasomnias
Japanese 睡眠時随伴症NOS, スイミンジズイハンショウNOS, スイミンジズイハンショウ, 良性新生児睡眠ミオクローヌス, 睡眠時随伴症, 酩酊様睡眠, 新生児睡眠ミオクローヌス-良性, 睡眠時異常行動, 睡眠様昏睡, 錯眠, パラソムニア
Swedish Parasomni
Czech parasomnie, Poruchy spánku, Parasomnie, Parasomnie NOS
Finnish Parasomniat
Russian PARASOMNIIA, NOVOROZHDENNYKH MIOKLONUS DOBROKACHESTVENNYI VO VREMIA SNA, НОВОРОЖДЕННЫХ МИОКЛОНУС ДОБРОКАЧЕСТВЕННЫЙ ВО ВРЕМЯ СНА, ПАРАСОМНИЯ
Croatian Not Translated[Parasomnias]
Polish Parasomnie
Hungarian Parasomnia k.m.n., Parasomniák, Parasomnia
Norwegian Parasomnier