Parasomnias in children

The International Classification of Sleep Disorders (ICSD-2) defines parasomnias as "undesirable physical events or experiences that occur during entry into sleep, within sleep, or during arousal from sleep." Parasomnias in childhood are common, more often benign, self-limited and typically resolving in adolescence. However, for the diagnosis it is often difficult to distinguish between other epileptic and/or non-epileptic events during sleep. 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 thought to be seizure related or in a presumed parasomnia, especially when it is not possible for the clinician to identify the etiology of the motor activity in sleep. The correct recognition of parasomnias is important to avoid misdiagnosis and to choose the appropriate treatment, when needed. We review here the main form of childhood parasomnias divided into three groups: 1) disorders of arousal (from NREM sleep); 2) parasomnias usually associated with REM sleep; 3) other parasomnias. Further studies are needed to elucidate the genetics, the pathophysiology and the triggering factors and also to clarify the relationship between NREM sleep structure and the occurrence of the episodes. © 2008 Steinkopff-Verlag.