Sleepwalking type: F51.3
Sleep terror type: F51.4
Non-rapid eye movement (NREM) sleep arousal disorders are part of a cluster of diagnoses called the sleep-wake disorders. Sleep-wake disorders are a group of psychiatric conditions that include:
These disorders are broadly characterized by disruptions in sleep and wakefulness. Individuals with insomnia disorder have frequent difficulty falling asleep or staying asleep. Individuals with hypersomnolence disorder feel excessively sleepy during the day, despite obtaining what for most people would be a full night of sleep. Individuals with parasomnias such as non-rapid eye movement sleep arousal disorders and nightmare disorder experience unusual behaviors while sleeping, such as sleep walking, or vivid and disturbing dreams or night terrors.
Some sleep-wake disorders, including insomnia disorder and hypersomnolence disorder, are associated with disturbances in the amount of time the individual spends asleep (too much or too little) or the times at which the individual sleeps (often outside of the desired sleeping window). Other disorders, such as the parasomnias, are not associated with disturbances in the quantity or timing of sleep per se, but are instead associated with behavioral disturbances during sleep or frequent highly distressing dreams.
NREM sleep arousal disorders, also called parasomnias, affect approximately 2 - 14% of children.
Although parasomnias can take several forms, a child is typically diagnosed with a NREM sleep arousal disorder when he or she experiences one of the following on a regular basis:
Individuals who experience sleepwalking or night terrors remember little or nothing of these episodes, including any dreams that may have occurred.
Occasional parasomnias are very common in young children and are often outgrown by middle childhood. Therefore, NREM sleep arousal disorders are diagnosed and treated only when the parasomnias occur repeatedly and cause clinically significant distress or impairment.
NREM sleep arousal disorders can range in severity from mild to severe. In severe cases, NREM sleep arousal disorders can adversely impact relationships with significant others and lead to negative consequences for the child or family members, particularly if the individual engages in behaviors that may put others at risk (e.g., sleep-related violent or sexual behavior).
NREM sleep arousal disorders can also lead to sleep avoidance (particularly in the case of night terrors) or impaired concentration during the day. NREM sleep arousal disorders often occur in isolation, but can co-occur with other psychological disorders, including major depressive disorder and obsessive-compulsive disorder.
NREM sleep arousal disorders are thought to stem from abnormalities in sleep architecture, including deeper sleep, greater occurrence and fragmentation of slow-wave sleep, and alterations in delta activity during sleep, which give rise to the disorder. Parasomnias are thought to increase in frequency following the consumption of alcohol and other substances, in response to lights or noises, and when the individual is experiencing stress. Parasomnias appear to have a genetic component, although having a genetic predisposition toward parasomnias does not necessarily mean that the individual will develop a parasomnia.
Few studies have investigated treatments for NREM sleep arousal disorders in children and no published guidelines are available.
However, the following treatments have shown some promise for reducing the occurrence of one or more parasomnias in children:
However, the following treatments have shown some promise for reducing the occurrence of one or more parasomnias in children: