Parasomnia is quite common in children. This medical term means various sleep disorders of psychogenic origin. Parents often face a situation where the baby is disturbed by night terrors, unpleasant dreams, and enuresis. What is the reason for such disorders? And how to deal with them? These and other questions are discussed in the article.
What is this?
The word "parasomnia" in Greek means "near sleep". This general term refers to various disorders of the regulation of the processes of inhibition and excitation in the brain. They occur during sleep, as well as when falling asleep, or after waking up. Doctors distinguish more than 20 types of such deviations. In medicine, the concept of "sleep disorder" is also used.
In childhood, the following forms of parasomnia are most common:
- confusion after waking up;
- somnambulism (sleepwalking);
- night terrors;
- nightmarish dreams;
- nighturinary incontinence;
- grinding teeth while sleeping (bruxism).
It is important to remember that the above manifestations can be symptoms of various diseases. This is not included in the concept of "parasomnia". This term refers only to those sleep disorders that are not associated with organic pathologies.
Symptoms and treatment of parasomnia in children depend on the type of sleep disorder. Further, in more detail about the clinical manifestations of these disorders and methods of correction.
Mechanism of occurrence
During the day, a person has the following functional states of the cerebral cortex:
- Wakefulness. This period is characterized by high activity of the brain and muscular system. In this state, a he althy person spends most of the day.
- The phase of slow sleep. Occurs immediately after falling asleep. It is characterized by a sharp decrease in brain activity. In this phase, vivid and memorable dreams occur very rarely. The person is fast asleep and very difficult to wake up.
- REM sleep. During this period, a person's breathing and heartbeat become more frequent, movements of the eyeballs are noted. Sleep is less deep than in the slow phase. Often there are dreams that a person usually remembers.
All these states are characterized by changes in the activity of the cerebral cortex, respiration and muscles. These processes are regulated by the central nervous system. When a person sleeps, he constantly alternates between slow-wave sleep and fast sleep.
The child is often mixedthe above functional states. For example, the cerebral cortex remains active during sleep. This causes somnambulism, nightmares, fears and other disorders.
There are times when the baby is already awake, but his nervous system is still in a sleepy state. As a result, after waking up, the child appears confused.
Parasomnia in children occurs due to the immaturity of the central nervous system. In a child, the neuroregulation of the processes of inhibition and excitation works less than in an adult. In childhood, sleep disorders are noted quite often.
Reasons
Let's consider the main causes of parasomnia in children:
- Infectious pathologies. In diseases accompanied by fever, babies often have nightmares and fears. This is due to the general intoxication of the body. In some cases, parasomnia may persist after recovery.
- Emotional stress. If a child experiences stress during the daytime, then the process of excitation predominates in the cerebral cortex. Due to the immaturity of the central nervous system, inhibition is delayed. This condition can continue during sleep, leading to sleepwalking and nightmares.
- Violations of the daily routine. If the child sleeps little, goes to bed late and gets up early, then he often has parasomnias. This is due to the lack of proper rest. A sudden change in the time zone can also provoke sleep disorders.
- Heredity. In more than half of the cases, parasomnia was noted withoutonly in children, but also in parents.
- Eating at night. If the child ate a lot in the evening, then he may experience sleep disorders. The digestive tract needs to digest food, because of this, the process of inhibition in the nervous system is delayed.
- Taking drugs. Some medications interfere with sleep phases. This may cause the child to have nightmares and fears.
ICD code
Most types of parasomnia according to ICD-10 are included in the group of diseases united under the code F51 ("Sleep disorders of non-organic etiology"). So, sleep disorders are classified, which are not a symptom of any disease, but exist independently.
We give codes for the most common types of parasomnia in childhood:
- somnambulism - F51.3;
- night terrors - F51.4;
- nightmares - F.51.5;
- confusion after waking up - F51.8.
Exceptions are bruxism and nocturnal enuresis. Teeth grinding during sleep is considered a somatoform disorder. So called disorders of psychogenic etiology, occurring with somatic manifestations. Bruxism code - F45.8.
With regard to bedwetting, the ICD-10 defines this disorder as an emotional disorder. Enuresis code of inorganic origin - F98.0.
Confusion after sleep
Confusion after waking up is one of the symptoms of parasomnia in children. This manifestation is most common in the ageup to 5 years.
This disorder is very frightening for parents, because the child's behavior looks very strange and unusual. Immediately after waking up, the baby has the following pathological signs:
- detached facial expression;
- lack of response to parents' requests;
- slurred and slow speech;
- answers to questions out of place;
- inadequate arousal;
- disorientation in space.
Parents have the feeling that the child has opened his eyes, but still continues to remain in the world of dreams. All attempts to calm the baby only aggravate the situation. At this point, the child's nervous system is partially in the sleep phase. This state lasts 5-25 minutes. It does not pose a particular danger to the baby. Confusional episodes usually resolve after age 5.
Sleepwalking
Sleepwalking (sleepwalking) occurs in 17% of children. Adolescents 12-14 years old are more likely to suffer from this disorder. The child is sleeping, but his muscular system is not resting, but is in an excited state. This causes sleepwalking.
This disorder is accompanied by the following symptoms:
- The child jumps up during sleep, or walks around the room.
- Children may perform various unconscious actions in this state (such as getting dressed or picking up objects).
- There is no reaction to the appeal, as the brain is in a state of sleep.
- Eyes can be opened, the look becomes "glassy". Some little somnambulists walk with closedeyes and at the same time orient themselves in space.
The next morning the child does not remember his walking during sleep. Attacks of sleepwalking do not affect the well-being of children in any way. However, there is a greater risk of injury while sleeping.
Night terrors
Usually, night terrors occur in children in the first few hours after falling asleep. Such a violation is most often observed at the age of 2-6 years. Boys are more susceptible to this disorder.
During the night fear, the child makes sudden body movements and wakes up. He looks extremely agitated, constantly crying and screaming. All attempts at reassurance end in failure. Children in this condition may act aggressively or injure themselves. They are disoriented and do not respond to the words of their parents.
This condition is accompanied by severe vegetative symptoms: nausea, vomiting, tachycardia, excessive sweating. The episode lasts from 15 to 40 minutes. Then the child falls asleep again, and in the morning does not remember anything.
Nightmares
Children often have very unpleasant and vivid dreams. Nightmares usually appear during REM sleep in the late morning. The child cries out or utters separate phrases and words when sleeping. Sometimes during a nightmare it can be very difficult to wake up.
Dreams are vivid and very disturbing. They contain scenes of chase, assault, violence and other dangers. In the morning the child can detailtalk about what you saw in a dream. Children with nightmares look very frightened when they wake up. They often cry when recounting the content of their nightmares.
Parents sometimes have a hard time distinguishing night terrors from nightmares. In the video below, you can see the opinion of Dr. Evgeny Olegovich Komarovsky about parasomnia in childhood. Renowned pediatrician explains in detail the difference between night terrors and unpleasant dreams.
Enuresis at night
Bedwetting occurs in children older than 5 years. At this age, the child can already control the urination reflex. Normally, children wake up immediately when they need to go to the toilet during sleep.
If the child suffers from nocturnal enuresis, then he cannot wake up during the urge to urinate. Most often this occurs during deep sleep.
In such cases, you can not shame the child. He cannot control the process of urination during a sound sleep. This disorder is very often associated with stress during the day.
In some cases, bedwetting can be a symptom of various diseases of the excretory organs and the nervous system. Only a doctor can distinguish enuresis with parasomnia from the symptoms of organic pathologies.
Bruxism
Teeth grinding during sleep is also a symptom of parasomnia. This is a fairly common disorder. With this violation, the child in a dream strongly compresses his jaw and grinds his teeth. In the morning, children usually complain of pain inoral cavity. No other pathological signs are noted.
Most often, bruxism is a reaction to stress. In this case, the child may experience difficulty falling asleep or increased drowsiness. This type of parasomnia in children can cause dental diseases: abrasion of tooth enamel, caries and gum disease.
Diagnosis
In case of sleep disorders, it is necessary to undergo an examination and consultation with various specialists: a pediatrician, a pediatric neurologist and a psychiatrist. After all, the manifestations of nocturnal parasomnia are often similar to the symptoms of organic diseases.
The doctor conducts a survey of the child's parents in order to identify the frequency and nature of sleep disorders, the duration of episodes, as well as hereditary predisposition. Parents are encouraged to monitor their child's behavior during sleep and record any disorders in a special diary.
To establish the nature of parasomnia, polysomnography is prescribed. This test is done while the baby is sleeping. With the help of a special device, brain activity, muscle tension and breathing during sleep are recorded.
It is very important to distinguish manifestations of parasomnia from epilepsy and other organic pathologies of the central nervous system. For this purpose, an electroencephalogram, MRI of the brain and dopplerography of the vessels of the head are prescribed.
If the child suffers from nocturnal enuresis, then kidney and bladder function should be examined to exclude urological diseases.
Therapy
For the successful treatment of parasomnia, it is necessary to normalize the daily routine. In the second half of the day, the child should be given only light food. Sleep should be at least 9-10 hours at night, and about 1-2 hours during the day. Children with sleep disorders need high physical activity in the morning and afternoon, and quiet time in the evenings.
With the help of entries in the diary, you can track: at what time the child most often has sleep disorders. Doctors recommend waking your child 10 to 15 minutes before a suspected parasomnia episode and then putting them back to sleep. This is especially necessary for nocturnal enuresis.
Behavioral correction is also applied. The child needs to visit a child psychotherapist. The doctor will conduct classes with the baby or teenager aimed at relieving emotional stress. At home, parents can use special evening rituals. It can be a relaxing bath, drinking tea from soothing herbs, gymnastics at a slow pace. Such activities enhance the processes of inhibition in the central nervous system before bedtime.
In many cases, medical treatment of parasomnia in children is necessary. Typically, a child is given herbal sedatives:
- "Persen";
- valerian extract (tablets);
- herbal remedies with mint or motherwort.
Tranquilizers are rarely prescribed for children. The body quickly gets used to such drugs. Used for severe sleep disorderspreparations "Fenibut" and "Phezam". They do not belong to the classic tranquilizers, but are nootropic drugs with an additional sedative effect. These are prescription drugs that should only be given to a child on the advice of a doctor.
Physiotherapeutic methods of treating parasomnia in children are also used: electrosleep, massage, baths with decoctions of sedative herbs. Such procedures are especially useful in the afternoon.
Forecast
In the vast majority of cases, normal sleep in children is restored fairly quickly after treatment. In addition, with age, the child's nervous system strengthens, and sleep disorders disappear.
If the parasomnia becomes protracted, then it is necessary to examine the child's he alth in more detail. In this case, sleep disorders may be a sign of neurological or psychiatric pathologies.
Prevention
How to prevent parasomnia in children? Pediatricians give the following recommendations:
- It is necessary to strictly observe the optimal regime of the day. The child needs to go to bed and wake up at the same time.
- We must not allow overwork and lack of sleep. Children should sleep at least 10-12 hours a day.
- Don't give your baby heavy or hard-to-digest food at night.
- It is very important to protect the child from stress. It is necessary to completely exclude watching scary movies and unpleasant TV shows. Parents should not allow quarrels in front of children. A child suffering from sleep disorders should be treated verycarefully.
- At the later time of the day, excessive physical activity of the child should not be allowed. Outdoor games and sports activities in the evening cause overexcitation of the nervous system.
- It is good to give your baby a glass of warm milk at night. This will help normalize sleep.
Such measures will help minimize the risk of developing parasomnia. Every parent needs to listen to these doctors' advice. After all, he althy and sound sleep is very important for a child.
