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Parasomnias in children

Parasomnien im Kindesalter

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Zusammenfassung

Die internationale Klassifikation der Schlafstörungen (lCSD-2) definiert Parasomnien als unerwünschte physische Ereignisse oder Empfindungen, die beim Einschlafen, während des Schlafes oder beim Erwachen aus dem Schlaf auftreten. Parasomnien sind in der Kindheit häufig, meist gutartig und verschwinden im Jugendalter wieder. Jedoch ist die Differentialdiagnose oft schwierig in Bezug auf eine Abgrenzung gegenüber epileptischen und nicht-epileptischen Ereignissen im Schlaf.

Die Polysomnographie reicht oft nicht zur Diagnose aus, und eine Video-Polysomnographie kann erforderlich sein, um Parasomnien von anderen Schlafstörungen zu unterscheiden, die durch Anfälle verursacht sein können. Dies ist insbesondere dann erforderlich, wenn es nicht möglich ist, die Ätiologie der motorischen Störung im Schlaf zu erkennen.

Das korrekte Erkennen der Parasomnien ist wichtig, um Fehldiagnosen zu vermeiden und eine angemessene Therapie zu wählen. Wir stellen hier die Hauptformen der kindlichen Parasomnien in drei Gruppen dar: 1) Aufwachstörungen (aus dem NREM Schlaf) 2) assoziierte Parasomnien 3) andere Parasomnien.

Künftige Studien müssen die Genetik, die Pathophysiologie, die auslösenden Faktoren und die Zusammenhänge zwischen NREM Schlafstruktur und dem Auftreten der parasomnischen Ereignisse klären.

Summary

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.

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Authors and Affiliations

  1. Center for Pediatric Sleep Disorders, Dept. of Developmental Neurology and Psychiatry University of Rome "La Sapienza", Via dei Sabelli 108, 00185, Rome, Italy

    O. Bruni MD & L. Novelli PhD

  2. Dept. of Paediatrics, University of Padua, Padua, Italy

    E. Finotti MD

  3. Sleep Research Centre, Dept. of Neurology, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy

    R. Ferri MD

Authors
  1. O. Bruni MD
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  2. E. Finotti MD
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  3. L. Novelli PhD
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  4. R. Ferri MD
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Correspondence to O. Bruni MD.

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Bruni, O., Finotti, E., Novelli, L. et al. Parasomnias in children. Somnologie 12, 14–22 (2008). https://doi.org/10.1007/s11818-008-0329-9

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