Parasomnia in children is quite common. This medical term means various sleep disorders of psychogenic origin. Parents often encounter a situation where the baby is worried about nightly fears, unpleasant dreams, enuresis. What is the reason for such disorders? And how to deal with them? These and other issues are discussed in the article.
What it is?
The word "parasomnia" in Greek means "near sleep." This general term refers to various disorders in the regulation of the processes of inhibition and excitation in the brain. They occur during sleep, as well as falling asleep, or after waking up. Doctors distinguish more than 20 types of such deviations. The term “sleep disturbance” is also used in medicine.
In childhood, the following forms of parasomnia are most often found:
- confusion after awakening;
- somnambulism (sleepwalking);
- nightly fears;
- nightmares;
- bed-wetting;
- gnashing of teeth in a dream (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 sleep disorders that are not associated with organic pathologies.
Symptoms and treatment of parasomnia in children depend on the type of sleep disturbance. Further in more detail about the clinical manifestations of these disorders and methods of correction.
Mechanism of occurrence
During the day, the following functional states of the cerebral cortex are observed in humans:
- Wakefulness. This period is characterized by high activity of the brain and muscle system. In this state, a healthy person spends most of the day.
- The phase of slow sleep. It occurs immediately after falling asleep. It is characterized by a sharp decrease in brain activity. In this phase, vivid and memorable dreams arise very rarely. The person is fast asleep, and it is very difficult to wake him up.
- REM sleep phase. During this period, a person's breathing and heartbeat become more frequent, eyeball movements are noted. Sleep is less deep than in the slow phase. Often there are dreams that a person usually remembers.
All these conditions 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 is sleeping, then he constantly alternates the phases of slow sleep and fast sleep.
In a child, the above functional conditions are often mixed. For example, the cerebral cortex continues to remain active during sleep. This causes somnambulism, nightmares, fears and other disorders.
There are times when the baby has already woken up, but his nervous system still remains in a sleepy state. As a result, after awakening, the child appears confused.
Parasomnia in children occurs due to the immaturity of the central nervous system. In a child, neuroregulation of the processes of inhibition and excitation works weaker than in an adult. In childhood, sleep disturbances are noted quite often.
Causes
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 general intoxication of the body. In some cases, parasomnia may persist after recovery.
- Emotional stress. If the child experiences stress during the daytime, then in the cerebral cortex the excitation process prevails. Due to the immaturity of the central nervous system, inhibition is delayed. This condition can continue during sleep, which leads to sleepwalking and nightmares.
- Violations of the regime of the day. If the child sleeps little, lies down late and gets up early, then he often has parasomnia. This is due to the lack of good rest. A sudden change in time zone can also provoke sleep disorders.
- Heredity. In more than half of cases, parasomnia was noted not only in children, but also in parents.
- Eating at night. If the child ate plentifully in the evening, then he may experience sleep disorders. The organs of the gastrointestinal tract need to digest food, because of this the process of inhibition in the nervous system is delayed.
- Acceptance of drugs. Some medications interfere with phase changes in sleep. Because of this, nightmares and fears can bother you.
ICD code
Most types of parasomnia according to ICD-10 are included in the group of diseases combined under the code F51 ("Sleep disorders of inorganic etiology"). So, sleep disorders are classified, which are not a symptom of any disease, but exist independently.
Here are the codes of the most common types of parasomnia in childhood:
- somnambulism - F51.3;
- nightly fears - F51.4;
- nightmares - F.51.5;
- confusion after waking up - F51.8.
The exceptions are bruxism and nocturnal enuresis. Teeth grinding in a dream is considered a somatoform disorder. So-called disorders of psychogenic etiology that occur with somatic manifestations. Bruxism code is F45.8.
As for bedwetting, ICD-10 defines this disorder as an emotional disorder. The inorganic enuresis code is F98.0.
Confusion after sleep
Confusion after waking up is one of the symptoms of parasomnia in children. Such a manifestation most often occurs before the age of 5 years.
This disorder is very scary 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 requests from parents;
- fuzzy and slow speech;
- answers to questions out of place;
- inadequate arousal;
- disorientation in space.
Parents have the feeling that the child opened his eyes, but still continues to remain in the dream world. All attempts to calm the baby only exacerbate the situation. At this point, the child’s nervous system is partially in the sleep phase. This condition lasts 5-25 minutes. It does not pose a particular danger to the baby. Typically, episodes of confusion pass over the age of 5 years.
Somnambulism
Walking in a dream (sleepwalking) is observed in 17% of children. This violation often affects adolescents 12-14 years old. The child is sleeping, but his muscular system does not rest, but is in an excited state. Because of this, a dream occurs.
This disorder is accompanied by the following manifestations:
- The child jumps up or walks around the room during sleep.
- Children can perform various unconscious actions in this state (for example, dressing or taking any items).
- There is no reaction to circulation, since the brain is in a state of sleep.
- Eyes can be opened, the look becomes "glassy". Some small somnambulists walk with their eyes closed while orienting themselves in space.
The next morning, the child does not remember his walk during sleep. The attacks of sleepwalking do not affect the well-being of children. However, there is a great risk of injury during sleepwalking.
Nightly fears
Usually, nightly fears occur in children in the first few hours after falling asleep. Such a violation is most often noted at the age of 2-6 years. Boys are more prone to this disorder.
During night fear, the child makes sudden movements and wakes up. He looks extremely excited, constantly crying and screaming. All attempts to calm down fail. Children in this condition may behave aggressively or inflict damage on 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 the next morning he does not remember anything.
Nightmares
Often children have very unpleasant and vivid dreams. Nightmares usually appear during the quick phase of sleep closer to the morning. The child cries out or utters separate phrases and words when sleeping. Sometimes it can be very difficult to wake up during a nightmare.
Dreams are vivid and very disturbing. They contain scenes of chase, assault, violence and other dangers. The next morning, the child can tell in detail about what he saw in a dream. Children with nightmares look very scared after waking up. They often cry, telling the contents of scary dreams.
It is sometimes difficult for parents to distinguish between nightly fears and nightmares. In the video below, you can get acquainted with the opinion of Dr. Evgeny Olegovich Komarovsky about parasomnia in childhood. The famous pediatrician explains in detail the difference between nightly fears and unpleasant dreams.
Enuresis at night
Bedwetting is observed in children older than 5 years. At this age, the child can already control the urination reflex. Normally, children immediately wake up when they urinate to 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 can not control the process of urination during a sound sleep. Such a disorder is very often associated with stress throughout the day.
In some cases, bedwetting can be a symptom of various diseases of the excretory organs and 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 his sleep greatly compresses his jaw and grinds his teeth. The next morning, children usually complain of pain in the oral 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: erasing tooth enamel, caries and gum disease.
Diagnostics
In case of sleep disorders, it is necessary to undergo examination and consultation with different specialists: pediatrician, pediatric neurologist and psychiatrist. After all, the manifestations of nocturnal parasomnia often happen, similar to the symptoms of organic diseases.
The doctor conducts a survey of the parents of the child in order to identify the frequency and nature of sleep disorders, duration of episodes, as well as a hereditary predisposition. Parents are advised to monitor the behavior of the child during sleep and record the existing disorders in a special diary.
To establish the nature of parasomnia, polysomnography is prescribed. This study is conducted when the baby is sleeping. Using a special device, brain activity, muscle tension and breathing during sleep are recorded.
It is very important to distinguish the manifestations of parasomnia from epilepsy and other organic CNS pathologies. 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 it is necessary to examine the function of the kidneys and bladder in order to exclude urological diseases.
Therapy
For the successful treatment of parasomnia, it is necessary to normalize the regimen of the day. In the second half of the day, the child needs to be given only light food. Sleep should be given 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 in the evenings - a quiet pastime.
Using the entries in the diary, you can track: at what time the child most often has sleep disturbances. Doctors recommend waking up the child 10-15 minutes before the alleged episode of parasomnia, and then again put to bed. This is especially necessary with 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 measures enhance the processes of inhibition in the central nervous system before bedtime.
In many cases, medical treatment of parasomnia in children is necessary. Usually, a plant-based sedative is prescribed for the child:
- Persen
- Valerian extract (in tablets);
- phytopreparations with mint or motherwort.
Tranquilizers for children are prescribed extremely rarely. The body quickly gets used to such drugs. In severe sleep disorders, Phenibut and Phezam are used. They do not belong to classical tranquilizers, but are nootropic drugs with an additional sedative effect. These are prescription drugs that can be given to a child only on the recommendation 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 quite quickly after treatment. In addition, with age, the child's nervous system strengthens, and sleep disturbances disappear.
If parasomnia becomes protracted, then it is necessary to examine the state of health of the child in more detail. In this case, sleep disorders can be a sign of neurological or psychiatric pathologies.
Prevention
How to prevent the occurrence of parasomnia in children? Pediatricians give the following recommendations:
- The optimal regimen of the day should be strictly observed. The child needs to go to bed and wake up at the same time.
- Overfatigue and lack of sleep should not be allowed. Children should sleep at least 10-12 hours a day.
- At night, the child should not be given heavy and indigestible food.
- It is very important to protect your child from stress. It is necessary to completely exclude watching scary movies and unpleasant TV shows. Parents should not allow quarrels with children. A baby suffering from sleep disorders should be treated very carefully.
- At a late time of the day, excessive physical activity of the child should not be allowed. Outdoor games and sports activities in the evenings cause nervous system overexcitation.
- It is useful to give the child a glass of warm milk for the night. This will help normalize sleep.
Such measures will help minimize the risk of developing parasomnia. Each parent needs to heed these medical advice. After all, a healthy and sound sleep is very important for a child.