Incomplete arousal from deep sleep in children causes night
time disruption and can present as confusional arousals, sleep
walking or night terrors. These nocturnal events are common
in childhood but can be extremely concerning to parents and
disruptive to families.
This article provides a framework for the initial assessment of
children’s nocturnal events.
Occasionally night time disturbances are seizures. A
framework discussing the clinical features of typical benign
childhood events and how to differentiate them from seizure
disorders is presented. Generally, sleep walking and night
terrors are self limiting and children grow out of them.
However, in some cases there are ongoing precipitants that
are important to identify and treat.
The night is broken by a spine chilling scream and a child starts running frantically around the house looking terrified as if someone is chasing them. In another house, a child quietly gets up when other family members are sleeping, and starts to dress in their school clothes and rearrange their school bag before wandering off to settle down to sleep on the living room couch. Down the street a mother holds her toddler who is screaming and yelling, and she worries he is in pain because she cannot soothe him. These are examples of the sometimes weird and disturbing night time events that parents describe to their doctor, terrified that there is something wrong with their child.
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