文摘
Night terrors, sleepwalking and nightmares are frequent parasomnias in children and adolescents. Parasomnia is defined as behavioral or physiological abnormalities during sleep or sleep-wake transition. According to the International Classification of Sleep Disorders (ICSD-3) these phenomena are equally categorized in children and adults and grouped into non-rapid eye movement (NREM) parasomnias, REM parasomnias and others. Night terror and sleepwalking are NREM parasomnias and usually occur in the first half of the night, whereas nightmares are REM parasomnias and generally occur in the second half of the night; however, parasomnias in early childhood significantly differ from those in adults concerning the frequency, presentation and prognosis. The prevalence of parasomnias is very different in different age groups and in childhood they are mostly self-limiting. The episodes of night terror (pavor nocturnus) are especially frightening for parents; therefore, the counselling and coaching of parents confronted with this problem are a special challenge for pediatricians. Specific medication is only indicated in very rare cases. Pediatric parasomnia can usually be correctly classified by the patient history alone but videos recorded by parents may be helpful. In selected cases (e. g. suspicion of sleep-related seizures) polysomnography may be necessary. Parasomnias persisting or appearing during adolescence have a poorer prognosis and show a high rate of comorbidities, which must be carefully investigated in order to discriminate between primary and secondary phenomena and also to decide on adequate treatment.