pediatrics
Sleep Problems in Children
Night Terrors and Sleepwalking
Night terrors are non-REM episodes of incomplete awakening with extreme anxiety shortly after falling asleep; they are most common between the ages of 3 and 8. The child screams and appears frightened, with a rapid heart rate and rapid breathing. The child seems unaware of the parents’ presence, may thrash around violently, and does not respond to comforting. The child may talk but is unable to answer questions. Usually, the child returns to sleep after a few minutes. Unlike with nightmares, the child cannot recall these episodes in detail. Night terrors are dramatic because the child may scream and may be inconsolable during the episodes. About one third of children with night terrors also sleepwalk (the act of rising from bed and walking around while apparently asleep, also called somnambulism). About 15% of children between the ages of 5 and 12 have at least one episode of sleepwalking. Night terrors and sleepwalking almost always stop on their own, although occasional episodes may occur for years. Usually, no treatment is needed, but if a disorder persists into adolescence or adulthood and/or is severe, treatment may be necessary. In children who need treatment, night terrors may sometimes respond to a sedative or certain antidepressants. There is some evidence that disrupted sleep associated with periodic leg movements often responds to iron supplementation ( Night terrors and sleepwalking references , 1.Leung W, Singh I, McWilliams S, et al: Iron deficiency and sleep—A scoping review.Sleep Med Rev51:101274, 2020. doi: 10.1016/j.smrv.2020.101274 2.Peirano PD, Algarin CR, Chamorro RA, et al: Sleep alterations and iron deficiency anemia in infancy.Sleep Med11(7):637–642, 2020. doi: 10.1016/j.sleep.2010.03.014 