Sona Nevsimalova1, Iva Prihodova, David Kemlink, Jelena Skibova. 1. Department of Neurology, Charles University, 1st Faculty of Medicine and General Teaching Hospital, Katerinska 30, 128 00 Prague 2, Czech Republic. Electronic address: snevsi@LF1.cuni.cz.
Abstract
BACKGROUND: Childhood parasomnias are believed to be a benign disorder due to immaturity of some neural circuits, synapses and receptors. The aim of our study was to explore a possible connection with other neurological developmental disorders. METHODS: 72 children (mean age 9.9 ± 5.0 years, 47 boys) were clinically examined and 88 nocturnal v-PSG and 22 v-EEG recordings were evaluated. The most frequent diagnostic findings were: sleepwalking in 24 children, confusional arousal in 21, sleep terror in 8, groaning and enuresis each in 7, non-specific arousal disorder in 4 patients, and REM-related parasomnia in only one child. For statistical evaluation chi-square test, the two-sample t-test and Mann-Whitney rank test were used. RESULTS: Perinatal risk history was found in 38% of the cohort. Developmental disorders were diagnosed in 30 children (41.7%), more frequently in combinations with: attention-hyperactivity disorder (30.6%), dyslexia and dysgraphia (13.9%), developmental dysphasia (9.7%), mild motor and/or intellectual dysfunction (6.9%). Abnormal movements in sleep, some of them also regarded as developmental, were diagnosed in 37 children (51.4%). Sleep-related breathing disorders were found in 29 patients (40.3%) -snoring (29.2%) and/or sleep apnea (11.1%). Only 16.7% had no comorbidity. Most of the children (60%) showed 2 or 3, exceptionally up to 5 comorbidities. Children, in whom no parasomnia was found in close relatives, had a mild but non-significant earlier onset of the disease (4.4 ± 4.0 against 6.3 ± 4.3 years). CONCLUSION: Childhood parasomnias are frequently associated with perinatal risk factors and developmental comorbidities, and can be regarded as a disorder of sleep maturation.
BACKGROUND: Childhood parasomnias are believed to be a benign disorder due to immaturity of some neural circuits, synapses and receptors. The aim of our study was to explore a possible connection with other neurological developmental disorders. METHODS: 72 children (mean age 9.9 ± 5.0 years, 47 boys) were clinically examined and 88 nocturnal v-PSG and 22 v-EEG recordings were evaluated. The most frequent diagnostic findings were: sleepwalking in 24 children, confusional arousal in 21, sleep terror in 8, groaning and enuresis each in 7, non-specific arousal disorder in 4 patients, and REM-related parasomnia in only one child. For statistical evaluation chi-square test, the two-sample t-test and Mann-Whitney rank test were used. RESULTS: Perinatal risk history was found in 38% of the cohort. Developmental disorders were diagnosed in 30 children (41.7%), more frequently in combinations with: attention-hyperactivity disorder (30.6%), dyslexia and dysgraphia (13.9%), developmental dysphasia (9.7%), mild motor and/or intellectual dysfunction (6.9%). Abnormal movements in sleep, some of them also regarded as developmental, were diagnosed in 37 children (51.4%). Sleep-related breathing disorders were found in 29 patients (40.3%) -snoring (29.2%) and/or sleep apnea (11.1%). Only 16.7% had no comorbidity. Most of the children (60%) showed 2 or 3, exceptionally up to 5 comorbidities. Children, in whom no parasomnia was found in close relatives, had a mild but non-significant earlier onset of the disease (4.4 ± 4.0 against 6.3 ± 4.3 years). CONCLUSION: Childhood parasomnias are frequently associated with perinatal risk factors and developmental comorbidities, and can be regarded as a disorder of sleep maturation.