Paroxysmal non-epileptic disorders during sleep

Abstract

Introduction. Sleep episodes are common in children, and sometimes they are disconcerting for the family, both because of the disruption they cause to nighttime rest and because of the concern about the possible impact of these events on health and development. We will describe some of the most frequent ones and review their clinical management.

Development. First, we will discuss some sleep-related movement disorders that are common in childhood. Benign nocturnal myoclonus in infants is a frequent reason for consultation in pediatrics. Restless legs syndrome, often related to periodic leg movements during sleep, is frequently associated with iron deficiency. Rhythmic sleep movements, which occur during falling asleep, do not usually require any type of intervention, although they are very noticeable for families. In the section dedicated to parasomnias, we differentiate those that occur in non-REM sleep (Rapid Eye Movements), such as sleepwalking, terrors and confusional awakenings, from those that occurin REM sleep. We will look for aspects that differentiate epileptic seizures in sleep. We will discuss some variants of normality that may also be a reason for consultation.

Conclusions. The clinical history is essential to differentiate paroxysmal episodes that occur during sleep. Some of them may require additional examinations. Most can be managed with sleep hygiene guidelines or pharmacological measures in exceptional cases.