KIDS' PARASOMNIA KEEPS PARENTS AWAKE AT NIGHT
Sleepwalking and night terrors often cause concern but there are tools that can help
Even though I am not a geneticist I enjoy entertaining my patients by giving them genetic advice.
Two conditions come to mind: parasomnias and bedwetting.
When I see a child who wets the bed or a child who sleepwalks or has night terrors, I start with the serious aspects of listening deeply, putting the pieces of the story together, and making suggestions around possible solutions.
I always aim to give them hope by explaining that these conditions will pass; I have never met a newlywed couple where one of the partners wet the bed.
But I tell my patients to be careful who they marry.
A family history of sleepwalking, sleep talking, night terrors or bedwetting means that there is around a 60 per cent chance in first-degree relatives to have the same problem.
Thus, jokingly, I tell patients who experience parasomnias not to ever get married to another person who also experienced parasomnias. It is almost certain their kids will have parasomnias, too.
Parasomnias refer to behaviours at night where a child is in a deep sleep, usually in the first half of the night, and most commonly a few hours after bedtime. This is a stage of sleep known as Stage 3.
The brain waves are slow waves, but the child suddenly may wake up from this deep sleep and appear to be confused and agitated. Parents may find it very stressful as the child is hard to console. But the good news is that the child usually has no difficulty going back to sleep and will not remember the events the next day.
Sleepwalking, in particular, is a parasomnia that may cause extra stress. The medical lexicon is somnambulism.
Children wake up from a deep sleep, usually a few hours after bedtime and calmly walk around in the house.
They may appear to be awake but they are not awake. They may show up at a parent's bed and talk nonsensically; they may even open a door and walk out of the house; they may urinate in places other than a toilet; they may turn on a stove or do other strange things, all the while not being fully awake.
Sleepwalking occurs in 15 per cent of children, and in six per cent there is at least one event of somnambulism per week.
Obstructive sleep apnea does not cause sleepwalking but it can trigger it, says Dr. Craig Canapari, a world-renowned pediatric sleep expert at Yale University.
Canapari's website provides resources on this topic and many other sleep-related disorders in children (www.drcraigcanapari.com).
Parasomnias can be confused with seizures. Seizures are usually more stereotyped, each event is the same in terms of movements, which are more rhythmic and repetitive.
Sleep deprivation is a clear trigger for sleepwalking and thus careful attention to adequate sleep is critical.
A safe sleeping environment is crucial. Canapari suggests the use of double-locked doors where one needs a key to get out.
Another alternative is the use of deadbolts that are out of children's reach. When families travel, he suggests the use of a portable door alarm.
Technology such as the Lully Sleep Guardian is another useful device to consider. It was developed by a Stanford Medical School doctor. It works on the principle of intermittent scheduled awakenings to prevent parasomnias.
This device has been shown to reduce parasomnia events by 80 per cent after four weeks of use.
For parents who want to avoid technology, waking a child up about 30 minutes prior to the typical time when parasomnia takes place may work. It has to be done nightly for one month before one may see results.
It is important to wake the child up to the point where the child is able to have a lucid conversation.
Night terrors occur in six per cent of children. Parents may be fast asleep and suddenly the screaming of a child at full volume causes them to rush into the room.
The child does not seem to see the parents, but may scream their names; screams may turn into sobs after a few minutes and the more the parents try to comfort the child, the more agitated the child becomes.
The child has no memory of these freaked-out family moments the next day.
Sleep talking is known as somniloquy. It is more common in children with obstructive sleep apnea. Canapari previously had a video on his website of a girl saying “bless me” after she sneezed in her sleep.
Parasomnias pass at some point, but meanwhile the reduced quality of life can really tire parents out, especially at one of the weirdest times in human history when COVID chaos ripples far and wide and some parents struggle to sleep due to their own stressors.