Many of us have problems sleeping. They are usually temporary issues based on our current situation — jet lag, changing work schedules, stress, stuff like that. After a brief period, we move along and our rest evens out.
Sometimes, it’s a bit deeper and lasting, creating serious problems with our slumber. Beyond bouts of insomnia and periodic bad dreams, there are those things called “parasomnias”. We touched on these briefly when discussing nightmares and night terrors. Defined as “an abnormal disruptor of sleep,” parasomnias fall into two distinct stages of sleep — non-Rapid Eye Movement (non-REM) and Rapid Eye Movement (REM) — and a category of “Other”.
These unique and unsettling disruptors rear their head through unusual movements, talking, emotions, and actions while we are resting or trying to. The level of how these manifest can make those around us believe we’re still awake. Parasomnias tend to affect children more than adults but can still carry on or develop in adulthood. The what, how, and why vary and they can go away on their own or medical care may be needed.
In short? These sleep disruptors are tricky and nothing to be sneezed at. There are countless articles on the different types out there — the common and unusual, where they come from and how to get rid of them. We’d like to take a moment and look at their beginnings, however, dive a bit into the place they start and the ones they touch the most: children.
“Sleep, pretty darling, do not cry, and I will sing a lullaby”
Parasomnias are a normal part of childhood development and most kids grow out of them. They reveal themselves as a child’s brain and body are growing, usually in five ways: nightmares, night or sleep terrors, sleepwalking or somnambulism, confusional arousal, and bedwetting or sleep enuresis. Typical and periodic, they tend to fade with age.
Healthy, happy kids may experience any of these at one time or another, prompted by something as simple as a bad day, a fever, a sudden scare, lack of sleep, or getting the hang of potty training. There are ways to help your child handle each of the usual five with ease and care to make it possible for them to face the day and get a good night’s rest. As with all sleep disorders, however, should you discover these are persistent and create physical, emotional, and mental distress for your kids, contact your pediatrician or a health professional immediately and discuss some care options. Also as an FYI, parasomnias are genetic, meaning if any of the five common ones run in your family, it is most likely your children will experience them in one form or another.
Nightmares are simply dreams that disturb us so much that they wake us up. They occur during REM sleep, when our body experiences partial paralysis — we’re deep in the throes of slumber and our body has completely given over to it. That, in itself, creates fear because we are vulnerable when we are having our bad dreams. We also tend to remember things that happen in REM and if we’ve “lived through” something with vivid, frightening imagery and has put us in a dangerous or uncomfortable situation that jolts us out of our rest, it scares us and heightens our terror. It lingers in our mind even when we’re awake, making it even scarier.
Why do we get them? Well, if your child has nightmares from time to time, stress can bring them on, something disturbing they’ve experienced — a scary image, difficult encounter, or a frightening story — and in some cases, post-traumatic stress disorder or acute trauma, medications, illness, or psychiatric disorders. Kids begin experiencing them as early as 18 months old and they usually fade with time.
For the most part, sitting with your child and reassuring them you are there helps a ton. Your presence when they are struggling to go back to sleep makes a huge difference and creates stability.
Night or Sleep Terrors
Night or sleep terrors are very different from nightmares. Occurring during Non-REM or NREM sleep, children may flail about, scream, sit up in their bed, and sweat. Their faces are full of fear and unlike nightmares, once the experience is over, there is no memory of the terror.
These intense disorders usually last under five minutes but can last up to twenty and are probably the most terrifying for a parent to experience. There is nothing you can do to help your child while they are in the midst of them and you may even think they are awake because in some instances, their eyes are open. They are not, however, and it’s not encouraged to try to wake them. Left unattended, they usually calm down and your little one will go right back to sleep, never even realizing what has happened.
Night terrors start when a child is around 4 years-old and end when they are 12, but toddlers have been known to display signs of them. They don’t normally carry into the teen years and sleepwalking often accompanies them. When that happens, it’s important to protect your child by clearing a path and providing them a safe space. The causes are very similar to nightmares, but because they occur during NREM, the experience is unique.
Sleepwalking or somnambulism
As soon as a child can walk, they are able to become a somnambulist aka sleepwalker. Boys do it more than girls and is probably the most common parasomnia next to nightmares. Also part of the NREM stage, your little one is usually rather calm and quiet as they do it, leaving their bed to walk toward familiar locations, inside and outside your home, this means, they may even try to go downstairs or out the front door. Clearing obstacles and gently helping them navigate their way through their path alleviates safety concerns.
These episodes usually last just about 5-15 minutes, and when your child wakes up from it they once again may not remember what happened or even where they are. The following confusion can cause anxiety or fear, and if you panic so will they. It’s best to reassure them and take them back to bed, calmly.
Genetics play a part in your children sleepwalking as do difficulty sleeping, fever, medications — the usual parasomnia suspects. Also like other childhood parasomnias, sleepwalking fades by teen years.
There is a unique simplicity with confusional arousal parasomnia. Your child sits up in bed, confused, dazed, eyes open, sometimes yelling, sometimes thrashing. It is similar to night or sleep terrors, but without the fear. This, too, takes place during NREM, and your child will most likely have no memory of it. Common for children between 2-5 years old, it’s best not to wake or try to wake them up because it can make them even more agitated. Better to wait it out, which can take up to 30 to 40 minutes.
A way that you can help them move beyond confusional arousal is to make sure they get 7-8 hours of sleep a night, and getting them back on a normal, stable slumber schedule.
Bedwetting or sleep enuresis
Of all the parasomnias, bedwetting or sleep enuresis comes with the most shame and embarrassment for children. It is normal for kids figuring out toilet training to urinate in their beds at night. They are learning how to control their bladder during the day and need a little extra help to take care of it while sleeping. By the time a child is 5 years-old, they are naturally able to take themselves to the bathroom when they need to, day or night.
Bedwetting becomes an issue when a child begins experiencing it at least two times a week for a period of time. This can come from stress over a trauma or even the lack of a hormone called “vasopressin”. At night, this hormone naturally increases, which lowers the amount of urine in the bladder and makes it easier to hold during sleep. If it is not produced appropriately, it can cause your child to urinate in their bed. Either way, once your kids continue to experience frequent bedwetting after the age of 5, it’s best to talk to a doctor.
As we said, this is one of the most uncomfortable parasomnias children face because they fear what people will think. The possibility of angering parents and having people find out — especially other kids — creates anxiety. They cannot help wetting the bed, and sleepovers and overnight travel brings about their own worries. Spending the night over a friend’s house means letting them and their parents know your child’s disorder to prepare them for potential accidents and sending them with supplies to manage the bedwetting. The same goes for when you are traveling — you’ll need to bring such things as your own pads or sheets, pull-ups or special underwear, or whatever helps your child get through the night, often heightening their embarrassment.
How a parent handles it determines how a child will move beyond it. It is not their fault they wet the bed. Reminding them of that helps them. Getting waterproof sheets and bed pads support them as well as having them change the sheets with you, gently talking to them, and stopping liquid before bedtime until it is easier to manage.
Navigating the world of parasomnia
Children look to their parents for help with things they don’t understand and sleep disorders are definitely a world they can’t begin to fully comprehend. “Why is this happening?” “Why don’t I remember?” “I’m scared to go to sleep.” These are all questions our kids ask when the normal everyday disruptions begin to become constant and affect their lives.
It’s also the questions asked as they grow into adulthood and find themselves still at their effect. Why? How? We’ve touched on the five common childhood parasomnias, but there are many more that infiltrate their rest and that of adults. This happens because of medications, health issues — physical, mental, emotional — and medical disorders that naturally disrupt sleep like sleep apnea, narcolepsy, etc., and irregular sleep patterns.
The way to overcome or even live with parasomnias ranges from simple life and sleep changes to engaging with a medical professional and even a sleep center.
Easy changes are those consistently recommended as a way to get better sleep and live a healthier lifestyle in general:
- Regular exercise
- Go to bed at the same time every night
- Limit your intake of caffeine before bed
- Hydrate throughout the day
- Limit your alcohol consumption
- Eat healthy
- Incorporate practices to help relieve/manage daily stress
You can also incorporate sleep journals, shut off all media and blue light to get a more restful sleep, and keep your room cool.
If you are living with parasomnias due to medical, health, and more serious issues, please seek the advice of a physician as soon as possible. These are nothing to mess with and it’s all about living your best life no matter what.