Parasomnias in neurodivergent childhood and the care of childhood sleep disorders

What are parasomnias and how do they affect neurodivergent infants?

Parasomnias are disorders that occur during sleep, especially in transitions between phases of deep sleep and wakefulness. Among the most common parasomnias in neurodivergent infants are:

1. Nightmares in childhood: They usually appear in the last third of the night and are characterized by intensely terrifying dreams that the infant remembers when they wake up. They may be related to stress, anxiety or lack of sleep, affecting boys and girls between 3 and 9 years old.
2. Night terrors in neurodivergent infants: They occur in the first third of the night and, unlike nightmares, the youngest does not remember the episode. During a night terror, you may scream, cry, or show signs of intense fear without actually being awake, and it's hard to wake you up. They are common between ages 4 and 12 and may be related to hereditary or physical factors, such as sleep deprivation or chronic pain.
3. Sleepwalking in boys and girls: This disorder causes episodes in which the infant walks or performs activities while asleep, usually in phases of deep sleep. Although he seems to be awake, he really isn't and he won't remember anything the next day. This disorder is common between ages 4 and 8 and can be exacerbated by conditions such as sleep apnea or fever.
4. Confused awakening: The child may wake up disoriented, showing confusion and slowness to respond to stimuli. This type of parasomnia usually disappears with age, but it can cause anxiety at home.
5. REM sleep behavior disorder in childhood: Although less common in childhood, this disorder occurs during the REM phase. The younger person may make sudden movements, such as blows or kicks, reflecting their dreams in physical actions. This disorder can be dangerous, as there is a risk of self-harm.

Identification, Diagnosis and Treatment

Observing your son or daughter during sleep and paying attention to their waking behavior can be crucial in identifying these disorders. For a proper diagnosis, it is helpful for those who care for the child to narrate the episodes to a health professional. In some cases, a sleep study, including electroencephalogram monitoring and video recording, is recommended to determine the sleep phase in which the episodes occur and to rule out other conditions, such as epilepsy.

Not all parasomnias require treatment, but some may benefit from specific interventions. Here are some practical tips for improving sleep and reducing episodes:

• Establish a consistent sleep routine: Having a regular schedule helps regulate sleep rhythms and can decrease the frequency of parasomnias.
• Avoid using electronic devices at night: Exposure to screens before sleeping can interfere with sleep quality.
• Create a suitable resting environment: The room should be dark, quiet and comfortable to promote restful sleep.
• Relaxation activities before bed: Soft reading or quiet music can help you relax before bed.
• Protecting the environment: Make sure that the place where you sleep is safe to prevent accidents, especially in cases of sleepwalking.

It is advisable to seek professional help if parasomnias are frequent, intense, or affect general well-being and family quality of life. A sleep disorder specialist can evaluate and suggest the best approach, from routine changes to therapeutic interventions.

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