sleep or from one stage of sleep to another. There is no known cause for this type of disorder, but medical or psychological problems are rarely associated with it. Children who experience rhythmic disorders may have morning headaches, nasal problems, and ear infections.
Another rhythmic disorder is restless legs syndrome (RLS), a sensory and motor abnormality that seems to have a genetic basis. In RLS the child's legs move repeatedly. Many people who have RLS also have periodic leg movement syndrome (PLMS)—this occurs during sleep when the legs move involuntarily.
Paroxysmal disorders are those that come on or recur suddenly. They include night terrors, nightmares, sleepwalking, and bed-wetting.
Night terrors (pavor nocturnus) are characterized by a sudden arousal from sleep with a piercing scream or cry. During the episode, heart and breathing rates may increase and the child's eyes may be open, but he probably will not remember what happened, other than waking up and feeling scared. Night terrors occur in the first third of the sleep cycle, when the child is in deep sleep. Instead of waking or moving into another stage of sleep, the child gets "stuck" between stages. This can occur in as many as 15 percent of young children and can be caused by being overly tired or having an interrupted sleep cycle. By themselves, night terrors are not dangerous, but a child in the midst of a night terror could jump out of bed and hurt himself.
Experts are not sure what causes night terrors. After evaluation to rule out any possible physical causes, such as certain neurological conditions, medication may be used as treatment.
Nightmares differ from night terrors in that they are usually psychologically based, are more often remembered, and are not usually dangerous. Nightmares also occur only during REM (rapid eye movement) sleep, when the sleeping child's eyes move quickly, and heart rate and breathing may be erratic.
Sleepwalking is not dangerous when it occurs only rarely, but it can be hazardous if the child often gets out of bed or walks long distances in his sleep. Because the child is not awake during an episode, dangerous objects should be removed from his bedroom, and windows should be locked. Following a medical evaluation, medication or a consistent sleep-wake cycle may help cut down or eliminate sleepwalking.
Bed-wetting (enuresis) is a common problem that is classified as a parasomnia because it occurs at night and can affect sleep. Bed-wetting also can negatively affect a child's self-esteem. It typically occurs in children between ages three and eight and eventually stops on its own, although in a few cases it can sometimes continue into adolescence (1 percent of 18 year olds bed-wet). A child who regularly wets the bed should see a doctor to rule out any physical cause.
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