Brain & development · 2025
Polysomnographic and clinical features of childhood non-REM parasomnias: A sleep center experience.
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Çıplaklıgil Aslı, Kurt Gök Duygu, Per Hüseyin, İsmailoğulları Sevda
Аннотация
INTRODUCTION: Non-REM parasomnias are common in childhood, yet studies investigating their clinical and polysomnographic features remain limited. This study aimed to assess the clinical and sleep characteristics of children diagnosed with non-rapid eye movement (non-REM) parasomnias and to describe the semiological features of episodes confirmed by video-polysomnography (vPSG).
METHOD: We retrospectively evaluated 88 children (2-18 years) referred with abnormal nocturnal motor behaviors who underwent overnight vPSG between 2016 and 2023. Demographic and clinical data, comorbidities, and electroencephalography (EEG) findings were recorded. In cases with observed parasomnia episodes on vPSG, motor patterns, EEG, electrocardiography (ECG) characteristics, and Frontal Lobe Epilepsy-Parasomnia (FLEP) scale scores were analyzed. Parasomnia episodes were classified based on motor complexity: simple, rising, and complex arousal movements.
RESULTS: Sixty-nine (78.4 %) patients referred for abnormal nocturnal behaviors were diagnosed with non-REM parasomnias by International Classification of Sleep Disorders-3 (ICSD-3), 20 (29 %) had confirmed episodes during vPSG (15 confusional arousal, 4 sleep terror, 1 somnambulism). Most episodes (91.1 %) occurred during N3 sleep. Simple arousal was the most common pattern (88.2 %). Episodes with complex motor features were longer and associated with autonomic signs such as tachycardia. Patients with comorbid epilepsy had a lower vPSG-confirmation rate (5.2 %) and higher FLEP scores. Electroencephalogram patterns included hypersynchronous delta and mixed-frequency theta-alpha activity.
CONCLUSION: This study characterized the semiological features of non-REM parasomnia episodes in pediatric patients. Although vPSG findings contributed to the objective description of motor patterns, the current data are not sufficient to conclude that vPSG is definitively useful for differential diagnosis. However, vPSG may aid in clarifying symptom profiles and excluding other comorbid conditions.
METHOD: We retrospectively evaluated 88 children (2-18 years) referred with abnormal nocturnal motor behaviors who underwent overnight vPSG between 2016 and 2023. Demographic and clinical data, comorbidities, and electroencephalography (EEG) findings were recorded. In cases with observed parasomnia episodes on vPSG, motor patterns, EEG, electrocardiography (ECG) characteristics, and Frontal Lobe Epilepsy-Parasomnia (FLEP) scale scores were analyzed. Parasomnia episodes were classified based on motor complexity: simple, rising, and complex arousal movements.
RESULTS: Sixty-nine (78.4 %) patients referred for abnormal nocturnal behaviors were diagnosed with non-REM parasomnias by International Classification of Sleep Disorders-3 (ICSD-3), 20 (29 %) had confirmed episodes during vPSG (15 confusional arousal, 4 sleep terror, 1 somnambulism). Most episodes (91.1 %) occurred during N3 sleep. Simple arousal was the most common pattern (88.2 %). Episodes with complex motor features were longer and associated with autonomic signs such as tachycardia. Patients with comorbid epilepsy had a lower vPSG-confirmation rate (5.2 %) and higher FLEP scores. Electroencephalogram patterns included hypersynchronous delta and mixed-frequency theta-alpha activity.
CONCLUSION: This study characterized the semiological features of non-REM parasomnia episodes in pediatric patients. Although vPSG findings contributed to the objective description of motor patterns, the current data are not sufficient to conclude that vPSG is definitively useful for differential diagnosis. However, vPSG may aid in clarifying symptom profiles and excluding other comorbid conditions.