Sleep disorders in children after burn injury.

Eighty-two children and adolescents between the ages of 30 months and 20 years (mean, 11.8 years) who were admitted to one of two pediatric burn units with a mean initial burn injury of 43.8% total body surface area and a mean age at time of injury of 4.2 years were studied 1 year or more after burn injury (mean, 7.3 years). Subjects were found to have profound at-home sleep disorders, which were manifested as nightmares in 30 subjects (37%), bed-wetting in 20 (24%), and sleep-walking in 6 (18%). Dream content related to normal childhood topics in 45 patients (55%), burn injury in 6 (7%), and burn treatment in 5 (6%). No relationship exists between age at time of burn, length of time after burn injury, cause of burn injury, family history of nightmares, or patient history of bed-wetting and the incidence of nightmares. Daytime naps were reported in 50 subjects (63%), although 46 (mean age, 11.7 years) were well beyond the normal age for napping.