Sleep and Sleep Disorders in Children and Teenagers

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: David Perlstein, MD, MBA, FAAP
    David Perlstein, MD, MBA, FAAP

    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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Confusional arousal symptoms in children

Confusional arousals are a variant of night terrors in older infants and toddlers that occur during the first half of the nighttime sleep sequence. It is felt that the child is so deeply asleep and the normal waking pattern at the end of the sleep cycle is suppressed.

The major distinguishing point of confusional arousals versus night terrors is that the former gradually build from moaning, to crying out, and may culminate in the child standing and yelling out apparent random words or phrases.

Conversely, night terrors tend to have an acute onset with the very rapid development of thrashing and yelling (commonly for the parents or caregivers). Confusional arousal and night terrors share several key points important for the child:

  • Don't try to awaken the child. They are asleep and if awakened, will have difficult time falling back to sleep.
  • Anything that upsets the normal sleep rhythms (illness, not sleeping in their own home, and disrupted naps) may trigger either pattern.

Night terror symptoms in children

Night terrors are somewhat rare events that have their highest frequency in children 4 to 12 years of age. They are commonly outgrown by adulthood, though some adults manifest the same brain EEG ("brain wave") changes during sleepwalking.

Night terrors differ from nightmares (see previously). Night terrors manifest themselves with the person bolting upright in bed, screaming and thrashing about and stare blankly at the concerned adult who has come to investigate. They tend to occur during the first third of the child's sleep cycle. Children characteristically do not "calm down" when their parent attempts to soothe what appears to be a fearful experience. EEG studies demonstrate that the child is not awake (i.e. he/she is asleep), and if awakened, has no knowledge or memory of the immediately preceding events. The duration of night terror episodes is short lived. Some authorities believe that night terrors may be a response to sleep deprivation, stress, fever, or fatigue.

Medically Reviewed by a Doctor on 6/18/2015

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