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Nachtschreck, Schlafwandeln und Albträume

Häufige Parasomnien im Kindes- und Jugendalter

Night terror, sleepwalking and nightmares

Frequent parasomnias in childhood and adolescence

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Zusammenfassung

Nachtschreck, Schlafwandeln und Albträume zählen zu den häufigsten Parasomnien im Kindes- und Jugendalter. Diese Parasomnien sind abnorme Episoden von Verhaltensmustern oder physiologischen Ereignissen während des Schlafs oder im Verlauf von Schlaf-Wach-Übergängen. Gemäß der International Classification of Sleep Disorders (ICSD-3) werden Parasomnien in „Non-rapid-eye-movement“(NREM)-Parasomnien, REM-Parasomnien und „Andere“ eingeteilt. Während Nachtschreck und Schlafwandeln zu den NREM-Parasomnien zählen und damit besonders häufig in der ersten Nachthälfte auftreten, sind Albträume eine REM-Schlaf-assoziierte Parasomnie und kommen demnach vorzugsweise in der zweiten Nachthälfte vor. Parasomnien unterscheiden sich insbesondere beim Kind im Vorschulalter bezüglich Häufigkeit, Präsentation und Prognose wesentlich von jenen des Erwachsenen. Die Prävalenz von Parasomnien bei Kindern ist stark altersabhängig; häufig verlaufen sie selbstlimitierend. Die genannten Parasomnien, insbesondere der Nachtschreck (Pavor nocturnus), sind jedoch für viele Eltern besorgniserregend; Kinderärzte sind daher bezüglich Aufklärung und (Verhaltens-)Beratung gefordert. Nur sehr selten ist eine medikamentöse Therapie angezeigt. Parasomnien bei Kindern können meist allein aufgrund der Anamnese eingestuft werden; von den Eltern angefertigte Videos sind oft hilfreich. Nur selten (insbesondere zur Differenzialdiagnose epileptischer Anfälle) ist eine Polysomnographie erforderlich. Ins Jugendalter perpetuierende oder erst im Jugendalter auftretende Parasomnien haben eine schlechtere Prognose und eine hohe Komorbidität. Letztere muss entsprechend abgeklärt werden, um zwischen Primär- und Sekundärphänomenen unterscheiden und eine adäquate Therapie einleiten zu können.

Abstract

Night terrors, sleepwalking and nightmares are frequent parasomnias in children and adolescents. Parasomnia is defined as behavioral or physiological abnormalities during sleep or sleep-wake transition. According to the International Classification of Sleep Disorders (ICSD-3) these phenomena are equally categorized in children and adults and grouped into non-rapid eye movement (NREM) parasomnias, REM parasomnias and others. Night terror and sleepwalking are NREM parasomnias and usually occur in the first half of the night, whereas nightmares are REM parasomnias and generally occur in the second half of the night; however, parasomnias in early childhood significantly differ from those in adults concerning the frequency, presentation and prognosis. The prevalence of parasomnias is very different in different age groups and in childhood they are mostly self-limiting. The episodes of night terror (pavor nocturnus) are especially frightening for parents; therefore, the counselling and coaching of parents confronted with this problem are a special challenge for pediatricians. Specific medication is only indicated in very rare cases. Pediatric parasomnia can usually be correctly classified by the patient history alone but videos recorded by parents may be helpful. In selected cases (e. g. suspicion of sleep-related seizures) polysomnography may be necessary. Parasomnias persisting or appearing during adolescence have a poorer prognosis and show a high rate of comorbidities, which must be carefully investigated in order to discriminate between primary and secondary phenomena and also to decide on adequate treatment.

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Literatur

  1. Arora T, Broglia E, Thomas GN, Taheri S (2014) Associations between specific technologies and adolescent sleep quantity, sleep quality, and parasomnias. Sleep Med 15:240–247

    Article  PubMed  Google Scholar 

  2. Bloomfield ER, Shatkin JP (2009) Parasomnias and movement disorders in children and adolescents. Child Adolesc Psychiatr Clin N Am 18:947–965

    Article  PubMed  Google Scholar 

  3. Brockmann PE, Diaz B, Damiani F, Villarroel L, Núñez F, Bruni O (2015) Impact of television on the quality of sleep in preschool children. Sleep Med. doi:10.1016/j.sleep.2015.06.005

    Google Scholar 

  4. Bruni O, Ferri R, Miano S, Verrillo E (2004) L‑5-Hydroxytryptophan treatment of sleep terrors in children. Eur J Pediatr 163:402–407

    Article  CAS  PubMed  Google Scholar 

  5. Bruni O, Ferri R, Novelli L, Finotti E, Miano S, Guilleminault C (2008) NREM sleep instability in children with sleep terrors: the role of slow wave activity interruptions. Clin Neurophysiol 119:985–992

    Article  PubMed  Google Scholar 

  6. Bruni O, Novelli L (2010) Sleep disorders in children. BMJ Clin Evid 2010:pii: 2304

    Google Scholar 

  7. Cao M, Guilleminault C (2010) Families with sleepwalking. Sleep Med 11:726–734

    Article  PubMed  Google Scholar 

  8. Carter KA, Hathaway NE, Lettieri CF (2014) Common sleep disorders in children. Am Fam Physician 89:368–377

    PubMed  Google Scholar 

  9. Cornaggia CM, Beghi M, Giovannini S, Boni A, Gobbi G (2010) Partial seizures with affective semiology versus pavor nocturnus. Epileptic Disord 12:65–68

    PubMed  Google Scholar 

  10. Csoka S, Simor P, Szabo G, Kopp MS, Bodizs R (2011) Early maternal separation, nightmares, and bad dreams: results from the Hungarostudy epidemiological panel. Attach Hum Dev 13:125–140

    Article  PubMed  Google Scholar 

  11. Darien RL (2014) American academy of sleep medicine. International classification of sleep disorders, 3. Aufl.

    Google Scholar 

  12. Derry CP, Harvey AS, Walker MC, Duncan JS, Berkovic SF (2009) NREM arousal parasomnias and their distinction from nocturnal frontal lobe epilepsy: a video EEG analysis. Sleep 32:1637–1644

    PubMed  PubMed Central  Google Scholar 

  13. Fisher HL, Lereya ST, Thompson A, Lewis G, Zammit S, Wolke D (2014) Childhood parasomnias and psychotic experiences at age 12 years in a United Kingdom birth cohort. Sleep 37:475–482

    PubMed  PubMed Central  Google Scholar 

  14. Furet O, Goodwin JL, Quan SF (2011) Incidence and remission of parasomnias among adolescent children in the Tucson Children’s Assessment of Sleep Apnea (TuCASA) Study. Southwest J Pulm Crit Care 2(93–101):93–101

    PubMed  PubMed Central  Google Scholar 

  15. Gehrman PR, Harb GC (2010) Treatment of nightmares in the context of posttraumatic stress disorder. J Clin Psychol 66:1185–1194

    Article  PubMed  Google Scholar 

  16. Ghalebandi M, Salehi M, Rasoulain M, Shooshtari MH, Naserbakht M, Salarifar MH (2011) Prevalence of parasomnia in school aged children in Tehran. Iran J Psychiatry 6:75–79

    PubMed  PubMed Central  Google Scholar 

  17. Hauri PJ, Silber MH, Boeve BF (2007) The treatment of parasomnias with hypnosis: a 5‑year follow-up study. J Clin Sleep Med 3:369–373

    PubMed  PubMed Central  Google Scholar 

  18. Ipsiroglu OS, Fatemi A, Werner I, Paditz E, Schwarz B (2002) Self-reported organic and nonorganic sleep problems in schoolchildren aged 11 to 15 years in Vienna. J Adolesc Health 31:436–442

    Article  PubMed  Google Scholar 

  19. Karnberger A, Kerbl R (2015) Albträume bei Kindern. 23. Jahrestagung der Österreichischen Gesellschaft für Schlafmedizin und Schlafforschung (ASRA), Linz, 23.–25. April 2015

    Google Scholar 

  20. Kerbl R, Karnberger A, Grigorow I (2015) Parasomnien im Kindesalter – Präsentationsformen und ein Streifzug durch die neuere Literatur. Somnol Schlafforsch Schlafmed 19(4):219–225

    Article  Google Scholar 

  21. Kotagal S (2012) Treatment of dyssomnias and parasomnias in childhood. Curr Treat Options Neurol 14:630–649

    Article  PubMed  Google Scholar 

  22. Kotagal S, Nichols CD, Grigg-Damberger MM, Marcus CL, Witmans MB, Kirk VG, D’Andrea LA, Hoban TF (2012) Non-respiratory indications for polysomnography and related procedures in children: an evidence-based review. Sleep 35:1451–1466

    PubMed  PubMed Central  Google Scholar 

  23. Mason TB, Pack AI (2007) Pediatric parasomnias. Sleep 30:141–151

    PubMed  Google Scholar 

  24. Mathew T, Sarma GR, Nadig R, Varghese R (2012) Topiramate-induced somnambulism in a migraineur: a probable idiosyncratic adverse effect. J Clin Sleep Med 8:197–198

    PubMed  PubMed Central  Google Scholar 

  25. Miano S, Peraita-Adrados R (2013) Nocturnal frontal lobe epilepsy is often misdiagnosed as sleep disorders in children: a case series. Rev Neurol 56:257–267

    PubMed  Google Scholar 

  26. Ming X, Sun YM, Nachajon RV, Brimacombe M, Walters AS (2009) Prevalence of parasomnia in autistic children with sleep disorders. Clin Med Pediatr 3:1–10

    PubMed  PubMed Central  Google Scholar 

  27. Nevsimalova S, Prihodova I, Kemlink D, Skibova J (2013) Childhood parasomnia – a disorder of sleep maturation? Eur J Paediatr Neurol 17:615–619

    Article  PubMed  Google Scholar 

  28. Nguyen BH, Perusse D, Paquet J, Petit D, Boivin M, Tremblay RE, Montplaisir J (2008) Sleep terrors in children: a prospective study of twins. Pediatrics 122:e1164–e1167

    Article  PubMed  Google Scholar 

  29. Ohayon MM, Guilleminault C, Priest RG (1999) Night terrors, sleepwalking, and confusional arousals in the general population: their frequency and relationship to other sleep and mental disorders. J Clin Psychiatry 60(4):268–276

    Article  CAS  PubMed  Google Scholar 

  30. Petit D, Pennestri MH, Paquet J, Desautels A, Zadra A, Vitaro F, Tremblay RE, Boivin M, Montplaisir J (2015) Childhood sleepwalking and sleep terrors: a longitudinal study of prevalence and familial aggregation. JAMA Pediatr 169:653–658

    Article  PubMed  Google Scholar 

  31. Petit D, Touchette E, Tremblay RE, Boivin M, Montplaisir J (2007) Dyssomnias and parasomnias in early childhood. Pediatrics 119:e1016–e1025

    Article  PubMed  Google Scholar 

  32. Picchietti DL, Stevens HE (2008) Early manifestations of restless legs syndrome in childhood and adolescence. Sleep Med 9:770–781

    Article  PubMed  Google Scholar 

  33. Rodopman-Arman A, Perdahli-Fis N, Ekinci O, Berkem M (2011) Sleep habits, parasomnias and associated behaviors in school children with attention deficit hyperactivity disorder (ADHD). Turk J Pediatr 53:397–403

    PubMed  Google Scholar 

  34. Sateia MJ (2014) International classification of sleep disorders-third edition: highlights and modifications. Chest 146:1387–1394

    Article  PubMed  Google Scholar 

  35. Schredl M, Dehmlow L, Schmitt J (2016) Interest in information about nightmares in patients with sleep disorders. J Clin Sleep Med 12:973–977

    Article  PubMed  Google Scholar 

  36. Silvestri R, Gagliano A, Arico I, Calarese T, Cedro C, Bruni O, Condurso R, Germano E, Gervasi G, Siracusano R, Vita G, Bramanti P (2009) Sleep disorders in children with Attention-Deficit/Hyperactivity Disorder (ADHD) recorded overnight by video-polysomnography. Sleep Med 10:1132–1138

    Article  PubMed  Google Scholar 

  37. Simard V, Nielsen TA, Tremblay RE, Boivin M, Montplaisir JY (2008) Longitudinal study of bad dreams in preschool-aged children: prevalence, demographic correlates, risk and protective factors. Sleep 31:62–70

    PubMed  PubMed Central  Google Scholar 

  38. Steinsbekk S, Berg-Nielsen TS, Wichstrom L (2013) Sleep disorders in preschoolers: prevalence and comorbidity with psychiatric symptoms. J Dev Behav Pediatr 34:633–641

    Article  PubMed  Google Scholar 

  39. Tang SS, Clarke T, Owens J, Pal DK (2011) Sleep behavior disturbances in rolandic epilepsy. J Child Neurol 26:239–243

    Article  PubMed  Google Scholar 

  40. Tinuper P, Bisulli F, Provini F (2012) The parasomnias: mechanisms and treatment. Epilepsia 53(Suppl 7):12–19

    Article  PubMed  Google Scholar 

  41. Wiater A, Lehmkuhl G (2011) Diagnostik und Therapie organischer und nicht organischer Schlafstörungen. Handbuch des Kinderschlafs. Grundlagen. Schattauer, Stuttgart

    Google Scholar 

  42. Wolke D, Lereya ST (2014) Bullying and parasomnias: a longitudinal cohort study. Pediatrics 134:e1040–e1048

    Article  PubMed  Google Scholar 

  43. Zadra A, Pilon M (2011) NREM parasomnias. Handb Clin Neurol 99:851–868

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Ärztlicher Dienst, Amt für Jugend und Familie, Stadt Graz, Keesgasse 6, 8011, Graz, Österreich

    W. Sauseng

  2. Abteilung für Kinder- und Jugendheilkunde, LKH Hochsteiermark, Standort Leoben, Leoben, Österreich

    L. Rauter & R. Kerbl

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  1. W. Sauseng
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  2. L. Rauter
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  3. R. Kerbl
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Correspondence to W. Sauseng.

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W. Sauseng, L. Rauter und R. Kerbl geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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R. Kerbl, Leoben

A. Wiater, Köln

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Sauseng, W., Rauter, L. & Kerbl, R. Nachtschreck, Schlafwandeln und Albträume. Monatsschr Kinderheilkd 164, 1096–1102 (2016). https://doi.org/10.1007/s00112-016-0170-3

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