NREM sleep instability in children with sleep terrors: The role of slow wave activity interruptions

Center for Pediatric Sleep Disorders, Department of Developmental Neurology and Psychiatry, University of Rome La Sapienza, Via dei Sabelli 108, 00185 Rome, Italy.
Clinical Neurophysiology (Impact Factor: 3.1). 05/2008; 119(5):985-92. DOI: 10.1016/j.clinph.2008.01.015
Source: PubMed


To evaluate NREM sleep instability, as measured by the cyclic alternating pattern (CAP), in children with sleep terrors (ST) vs. normal controls.
Ten boys (mean age: 8.5 years, range 5-13) meeting the following inclusion criteria: (a) complaint of ST several times a month, (b) a history of ST confirmed by a third person, and (c) a diagnosis of ST according to the ICSD-2 criteria. Eleven age-matched control children with parental report of at least 8.5h of nightly sleep, absence of known daytime consequences of sleep disorders were recruited by advertisement from the community. Sleep was visually scored for sleep macrostructure and CAP using standard criteria.
Sleep macrostructure showed only a significantly increased number of awakenings per hour and reduced sleep efficiency in ST subjects. CAP parameters analysis revealed several significant differences in ST vs. controls: an increase of total CAP rate in SWS, of A1 index in SWS and of the mean duration of A phases while B phases had a decreased duration, exclusively in SWS. The normalized CAP interval-distribution graphs showed significant differences in SWS with interval classes 10< or = i < 35s higher in children with ST and intervals classes above 50s higher in normal controls.
Children with ST showed faster alternations of the amplitude of slow EEG bursts during SWS. This abnormally fast alternation of the EEG amplitude in SWS is linked to the frequent intrusion of CAP B phases interrupting the continuity of slow delta activity and could be considered as a neurophysiological marker of ST.
This abnormal alternation of the EEG amplitude in SWS is associated with the occurrence of parasomnias and might be considered as a neurophysiological marker of disorders of arousal.

Download full-text


Available from: Oliviero Bruni, May 08, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: Die internationale Klassifikation der Schlafstörungen (lCSD-2) definiert Parasomnien als unerwünschte physische Ereignisse oder Empfindungen, die beim Einschlafen, während des Schlafes oder beim Erwachen aus dem Schlaf auftreten. Parasomnien sind in der Kindheit häufig, meist gutartig und verschwinden im Jugendalter wieder. Jedoch ist die Differentialdiagnose oft schwierig in Bezug auf eine Abgrenzung gegenüber epileptischen und nicht-epileptischen Ereignissen im Schlaf. Die Polysomnographie reicht oft nicht zur Diagnose aus, und eine Video-Polysomnographie kann erforderlich sein, um Parasomnien von anderen Schlafstörungen zu unterscheiden, die durch Anfälle verursacht sein können. Dies ist insbesondere dann erforderlich, wenn es nicht möglich ist, die Ätiologie der motorischen Störung im Schlaf zu erkennen. Das korrekte Erkennen der Parasomnien ist wichtig, um Fehldiagnosen zu vermeiden und eine angemessene Therapie zu wählen. Wir stellen hier die Hauptformen der kindlichen Parasomnien in drei Gruppen dar: 1) Aufwachstörungen (aus dem NREM Schlaf) 2) assoziierte Parasomnien 3) andere Parasomnien. Künftige Studien müssen die Genetik, die Pathophysiologie, die auslösenden Faktoren und die Zusammenhänge zwischen NREM Schlafstruktur und dem Auftreten der parasomnischen Ereignisse klären.
    No preview · Article · Mar 2008 · Somnologie - Schlafforschung und Schlafmedizin
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Parasomnias are undesirable physical events which occur during sleep, usually presenting as motor phenomena associated with arousal. They are common in childhood and adolescence, and may result in significant distress to the victim and/or family members, and occasionally result in violent and injurious behavior. Extensive study of these conditions has identified a wide variety of underlying conditions, and has permitted the development of a classification system, with indications for evaluation and treatment.
    Preview · Article · Feb 1990 · Paediatrician
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Thesis (M.S.)--State University of New York at Buffalo, 2001. Includes bibliographical references (leaves 101-106). Photocopy of typescript.
    Full-text · Article · Jan 2001
Show more