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Original Investigation |

Childhood Sleepwalking and Sleep Terrors A Longitudinal Study of Prevalence and Familial Aggregation

Dominique Petit, PhD1,2; Marie-Hélène Pennestri, PhD1,3; Jean Paquet, PhD1,2; Alex Desautels, MD, PhD1,4,5; Antonio Zadra, PhD1,6; Frank Vitaro, PhD7,8; Richard E. Tremblay, PhD6,8,9,10; Michel Boivin, PhD11,12; Jacques Montplaisir, MD, PhD1,2
[+] Author Affiliations
1Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
2Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada
3Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
4Department of Neurosciences, Université de Montréal, Montreal, Quebec, Canada
5Service of Neurology, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
6Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
7School of Psychoeducation, Université de Montréal, Montreal, Quebec, Canada
8Research Unit on Children’s Psychosocial Maladjustment, Université de Montréal, Montreal, Quebec, Canada
9Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
10School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
11Research Unit on Children’s Psychosocial Maladjustment, Laval University, Quebec City, Quebec, Canada
12Institute of Genetic, Neurobiological, and Social Foundations of Child Development, Tomsk State University, Tomsk, Tomsk Oblast, Russian Federation
JAMA Pediatr. 2015;169(7):653-658. doi:10.1001/jamapediatrics.2015.127.
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Importance  Childhood sleepwalking and sleep terrors are 2 parasomnias with a risk of serious injury for which familial aggregation has been shown.

Objectives  To assess the prevalence of sleepwalking and sleep terrors during childhood; to investigate the link between early sleep terrors and sleepwalking later in childhood; and to evaluate the degree of association between parental history of sleepwalking and presence of somnambulism and sleep terrors in children.

Design, Setting, and Participants  Sleep data from a large prospective longitudinal cohort (the Quebec Longitudinal Study of Child Development) of 1940 children born in 1997 and 1998 in the province were studied from March 1999 to March 2011.

Main Outcomes and Measures  Prevalence of sleep terrors and sleepwalking was assessed yearly from ages 11/2 and 21/2 years, respectively, to age 13 years through a questionnaire completed by the mother. Parental history of sleepwalking was also queried.

Results  The peak of prevalence was observed at 11/2 years for sleep terrors (34.4% of children; 95% CI, 32.3%-36.5%) and at age 10 years for sleepwalking (13.4%; 95% CI, 11.3%-15.5%). As many as one-third of the children who had early childhood sleep terrors developed sleepwalking later in childhood. The prevalence of childhood sleepwalking increases with the degree of parental history of sleepwalking: 22.5% (95% CI, 19.2%-25.8%) for children without a parental history of sleepwalking, 47.4% (95% CI, 38.9%-55.9%) for children who had 1 parent with a history of sleepwalking, and 61.5% (95% CI, 42.8%-80.2%) for children whose mother and father had a history of sleepwalking. Moreover, parental history of sleepwalking predicted the incidence of sleep terrors in children as well as the persistent nature of sleep terrors.

Conclusions and Relevance  These findings substantiate the strong familial aggregation for the 2 parasomnias and lend support to the notion that sleepwalking and sleep terrors represent 2 manifestations of the same underlying pathophysiological entity.

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Figure.
Onset of New Cases of Sleep Terrors and Sleepwalking as a Function of Age

From the peak prevalence of 34.4% at age 11/2 years, the number of new cases of sleep terrors (orange squares) decreased rapidly each year to reach 10% at age 7 years. Conversely, the number of new cases of sleepwalking (open circles) increased steadily until age 12 years. Assessment of sleep terrors begins at age 21/2 years and assessment of sleepwalking at 31/2 years because the data presented here are the new cases reported after the first assessment time. Error bars represent 95% CIs.

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