Sleep terrors (pavor nocturnus), estimated to occur in 1% to 3% of children,1 are frequently a cause of considerable parental anxiety because of the often extreme level of agitation and arousal involved in their clinical presentation. Sleep terrors are primarily defined as an arousal disorder, arising out of stage 3 or 4 non–rapid eye movement (REM) sleep, and are felt to be a reflection of relative central nervous system maturation delay.2 However, relatively little is known about the pathophysiology of arousal disorders, which also include somnambulism (sleepwalking) and confusional arousals. We report a case of a child with a very dramatic presentation of sleep terrors, in whom the constellation of potential precipitating and exacerbating factors suggests an etiologic model of complex interactions among several psychological and medical variables.
Sleep study results (percentage of time spent in various sleep stages). REM indicates rapid eye movement.
Potential chronic and acute risk factors for night terrors. CNS indicates central nervous system; OSAS, obstructive sleep apnea syndrome.
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