Losing Sleep: Parasomnias in Children

The impact of children on a parent’s sleep schedule was something I did not grasp until I became a parent. Of course, everyone told me when I was pregnant with The Bear to “rest up.” I heard them, but  I couldn’t fathom the level of sleep deprivation we would experience until it happened. His first year he slept through the night without waking up once. I remember because it was Christmas Eve and when I woke up I felt like a kid on Christmas morning.

But the other eleven months and 29 days were a different story. I was frustrated. I felt insane. I felt incompetent. Sad. Resentful. Exhausted.

He just wouldn’t sleep. We tried EVERYTHING. Our very diplomatic pediatrician told us that we should try whichever method of sleep training we preferred. Nice, but not helpful. One side of our family championed the “No Tears” method. We tried to meet his needs to soothe him: rock him, change him, feed him, sing to him, and cuddle him. The situation did not improve. The other side suggested the “Cry It Out” method. We discovered our son had quite a set of lungs and was incredibly stubborn. One awful night we went 76 minutes of nonstop crying. I couldn’t do it again. I constantly felt I needed to explain and justify what I was doing to everyone. And it wasn’t working so I felt stupid when I did.

Fortunately, I discovered I was not alone. A friend and new mom at work asked if I had heard about “the sleep lady.” I hadn’t. (As much as I wanted to research and read about sleep training, I was attempting to balance my new roles as a mother, a wife with a child, and a working mom.) I learned that “the sleep lady” was a pediatric sleep specialist. I still felt that The Bear’s poor sleeping was a result of my incompetence and if I tried harder, I could fix this myself. That sounds crazy to me now, but as a new parent I was still figuring things out. I avoided looking into it for a couple months.  Eventually, I did call. It would be a few weeks before I could get in and schedule a sitter to keep the boy while I went. We also were asked to fill out a sleep log of all The Bear’s naps, bedtimes, and night wakings. Meticulously, I  made sure every second of sleep (or lack of) was accounted for on the logs. We also filled out forms on our family medical history.

The day of the appointment came and I was praying for relief. The sleep specialist reviewed our logs and interviewed me about The Bear’s sleep habits. Misconceptions about sleep in infants were dispelled. Sleep requirements were clarified. Napping instructions were provided. This influx of information felt good. For the first time, I felt in control and prepared. The sleep specialist designed a sleep training plan that was a combination of “No Tears” and CIO. She talked me through what to expect and what I would need to do. I felt empowered. As we were concluding she asked if I had any questions. Glancing down at the scribbles in my notebook I mentioned, “There is one more thing. Sometimes he has these fits where he is crying and flailing, but he appears to be asleep. We can’t get him to wake up. He looks like he’s in pain, but then he’ll just stop suddenly and go back to sleep. What should I do when happens?”

Her demeanor changed. “Tell me more about that.”

I basically repeated the same thing. She explained to me that these episodes had a name: confusion arousal. They occur in children ages 6 months to 6 years. Confusion arousal has the potential to evolve into night terrors and sleepwalking. It is often heredity. (It turns out that sleeping walking was prevalent in our families on both sides.) She said the most effective treatment was diligence to the sleep requirement for his age EVERY day, a consistent nap routine, and a safe sleeping environment.

Fast forward to today- almost 3 years later. What do I know now?

Losing Sleep

1.  The specialist did me a big favor that day by not telling me that my son’s predisposition for sleepwalking, night terrors, and nightmares was a type of sleep disorder. She never used those words. She just explained what it was and how to treat it. Honestly, that’s all I needed to know at the time. And luckily, because I was so relieved we were all sleeping I didn’t even think to look into it more. In my sleep-deprived mindset, I would have been terrified by the word “disorder.”  In the last year, I’ve done some research out of curiosity and I learned that sleepwalking, night terrors, and nightmares are parasomnias. Any sleep disorder that disrupts sleep is considered a parasomnia.  They are episodic and believed to be caused by an immature central nervous system which is why they show up in children. (Click here for an article with more information from the American Academy of Family Physicians.)

2. My son is not “not a good sleeper.” Occasionally when I mention that The Bear has a sleep disorder empathetic conversationalists offer, “My kids were not good sleepers either” or “None of my kids ever slept through the night.” I really appreciate the compassion, but it’s not the same thing. My daughter, Baybay, is not a good sleeper. I know what that looks like. The Bear is a great sleeper when he gets adequate rest. When he doesn’t he wakes up screaming, banging his body into his bed, and bawling. My daughter has never done this.

3. Limiting The Bear’s screen time before bedtime decreases his episodes. I know I sound like The Perfect Mom when it’s discovered that the kids don’t watch TV during the week. But during a night terror one evening, The Bear kept yelling, “No Thomas, I don’t to go to Tidmouth Sheds! No! No!” I know it sounds silly, but he was having a bad dream about the show he watched before bedtime. After that we cut TV on school nights and the couple hours before bedtime on the weekends.

4. Confusion arousal in a baby: Your best strategy is to ride it out. Refrain from stimulating the baby with songs or toys. Gentle and soothing touches can help.

5. Night terrors in a toddler/preschooler: Don’t ask questions. Like confusion arousal you do not want to stimulate the child. It’s really hard to hold back the, “what can I do for you?” or “are you okay?,” but try. Again, you have to ride it out and keep the child safe. Once I put some stuffed animals under and around the Bear’s legs to keep him from bruising them on his bed during a kicking fit. It’s tough- especially at 2:30 a.m.

6. Sleep Walking: This has only happened once and it was really scary. We tried to refrain from questions and him guide back to bed. He did run into a wall which upset him (and us), but he was fine. We put a baby gate across his door for several days following. All his furniture is bolted to the walls.

7.  Nightmares: We’ve only had a few instances of nightmares. We handled them the same way our parents did- crawl in bed with us and snuggle.

8. Sound machines worked very well for us. I remember receiving a Sleep Sheep before The Bear was born and wondering just how useful it would be. Turns out- VERY! I read an article referencing a new study reporting sound machines could be damaging to a baby’s hearing if played too loud. (I’m assuming Captain Obvious conducted this study.)  I like the Sleep Sheep because you can adjust the volume and set a timer for 23 minutes or 45 minutes. Then it shuts off.  It’s great for car rides, traveling, and cuing your child’s brain into sleep mode. I enjoyed it so much when I was co-sleeping with my newborns that I now have an app that turns my phone into my own sound machine (it also really helps drown out snoring!).

9. Life is going to get in the way of our sleep schedule. Illness is our biggest liability. One night of throwing up leads to a week of arousal, terrors, and once even sleepwalking. But we power through and do everything we can to meet our sleep requirement through naps and bedtime. Another challenge is traveling. We’re excited, eat differently, and sleep in different places. Sometimes it’s really hard to be diligent about napping and sleeping. (A video baby monitor was an outstanding gift and a game changer- especially for traveling.)  Recently, we were consulted by The Bear’s pre-K teachers about reducing his nap time at school because he wasn’t falling asleep. He then had to sit in the dark for 90 minutes with other napping preschoolers. I totally understand this request, but we had to devise some strategies to ensure he still gets the 12.5 hours of sleep a three-year old needs. So he goes to bed 15 minutes earlier and we have breakfast in the car so he can sleep 20 minutes later. So far so good!

10. For a while I had this weird guilt about telling people my son had a sleep disorder. It doesn’t require medication and only an occasional consult with a specialist. Nothing appears abnormal physically. There is very little threat of danger unless he is hurt during sleep walking or night terrors. I guess I felt like there wasn’t “enough wrong” for me to earn sympathy. I know so many families that manage life-threatening allergies or life-long hearing impairment. Parasomnia didn’t sound like a real problem. Then a few months ago my son had a bad  week of episodes which had not happened in many months. It was taxing on our entire family, but validated I am allowed to identify and discuss his disorder. It’s not a contest. It’s a challenge and we work through it as a family. And if I need a little compassion or support, it’s okay to ask for it.

For more information about childhood sleep, check St. Luke’s Pediatric Sleep Center. That’s where you’ll find “the sleep lady.” FYI, she does phone consults and my insurance covered the cost of the visit. If any of these parasomnias hit home with you, I’d love to hear from you in the comments section below.  I’m still learning and would love some support from others who travel a similar path. If you just have kids that are “not good sleepers,” I’ve got one of those too and I welcome your comments and ideas. Sweet dreams!

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6 thoughts on “Losing Sleep: Parasomnias in Children

  1. I am just about at the end of my rope right now and I feel like all the new mom’s that I know right now don’t have children with sleep issues. My one-year-old has his moments of good sleep (is a great napper!) but lately, he too has been waking up at night flailing and screaming like he is in pain. I chalked it up to teething – but there are still no teeth visible! (NO TEETH AT ALL!!!) I felt and still feel a lot like you did – I am a good mom, I should be able to figure out my child myself! Maybe it’s time for the sleep lady…

    • Mary, it sounds like you have put a lot of thought into what is happening with your little one. We also chocked up many of The Bears confusion arousals to teething (and maybe some of them were). It is really hard to analyze what is happening- especially when you are so sleep-deprived yourself. A helpful activity might be to keep a log for 5-7 days to track how much sleep your child is getting daily. Then compare his total hours of sleep a day (including naps) to the 13.5 hours of sleep a day a one-year requires. If you aren’t consistently meeting that it may be valuable to touch base with “the sleep lady” or your pediatrician. My new pediatrician has been a great resource (compared to the one I mentioned in the post). Please keep me posted on how you and your family are doing. Lauren and I are here to listen and support you!

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