Childhood non-REM parasomnia associated with obstructive sleep apnea: effectiveness of CPAP treatment

Abstract

Parasomnias are neurological disorders characterized by undesirable physical events or experiences that occur during sleep. Obstrictive sleep apnea (OSA) is increasingly recognized as an aggravating factor for parasomnias, however, the association between the two disorders has not been well elucidated among children. The aim of the study was to identify the association between non-REM parasomnia and OSA in cases of children especially focusing on the effect of OSA treatment. Two cases of non-REM parasomnia (9 and 11 years old) presented with sleepwalking, sleep terrors and snoring were involved. Polysomnography (PSG) was conducted to identify the characteristics of nocturnal events and the severity of OSA. Treatment of OSA was introduced with CPAP and the PSG parameters under CPAP were evaluated. Improvement of parasomnia events were followed for at least 3 months. Nocturnal events were observed during slow wave sleep and severe OSA (apnea hypopnea index of more than 15) was also noted in both cases. Treatment with CPAP dramatically improved non-REM parasomnia in one case, however, nocturnal event did not decrease with CPAP in another case. Presence of OSA could aggravate the severity of non-REM parasomnia in children. Importance of conducting the screening of OSA among children with non-REM parasomnia has been suggested.