Jan. 8, 2003 -- Frequent episodes of sleepwalking and sleep terrors in children may result from allergies, swollen tonsils, and other factors that interfere with nighttime breathing -- and may be cured with surgery to remove the tonsils and adenoids.
So conclude Stanford University researchers in a breakthrough study that offers new insight into these two puzzling sleep disturbances, which some experts say may occur at least once in up to 50% of children during their lifetime. Although often attributed to stress or anxiety, it's not really clear what triggers these nocturnal nuisances, how to treat them, or why they can persist for months or years.
In their study, published in the January issue of Pediatrics, the researchers found that nearly all of the 84 children with recurring sleepwalking and/or sleep terrors suffered problems that affected sleep-time breathing -- such as habitual snoring, a history of upper respiratory infection, earaches, or mouth breathing. Meanwhile, virtually none of 36 other "control" children without sleep disturbances experienced such so-called "sleep-disordered breathing."
Most of the children with sleep-disordered breathing were then treated with tonsillectomy or adenoidectomy, procedures to remove enlarged tonsils and adenoids and help improve airflow.
"They were all cured of their sleep disturbances," says Christian Guilleminault, MD, BiolD, director of clinical research at the Stanford University Sleep Disorders Clinic. "Now, it's a matter of convincing the pediatricians and [ear nose and throat] surgeons that persistent sleepwalking and sleep terrors may be related to breathing problems -- and not just anxiety. In fact, six of the children could not get surgery because surgeons had never heard of the relationship and refused to operate on them."
While it's well documented how breathing difficulties can affect adult sleep patterns and quality, this study marks the impact they may have on children.
"To bring this into the pediatric arena, where there is less awareness of some of these relationships, is really important," says Carl E. Hunt, MD, pediatrician and director of the National Center on Sleep Disorders Research, part of the federal National Institutes of Health. "It's also a call for parents to know that it's not normal for children to snore loudly and frequently. If your child is developing or already having recurring problems with sleepwalking or night terrors and he or she frequently snores, it certainly increases the need to be evaluated."