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Sleep Disorders

Son yells in his sleep

05/16/2008

Question:

My son just turned 4. Almost nightly, probably 85% of the time, he starts yelling in his sleep. It can occur at any time during the night. Sometimes it is just yelling and other times he is saying things such as No Doo-Doo (doo-doo is what he calls his older sister) or he is yelling for mommy, things like that. He does get very sweaty shortly after falling asleep. Sometimes we can wake him up when he is yelling and he will respond and calm down if you turn on his music; so that makes me think it is not night terrors. Sometimes he does this multiple times a night, sometimes just once, and sometimes not at all. I was reserved to think this is just how he is, but on occasion I start to worry about it. My older daughter has never done anything like this and she is now almost 8 years old. I was hoping that my son would start to grow out of it, but that doesn`t seem to be happening. Most of the time we just let him yell/cry and we don`t go to him, but some nights the yelling is really bad. Any thoughts you have would be appreciated.

Answer:

You described your 4 yr old son who about 85% of nights yells in his sleep at different time during the night.

This behavior is common in children. We call this kind of unusual behavior during sleep a parasomnia.

Parasomnias include sleepwalking, confusional arousals, sleep terrors and nightmares. These disorders share a number of important features including the timing of night, type of behaviors and whether they can be remembered by the child the next morning.

While sudden movements or talking can occur during any sleep stage, they are most frequent during slow wave sleep (also called deep sleep). In toddlers and preschool children, the most common type of parasomnia is confusional arousals, which are events that are not remembered by the child in the morning. During these episodes, children may thrash about with eyes open acting confused or agitated. They generally will last 5-30 minutes. There is frequently a family history of these kinds of episodes.

Factors felt to increase the number of these episodes are sleep deprivation, a chaotic sleep wake schedule, stopping afternoon napping, an increase in physical activity, new snoring during the night or frequent leg movements or pains during the night. A new stressful circumstance such as starting preschool or the birth of a new sibling can also be important.

The good news is that these events are harmless and generally self-limited. There is no specific treatment other than reassurance after proper diagnosis. Basic safety precautions in the bedroom are recommended. Usually it is simply best for the parent to make sure the child is safe but to not try to hold or awaken the child which may only prolong the event. The parent's job is to ensure that no injury occurs. If there are specific psychological stresses identified that appear to be related to the onset, then these should be addressed.

I suggest further discussion with your child's doctor.

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Response by:

Mark   Splaingard, MD Mark Splaingard, MD
Clinical Professor of Pediatrics
College of Medicine
The Ohio State University