Confusional arousals: frequent in children aged <5 years and less common in older childhood (the prevalence of confusional arousals in adults is about 2% to 4%).[1]American Academy of Sleep Medicine. The AASM international classification of sleep disorders - third edition, text revision (ICSD-3-TR). Jun 2023 [internet publication].
https://aasm.org/clinical-resources/international-classification-sleep-disorders
A strong familial pattern exists for idiopathic confusional arousals.
Sleepwalking: the prevalence among children is around 5%, but this is likely to be an underestimate.[7]Stallman HM, Kohler M. Prevalence of sleepwalking: a systematic review and meta-analysis. PLoS One. 2016 Nov 10;11(11):e0164769.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0164769
http://www.ncbi.nlm.nih.gov/pubmed/27832078?tool=bestpractice.com
One Canadian study reported a prevalence of approximately 29% for the entire childhood period (aged 2.5-13 years), with a peak prevalence of 13% at around 10-13 years.[8]Petit D, Pennestri MH, Paquet J, et al. Childhood sleepwalking and sleep terrors: a longitudinal study of prevalence and familial aggregation. JAMA Pediatr. 2015 Jul;169(7):653-8.
http://www.ncbi.nlm.nih.gov/pubmed/25938617?tool=bestpractice.com
Sleepwalking decreases significantly with advancing age.[7]Stallman HM, Kohler M. Prevalence of sleepwalking: a systematic review and meta-analysis. PLoS One. 2016 Nov 10;11(11):e0164769.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0164769
http://www.ncbi.nlm.nih.gov/pubmed/27832078?tool=bestpractice.com
Sleepwalking occurs more often in girls during childhood but more often in men during adulthood.[5]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. text revision, (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022
Sleep terrors: particularly common in early childhood.[6]Bruni O, DelRosso LM, Melegari MG, et al. The parasomnias. Child Adolesc Psychiatr Clin N Am. 2021 Jan;30(1):131-42.
http://www.ncbi.nlm.nih.gov/pubmed/33223057?tool=bestpractice.com
One Canadian study reported a prevalence of around 34% for children aged 1.5 years. This rapidly decreased to around 13% at 5 years, and slowly tapered to around 5% at 13 years.[8]Petit D, Pennestri MH, Paquet J, et al. Childhood sleepwalking and sleep terrors: a longitudinal study of prevalence and familial aggregation. JAMA Pediatr. 2015 Jul;169(7):653-8.
http://www.ncbi.nlm.nih.gov/pubmed/25938617?tool=bestpractice.com
Nightmares: it is important to differentiate the prevalence of nightmares from that of ‘nightmare disorder’.[9]Gieselmann A, Ait Aoudia M, Carr M, et al. Aetiology and treatment of nightmare disorder: state of the art and future perspectives. J Sleep Res. 2019 Aug;28(4):e12820.
https://onlinelibrary.wiley.com/doi/10.1111/jsr.12820
http://www.ncbi.nlm.nih.gov/pubmed/30697860?tool=bestpractice.com
Nightmares are common among children, beginning as young as 2.5 years and occurring in 60% to 70%.[1]American Academy of Sleep Medicine. The AASM international classification of sleep disorders - third edition, text revision (ICSD-3-TR). Jun 2023 [internet publication].
https://aasm.org/clinical-resources/international-classification-sleep-disorders
Nightmare prevalence peaks between the aged of 10-14 years and decreases with age.[10]El Sabbagh E, Johns AN, Mather CE, et al. A systematic review of nightmare prevalence in children. Sleep Med Rev. 2023 Oct;71:101834.
http://www.ncbi.nlm.nih.gov/pubmed/37651893?tool=bestpractice.com
In contrast, nightmare disorder, characterised by recurrent nightmares causing significant distress or impairment, is less common. One international study estimated the prevalence of nightmare disorder in children at 3% to 6%.[10]El Sabbagh E, Johns AN, Mather CE, et al. A systematic review of nightmare prevalence in children. Sleep Med Rev. 2023 Oct;71:101834.
http://www.ncbi.nlm.nih.gov/pubmed/37651893?tool=bestpractice.com
Recurrent isolated sleep paralysis: one study from Mexico reviewing the prevalence and characteristics of sleep paralysis in adolescents revealed a mean age of 15.9 years and a prevalence rate of 27.6%.[11]Jimenez-Genchi A, Avila-Rodriguez VM, Sanchez-Rojas F, et al. Sleep paralysis in adolescents: the 'a dead body climbed on top of me' phenomenon in Mexico. Psychiatry Clin Neurosci. 2009;63;546-549.
http://www.ncbi.nlm.nih.gov/pubmed/19496997?tool=bestpractice.com
Rapid eye movement sleep behaviour disorder (RBD): prevalence is around 1% to 2% in middle to older-aged individuals.[5]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. text revision, (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022 Once thought to occur exclusively in adults, RBD has now been reported in children and adolescents.[12]Nevsimalova S, Prihodova I, Kemlink D, et al. REM behavior disorder (RBD) can be one of the first symptoms of childhood narcolepsy. Sleep Med. 2007;8:784-786.
http://www.ncbi.nlm.nih.gov/pubmed/17569582?tool=bestpractice.com
[13]Stores G. Rapid eye movement sleep behaviour disorder in children and adolescents. Dev Med Child Neurol. 2008;50:728-732.
http://onlinelibrary.wiley.com/doi/10.1111/j.1469-8749.2008.03071.x/full
http://www.ncbi.nlm.nih.gov/pubmed/18834385?tool=bestpractice.com
It is very rare in children, but its presence may be associated with narcolepsy, epilepsy, and the use of antidepressants.[12]Nevsimalova S, Prihodova I, Kemlink D, et al. REM behavior disorder (RBD) can be one of the first symptoms of childhood narcolepsy. Sleep Med. 2007;8:784-786.
http://www.ncbi.nlm.nih.gov/pubmed/17569582?tool=bestpractice.com
[13]Stores G. Rapid eye movement sleep behaviour disorder in children and adolescents. Dev Med Child Neurol. 2008;50:728-732.
http://onlinelibrary.wiley.com/doi/10.1111/j.1469-8749.2008.03071.x/full
http://www.ncbi.nlm.nih.gov/pubmed/18834385?tool=bestpractice.com
[14]Bonakis A, Howard RS, Ebrahim IO, et al. REM sleep behaviour disorder (RBD) and its associations in young patients. Sleep Med. 2009;10:641-645.
http://www.ncbi.nlm.nih.gov/pubmed/19109063?tool=bestpractice.com
[15]Bonakis A, Howard RS, Williams A. Narcolepsy presenting as REM sleep behaviour disorder. Clin Neurol Neurosurg. 2008;110:518-520.
http://www.ncbi.nlm.nih.gov/pubmed/18343568?tool=bestpractice.com
[16]Dauvilliers Y, Rompre S, Gagnon JF, et al. REM sleep characteristics in narcolepsy and REM sleep behavior disorder. Sleep. 2007;30:844-849.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1978363/?tool=pubmed
http://www.ncbi.nlm.nih.gov/pubmed/17682654?tool=bestpractice.com
The overall prevalence of violent behaviours during sleep in the general population is estimated at 2% (people aged between 15 and 100 years), and of these behaviours, about 25% were probably due to RBD, giving an overall prevalence of 0.5% for the disorder.[17]Ohayon MM, Caulet M, Priest RG. Violent behavior during sleep. J Clin Psychiatry. 1997;58:369-376.
http://www.ncbi.nlm.nih.gov/pubmed/9515980?tool=bestpractice.com