Sleepwalking and Night Crying in Children: Causes and Solutions

Dream behavior during sleep

Hello, doctor! My son is currently six and a half years old.
He has not attended preschool for four months due to treatment for sinusitis.
He has a long-standing issue with not wanting to sleep and having difficulty falling asleep.
For the past nine days, every night after falling asleep for about 45 to 60 minutes (this has been consistent every night), he starts crying.
Only one night did he sleep through until morning (that day he had a folk remedy treatment).
While crying, he sits up and talks in his sleep about things he did during the day, with his eyes open.
He can gradually respond clearly to questions but does not remember what he dreamed about.
On one occasion, he got up to look for a toy.
Since he can respond to questions, I can guide him back to sleep, and once he falls asleep again, he sleeps soundly until morning.
His behavior during the day is normal, and there are no physiological abnormalities.
I would like to ask the doctor if this behavior is normal, what might be causing it, and what solutions are available.
Thank you!

Tina, 30~39 year old female. Ask Date: 2001/03/17

Dr. Li Junren reply Psychiatry

The phenomenon you described is known as somnambulism, which typically begins to appear between the ages of 6 and 8, peaks around 12 years old, and generally decreases or disappears by around 15.
Somnambulism occurs during specific periods of the sleep cycle, and during these episodes, the individual is not actually dreaming (hence the term "sleepwalking" is somewhat misleading), so children do not remember having any dreams.
Approximately 15% of children experience somnambulism, which is a common occurrence and usually not a cause for excessive concern.

It is important to note the following:
1.
Keep the bedroom environment simple to avoid injuries or contact with dangerous objects during episodes of somnambulism.

2.
Excessive fatigue or excitement during the day can increase the likelihood of somnambulism at night.

3.
If the frequency of somnambulism is high or poses a risk of injury, a psychiatrist may prescribe medication to help reduce the episodes.

4.
If somnambulism persists into adulthood, it is advisable to consult a neurologist for a thorough evaluation to clarify any potential issues (most cases are mild abnormalities).

Reply Date: 2001/03/17

More Info

Sleep disturbances in children, such as sleepwalking and night crying, can be concerning for parents. In your case, your six-and-a-half-year-old son is experiencing episodes of crying and sleep talking shortly after falling asleep, which can be distressing for both him and you. Understanding the underlying causes and potential solutions can help alleviate these issues.

Understanding the Behavior
1. Sleep Stages and Sleep Disorders: Children experience different stages of sleep, including non-REM (Rapid Eye Movement) and REM sleep. Sleepwalking typically occurs during non-REM sleep, particularly in the first third of the night. In contrast, night terrors can occur during deep sleep and are characterized by intense fear and confusion, often with little memory of the event. Your son's behavior seems to align more with sleep talking and possibly night terrors, given that he is sitting up, responding to questions, and then returning to sleep.

2. Triggers: Various factors can contribute to sleep disturbances in children:
- Stress and Anxiety: Changes in routine, such as not attending preschool due to sinusitis treatment, can lead to anxiety and affect sleep patterns.

- Overstimulation: Engaging in stimulating activities before bedtime can make it harder for children to settle down.

- Physical Health: Conditions like sinusitis can cause discomfort, leading to difficulty sleeping. Even if your son appears healthy during the day, underlying issues can still affect his sleep.

3. Developmental Factors: Children often go through phases of sleep disturbances as part of their development. As they grow, their sleep patterns may change, and they may experience nightmares or night terrors.

Solutions and Recommendations
1. Establish a Consistent Bedtime Routine: A calming bedtime routine can signal to your child that it’s time to wind down. This could include activities such as reading a book, dimming the lights, and engaging in quiet play. Consistency is key, as it helps regulate their internal clock.

2. Create a Comfortable Sleep Environment: Ensure that your child's sleeping area is conducive to sleep. This includes a comfortable mattress, appropriate room temperature, and minimal noise and light. Consider using blackout curtains and white noise machines if necessary.

3. Monitor Daytime Activities: Encourage a balance of physical activity and quiet time during the day. Ensure that your child has ample opportunities for physical play, but also incorporate quiet activities in the evening to help them transition to sleep.

4. Address Potential Stressors: Since your son has not been attending preschool, he may be experiencing some anxiety or stress. Engage in conversations about his feelings and reassure him. If he expresses fears or concerns, validate those feelings and provide comfort.

5. Limit Stimulants: Avoid caffeine and sugar in the hours leading up to bedtime. Additionally, limit screen time before bed, as the blue light emitted by screens can interfere with melatonin production and disrupt sleep.

6. Consult a Pediatrician or Sleep Specialist: If the sleep disturbances persist or worsen, it may be beneficial to consult a pediatrician or a sleep specialist. They can assess for any underlying medical conditions and provide tailored advice or interventions.

7. Consider Professional Support: If anxiety or stress seems to be a significant factor, consider speaking with a child psychologist. They can provide strategies to help your child cope with any emotional challenges.

Conclusion
Sleep disturbances like sleepwalking and night crying can be common in children, especially during times of change or stress. By establishing a consistent bedtime routine, creating a comfortable sleep environment, and addressing any underlying issues, you can help your son achieve better sleep. If the situation does not improve, do not hesitate to seek professional help to ensure your child's well-being. Remember, sleep is crucial for a child's development, and addressing these issues early can lead to healthier sleep patterns in the future.

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