Pediatric sleep disorders are reviewed from the Infant and Family Development Laboratory, Department of Psychiatry and Graduate Program in Human Development, University of California, Davis. Sleep disorders associated with neurological disorders include: 1) sleep-related epilepsy; 2) sleep-related headaches; 3) degenerative disorders; 4) developmental disorders (Down syndrome; Prader-Willi syndrome); 5) methylphenidate treatment for ADHD causing sleep disturbance; and 6) Kleine-Levin syndrome, with episodic excessive somnolence. Medical and psychiatric disorders that interfere with sleep include: asthma, gastroesophageal reflux, psychoses, mood disorders, anxiety, and substance abuse disorders. Primary sleep disorders include dyssomnias (obstructive sleep apnea with enlarged tonsils and adenoids, narcolepsy, extrinsic sleep irregularities of infants, circadian rhythm sleep disorders); parasomnias (sleep terrors, sleepwalking, head banging, rocking, talking, leg cramps, nightmares, bruxism, enuresis). [1]

COMMENT. The pediatric neurologist may be consulted because of REM parasomnias and the differentiation of nightmares, sleep terrors, and nocturnal frontal lobe seizures. EEGs are frequently nonspecific, and video-polysomnographic monitoring is often necessary. A trial of anticonvulsant medication, eg clonazepam, may be warranted in suspected but unconfirmed cases of seizures. (see Ped Neur Briefs Oct 1996 for reports of nocturnal frontal lobe epilepsy and differential diagnosis).