Primary prevention

Although some parasomnias are considered normal in children, it is good practice to ensure adequate sleep time and avoid sleep deprivation. Good sleep hygiene includes the following measures: American Academy of Sleep Medicine: healthy sleep habits Opens in new window

  • Going to bed and getting up at the same time each day

  • Avoiding excessive and late daytime naps

  • Avoiding excessive light exposure before bedtime (including TV, video games, and computer use)

  • Avoiding spending a lot of time awake in bed

  • Getting regular exercise every day in the mid to late afternoon

  • Limiting caffeine-containing drinks

  • Avoidance of nicotine (relevant in adolescents)

  • Avoidance of alcohol (relevant in adolescents)

  • Avoidance of dealing with school-related or work-related issues before bedtime (work issues may be relevant in older adolescents)

  • If sleep onset does not take place within 20 minutes of going to bed, it is suggested that the patient gets out of bed and engages in a relaxing activity, such as reading for a while, and then returns to bed when feeling sleepy.

Secondary prevention

Children and their parents need to be counselled concerning the need for good sleep hygiene, avoidance of stress if possible, and avoidance of caffeine and alcohol use (relevant in adolescents).

Prevention of sleep-related injury is an important consideration. During an episode of confusional arousal, sleepwalking, or sleep terror, no restraint or interference should be instituted. Environment modifications may be necessary to ensure patient safety and prevent injury. Examples of possible measures include sleeping in a padded bed on the ground floor, keeping the windows closed and covered with curtains (especially if sleepwalking is likely), placing door alarms on doors exiting the home, and removing sharp objects from the bedroom environment. Parents should also consider removal of any potentially dangerous items and store them in locked boxes (medications, car keys, knives, and guns).[48]

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