Investigation of Clinical Features and Comorbid Psychopathologies of Children with Sleep Terrors

Yıl 2024, , 421 - 433, 30.09.2024

Özlem Şireli , Ayla Uzun Çiçek , Elif Abanoz , İlknur Ucuz , Yüksel Sümeyra Naralan

https://doi.org/10.34087/cbusbed.1479121

Öz

Giriş ve Amaç: Bu çalışmada, uyku terörü tanısı konulan çocukların uyku ortamı ve uyku alışkanlıkları, eşlik eden psikiyatrik bozukluklar, diğer parasomnialar ve tedavi geçmişi dahil klinik özelliklerinin incelenmesi amaçlanmıştır.
Gereç ve Yöntemler: Çalışmaya, 2020-2024 yılları arasında 3 farklı Çocuk ve Ergen Psikiyatri polikliniğinde DSM-5 tanı kriterlerine göre uyku terörü tanısı konulmuş 51 çocuk dahil edilmiştir. Olguların sosyodemografik ve klinik özellikleri geriye dönük olarak dosya üzerinden incelenmiştir.
Bulgular: Of the 51 participants, 30 (58.8%) were male, 21 (41.2%) were female and the mean age at the time of admission was 6.76±1.45 years (min-max: 3-10 years). Olguların15’inin (%29.4) gürültülü bir ortamda uyduğu, 41’inin (%80,4) uyku terörü atağı dışında uykularının kesintiye uğradığı belirlenmiştir. 17’sinde (%33,3) en az bir psikiyatrik bozukluk saptanmış olup, en sık [n=5 (%9,8)] komorbid psikiyatrik bozukluk dikkat eksikliği hiperaktivite bozukluğudur. 14’ünde (%27,5) diğer parasomnilerin eşlik ettiği belirlenmiştir. Olguların klinik özellikleri yaş grubuna göre karşılaştırıldığında, okul öncesi dönemdekilerde tam retrograd amnezinin, okul çağındakilerinde ise atak sırasındaki motor aktivitenin, bedensel yaralanma ve/veya maddi hasarın, atak esnasında tam uyanmanın anlamlı olarak yüksek olduğu saptanmıştır. Ebeveynlerin %64,7’sinin atak esansında yanlış müdahalede bulunduğu, olguların %29,4’ünde, tedavi geçmişinde yanlış ilaç uygulandığı belirlenmiştir.
Sonuç: Çocukluk dönemi uyku teröründe, tanısal değerlendirme sürecinde olası tetikleyici etmenlerin tespiti, eşlik eden psikiyatrik bozuklukların saptanması, tedavide ebeveynlerin psikoeğitimi, gerekli olduğu durumlarda medikasyonda uygun ilaç seçimi oldukça önemlidir.

Anahtar Kelimeler

Uyku terörü, parasomnia, psikiyatrik komorbidite

Investigation of Clinical Features and Comorbid Psychopathologies of Children with Sleep Terrors

Öz

Aim: In this study, it was aimed to investigate the clinical characteristics of children diagnosed with sleep terrors, including sleep environment and sleep habits, clinical features and comorbid psychiatric disorders.
Method: Between 2020 and 2024, 51 children who were diagnosed with sleep terror according to DSM-5 diagnostic criteria in 3 different Child and Adolescent Psychiatry clinics were included in the study. The sociodemographic and clinical characteristics of the cases were examined retrospectively through the files.
Results: Of the 51 participants, 30 (58.8%) were male, 21 (41.2%) were female and the mean age at the time of admission was 6.76±1.45 years. It was determined that 15 (29.4%) of the cases slept in a noisy environment and 41 (80.4%) of the cases had their sleep interrupted except for sleep terror attacks. At least one psychiatric disorder was detected in 17 (33.3%) patients, and the most common (9.8%) comorbid psychiatric disorder was attention deficit hyperactivity disorder. It was found that complete retrograde amnesia was significantly higher in preschoolers, and motor activity during the attack, physical injury and/or material damage, and full awakening during the attack were significantly higher in school-age children. It was determined that 64.7% of the parents intervened incorrectly during the episode, and in 29.4% of the cases, the wrong medication was applied in the treatment history.
Conclusion: In sleep terrors, identification of triggering factors and comorbid psychiatric disorders during the diagnostic evaluation process, psychoeducation of parents in treatment, and selection of appropriate medication for medication are very important.

Anahtar Kelimeler

Sleep terrors, parasomnia, comorbid psychiatric disorder

Etik Beyan

All procedures were performed in accordance with the Good Clinical Practice procedures and the current revision of the Declaration of Helsinki and the study protocol was approved by the local institutional Ethics Committee.

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