Version July 2025
| Disorder | Transition from wakefulness into sleep | NREM sleep | REM sleep | Comments |
| Parasomnias | ||||
| Confusional arousals | X* | Very common in young children and usually resolve by late childhood. | ||
| Sleepwalking | X* | |||
| Sleep terrors | X* | |||
| Nightmares | X | Most common in children; persist into adulthood in 2 to 8% of the population. | ||
| Sleep paralysis | X | Onset usually in adolescence. | ||
| Sleep enuresis | X | X | Defined as age >5 years and two or more episodes/week. | |
| REM sleep behavior disorder | X | Seen more frequently in adults than in children. Strong association with synucleinopathy in adults. In children, associated with narcolepsy type 1, serotonergic antidepressants, or structural brainstem lesions. | ||
| Parasomnia overlap disorder | X | X | REM sleep behavior disorder combined with another parasomnia. | |
| Sleep-related movement disorders | ||||
| Restless legs syndrome (RLS) | Urge to move legs occurs at rest while awake. Often associated with iron deficiency; refer to UpToDate topic on RLS in children. | |||
| Periodic limb movement disorder (PLMD) | X | Often associated with iron deficiency and RLS. | ||
| Nocturnal muscle cramps | May be idiopathic or secondary to other medical conditions. In children these are typically benign and self-limited. The frequency tends to increase with advancing age. | |||
| Bruxism | X | |||
| Rhythmic movement disorder (RMD) | X | X | (X) | Rhythmic movements at sleep onset are common and benign in infants and toddlers. This is termed rhythmic movement disorder if there is associated self-injury, interference with sleep, or effects on daytime function. The exclusively REM-related rhythmic movements occur more frequently in adults. |
| Benign sleep myoclonus of infancy | X | Occurs in neurologically normal infants younger than six months of age. | ||
| Propriospinal myoclonus at sleep onset | X | Usually adult-onset. Clinically similar to hypnic jerks. Daytime emergence of movements can suggest seizure or spinal cord pathology. | ||
| Isolated symptoms and normal variants | ||||
| X | Common at all ages; occurs at sleep onset. | ||
| X | X | Common at all ages; typically near sleep onset. | |
| X | Benign and nonprogressive myoclonus that is subtle, mainly characterized by EMG findings during PSG. Commonly an incidental finding. | ||
| X | Catathrenia is usually categorized with sleep-related breathing disorders because it appears to be associated with prolonged expiration. | ||
| Sleep-related medical and neurological disorders | ||||
| Sleep-related epilepsy | X* | Episodes tend to be brief, stereotyped, and occur in clusters, randomly through the night. | ||
EMG: electromyography; NREM: non-rapid eye movement; PLMD: periodic limb movement disorder; PSG: polysomnography; REM: rapid eye movement; RLS: restless legs syndrome; RMD: rhythmic movement disorder.
* Confusional arousals, sleepwalking and night terrors arise during stage N3 of NREM sleep, which tends to occur during the first third of the night. Sleep-related epilepsy tends to occur during stage N1 or N2 of NREM sleep, and is more likely to occur in clusters and randomly through the night.