1. Aim To identify common co-existing sleep disorders in childhood parasomnia and To assess sleep architecture in subgroup of children with parasomnia Introduction Parasomnia is a very common sleep problem in children and AASM defines parasomnia as “underlying physical events or experiences that occur during entry into sleep, within sleep or during arousals from sleep” Prevalence of Parasomnia – 10-15% Parasomnia is classified based on the sleep architecture NREM – sleep terrors, sleep walking, confusional arousal REM – RBD, night mares, sleep paralysis Unrelated – catathrenia, nocturnal enuresis Guilleminault et. al. in 2003 demonstrated 1.Disappearance of parasomnia after the treatment of the SDB or RLS/PLMS 2.High frequency of SDB in family members of children with parasomnia suggesting that SDB could precipitate certain parasomnias Method This was a IRB approved retrospective study from January 2000 to September 2012. We reviewed the medical records regarding - demographics, clinical features etc. We also collected data from one night polysomnography findings. A subgroup analysis which comprised of prepubertal children was compared with well established normative data by Gozal et al 2006. OSA means with OI more than 1 and PLMD means the PLM index more than 10. Results Total number of children enrolled – 145 Mean age of study population – 11.3 yrs Number of prepubertal children (subgroup analysis)– 80 Mean age of the prepubertal children – 8.6 yrs References 1. AAMS manual of polysomnography 2. Sleep walking and sleep terrors in prepubertal children : what triggers them, C. Guilleminault et al. PEDIATRICS 2003 3. Polysomnographic Characteristics in Normal Preschool and Early School-Aged Children – PEDIATRICS 2006 Conclusion (1) Symptoms of sleep disordered breathing, insomnia, and PLMD are common in patients with parasomnia (2) Polysomnography identify frequent co-existing sleep disorders such as obstructive sleep apnea and PLMD (3) Parasomnia in children is associated with significant daytime consequences including daytime headaches, EDS and mood disturbances (4) Parasomnia in preadolescents is associated with changes in the sleep architecture 1. No change in arousal index 2. Increased percentage of slow wave sleep 3. Decreased sleep efficiency Further study is needed to evaluate whether daytime consequences are the result of pediatric parasomnia or co-existing sleep disorders Example of sleep walking in a 12 yr old girl Sleep complaints and co-existing sleep disorders in childhood parasomnias Arveity R Setty MD, Guo Yuping MS, Narong Simakajornboon MD Subgroup analysis Inclusion criteria We included children from age 1 – 18 yrs, both males and females who were referred with the diagnosis of parasomnia. All of them had formal sleep consultation and evaluation including an overnight polysomnography. Exclusion criteria We exclude infants and children who were treated for SDB, children diagnosed with nocturnal seizures, and children who did not have overnight polysomnography. * * * * * P<0.05 percentage Polysomnographic data