eyes open

[carol918]

I have a 7 year old daughter that is great about going to bed at night, but when I check on her in the middle of the night she has her eyes open and sometimes is talking and playing, but she is still very much asleep.  Should I be concerned and call her pediatrician?????

[Enoch Choi, MD]

http://pediatrics.aappublications.org/cgi/content/full/106/1/67
is a good reference that reviews somniloquy, which is the term we doctors use for talking while asleep.  It's very very common and usually is temporary, although it can make your child tired when she gets up.  Here's a quote from the article:

Conclusions.  Although sleepwalking, night terrors, enuresis, and body rocking dramatically decreased during childhood, somniloquy, leg restlessness, and sleep bruxism were still highly prevalent at age 13 years, paralleling results found in adults. Sleepwalking, night terrors, and somniloquy are conditions often found together. The only robust gender difference was for enuresis. High anxiety scores in parasomnias are reported for the first time in a large, controlled study. Sociodemographic variables do not seem to play a major role in the occurrence of parasomnias.  Key words:  sleep disorders, parasomnias, epidemiology, gender differences, anxiety, childhood, adolescence.

Also, I think you'd find this interesting, from the introduction of the article:

Somniloquy consists of talking during sleep. It is the most frequent parasomnia and is often considered a universal experience. Reimão and Lefévre (reference 3) surveyed a representative sample of 2022 school-aged children from 3 to 10 years old from the São Paulo region. They noted that approximately one half of the children presented somniloquy at least once a year, and that <10% of the sample presented somniloquy every night. "Sleepwalking consists of a series of complex behaviors that are initiated during slow-wave sleep and result in walking during sleep." (reference 1) Motor behaviors can range from sitting up in bed to an apparent frantic attempt to escape. Klackenberg (reference 4) studied a representative sample of 212 Swedish children 6 to 16 years old, and found that the greatest prevalence of sleepwalking was 16.7% at age 12 years. Night terrors (also called pavor nocturnus) are best described as arousal responses occurring early during the night and are associated with the feeling of fear, a loud piercing scream, and an autonomic activation manifested by tachycardia and sudation. Vela-Bueno et al (reference 5) studied 487 schoolchildren from Madrid representative of different socioeconomic groups. They reported that 6.2% of the children from 6 to 12 years of age presented at least 1 night terror episode per year.

References:
1. American Sleep Disorders Association. International Classification of Sleep Disorders, Revised: Diagnostic and Coding Manual. Rochester, MN: American Sleep Disorders Association; 1997
3. Reimão RN, Lefévre AB Prevalence of sleep-talking in childhood. Brain Dev 1980; 2:353-357 [Medline]
4. Klackenberg G Somnambulism in childhood-prevalence, course and behavioral correlations. Acta Paediatr 1982; 71:495-499
5. Vela-Bueno A, Bixler EO, Dobladez-Blanco B, Rubio ME, Mattison RE, Kales A Prevalence of night terrors and nightmares in elementary school children: a pilot study. Res Commun Psychol Psychiatry Behav 1985; 10:177-188


Dr. Enoch Choi, MD
Palo Alto, CA