Night Terrors

One night when he was 1, Jaden’s screams woke his parents. “Screaming, crying – obviously looking at you, seeming that he’s all there, but you wave your hand in front of his face sometimes and there’s no response,” says his mom Julia Rafter.

Jaden was having a night terror. Psychologist Dr. Jennifer S. Thorpe explains: “Night terrors are a class of sleep disturbances called partial arousals. They can include anything from sleep walking to sleep talking. They usually occur in the first third of the night during the deepest part of sleep – during the transition from that deep sleep into a lighter sleep.”

Night terrors can be caused by sleep deprivation or a change in schedule, like giving up a nap, or even stress. “Maybe there’s something that’s going on in the family. Maybe they’ve gone from a summer schedule to a school schedule. Any change can be a stress if it’s experienced that way by the child,” says Thorpe.

The night terrors themselves don’t bother the child. In fact, they don’t even remember the episodes. It’s the parents who suffer. Rafter says, “Your heart is wrenching, because your child is literally sitting there thrashing about – especially when they hit the sides of the crib sometimes with their head and yet – no matter what you say or what you do, your heart – you’re just desperate.”

Experts say, first, talk to your pediatrician to rule out any medical issues like sleep apnea. Second, stay with your child during a night terror to make sure he or she doesn’t get hurt. Then establish a calm bedtime routine and try to identify – and avoid – your child’s triggers.

For Jaden, his trigger was over-stimulation. Now that his parents know this, they stick to his nighttime routine, and it’s made all the difference. “Oh for us it’s worked. It’s worked great, and it’s made our life a lot easier,” says Rafter.

Night terrors appear mostly in young children, typically between the ages of 3 and 5. Two to 3 percent of all children will experience episodes of night terrors. By the time they begin school, most will have outgrown these generally harmless events.

A night terror is not a nightmare. Nightmares occur during the dream phase of sleep known as REM sleep. REM is an abbreviation for Rapid Eye Movement, which is also known as “dreaming” sleep. The circumstances of the nightmare will frighten the child, who usually will wake up with a vivid memory of a long movie-like dream. Night terrors, on the other hand, occur during a phase of deep non-REM sleep – usually an hour or two after the child goes to bed. During a night terror, which may last anywhere from a few minutes to an hour, the child is still asleep. His or her eyes may be open, but he or she is not awake. It is difficult to arouse someone during a night terror. Upon waking, the child has absolutely no recollection of the episode other than a sense of fear.

Indications of a night terror include: sudden awakening from sleep, persistent fear or terror that occurs at night, screaming, sweating, confusion, rapid heart rate, inability to explain what happened, usually no recall of “bad dreams” or nightmares, and a vague sense of frightening images. During an episode, many people see spiders, snakes, animals or people in the room, are unable to fully wake up, are difficult to comfort, and possess no memory of the event the next day.

• Night terrors are nocturnal episodes of extreme terror and panic .
• Night terrors occur most often in children.
• Night terrors are similar to other arousal disorders, such as sleepwalking, that occur during deep sleep.
• Night terrors can generate a heart rate of 160 to 170 beats per minute.
• Increased brain activity initiates night terrors. The common thought among researchers is that a chemical trigger in the brain causes it to “misfire” and cause a night terror.

Nightmares and night terrors in children are usually disturbing to parents and family members. Therefore, proper diagnosis and education are important components of management.

It is essential to control the environment by removing dangerous objects and providing barriers to prevent escape from a safe sleeping environment. Don’t allow children who have nightmares or night terrors to sleep in bunk beds.

Reassurance and support are often the only therapy required because night terrors rarely, if ever, reflect underlying illness and usually disappear with maturity. Pharmacologic intervention is not usually necessary. In fact, it should be discouraged because it may contribute to further sleep disruption.

If you or your spouse had night terrors, it’s likely that your child will, too. Fatigue and psychological stress may also play roles in their occurrence. Make sure your child is getting plenty of rest. Be aware of things that may be upsetting to your child, and to the extent you are able, try to minimize the distress.

Children usually have night terrors at the same time each night, generally in the first few hours after falling asleep. Doctors suggest you wake your child about 30 minutes before the night terror usually happens. Get your child out of bed and have him or her talk to you. Keep your child awake for 5 minutes, and then let him or her go back to sleep.

• If night terrors occur frequently or over a long period of time, discuss this with your child’s doctor.
• Talk with your doctor if your child ever gets hurt while sleeping. Your doctor may want to study your child during sleep.
• Night terrors in children are usually not caused by mental or physical illness.

American Academy of Family Physicians
familydoctor.org
KidsHealth.org
Night Terror Resource Center