Night Terrors: What are they and what to do about them

 

Night Terrors. Have you ever been woken up in the middle of the night by the sound of your child screaming? Does it seem like they have had a nightmare, except they never seem completely awake and the next morning they can’t remember what happened? You might be facing a case of night terrors.  

A night terror is a sleeping disorder that usually occurs in small children and can be very traumatic for parents to witness one of these episodes. What exactly are night terrors? Are they the same as nightmares? How should parents handle these episodes?

night terrors

Night terrors

Parents are naturally concerned about the quality of sleep their children get. Quality sleep is fundamental throughout life, but it is especially important during childhood. While we sleep we strengthen our memory by internalizing all of the information we learned throughout the day and help restore our whole body. Childhood is a time of learning, and because sleeping is essential to learning and memory, it’s especially important to look after our children’s sleep habits and cycles.

Sleeping disorders are typically more common in adults than children,  and it seems adults would have the kind of concerns that could alter their sleep (money, work, family, etc. stress). But the truth is that children also have sleeping issues, like insomnia in children, nightmares, night terrors, sleepwalking, etc.

What are night terrors?

To understand night terrors we need to understand the stages of sleep that we go through at night.

There are two principle stages of sleep that alternate at night:

  • Non-REM, where there is hardly any eye movement
  • REM, characterized by rapid eye movement. This is the stage of deep sleep, where it’s difficult for us to wake up. It’s also when dreams and nightmares occur.

The Non-REM stage has various stages that start as soon as we fall asleep. The first is the transition from wakefulness to sleep, then light sleep, and the last two stages are deep sleep. It’s in these stages of Non-REM deep sleep where night terrors happen, which is usually around 90 minutes after falling asleep.

Night terrors are characterized by frequent episodes of crying and intense fear while sleeping. Most children usually remember nightmares after the happen, and are able to recall what it was about. However, night terrors are different, in that children do not remember the incident.

These episodes can also be accompanied by tachycardia (an increase in heart rate), and an increase in breathing and perspiration.

Night terrors usually cause children to suddenly “wake” and sit up straight in bed. They can appear awake but confused, disoriented, unresponsive to stimuli, and seem unaware of the presence of their parents. Children during a night terror episode likely won’t talk or respond to their parents, and they will likely be moving and tossing and turning in bed.

This type of sleep disorder is usually more frequently found in children between 3 and 8 years old and tapers off at the beginning of adolescence.

According to a study, if night terrors and other sleep disorders continue beyond the age of 9, it may be a sign of abuse. Therefore, it is important to be aware of the emotional reactions of the child in order notice any changes, and encourage open communication and relationship between parents and children.

What is the difference between night terrors and nightmares?

Nightmares

  • They remember the next day that they have had a nightmare
  • They can recall their dreams
  • They wake up after a nightmare
  • It happens in the REM stage of sleep
  • They calm down with relative ease
  • They seek the comfort of their parents

Night terrors

  • They don’t remember the episode the next day
  • They can’t remember their dream (because they actually didn’t have one)
  • They remain asleep through the night terror
  • It occurs during the Non-REM stage of sleep
  • It takes a while to calm them down
  • They don’t seem aware of the presence of their parents.

If the episode seems to be more disturbing for the parent than the child, it is likely that they child was experiencing a night terror. On the other hand, if the child is the more shaken up, then they have had a nightmare.

Cause of night terrors

Night terrors tend to have a hereditary component. It’s not uncommon for them to occur in children whose parents also suffered from night terrors or sleepwalking. However, most of the time there is no identifiable cause and it doesn’t mean there is a psychological problem or that they are worried about something. However, you should always be aware of anything out of the ordinary. Here are some aspects that could influence the occurrence of night terrors:

  • Stressful events
  • Fever
  • Fatigue and lack of sleep
  • Medication. There are certain medicines that affect the central nervous system
  • Recent use of anesthesia during surgery
  • Stimuli can cause children to wake up from deep sleep, such as noise, a full bladder, anxiety…

What should I do if my child has night terrors?

During a night terror episode don’t try to wake them up, they will be disoriented and it will be difficult for them to go back to sleep. Don’t try to calm them down, just wait until the episode passes and make sure they don’t harm themselves. Although night terrors can be distressing to witness, they don’t do any harm to your child.

  • Make their room a safe environment to avoid them from hurting themselves during night terrors.
  • It’s important to keep a healthy bedtime routine. Always have them go to bed and wake-up at the same time and try to make sure the minutes right before bedtime are relaxing.
  • Try to eliminate any stimulus that could disturb their sleep, such as noise and lights, and make sure that they go to the bathroom before going to bed.
  • Make sure they get enough sleep, and be aware of signs of fatigue and exhaustion.
  • Try to find out if there is something that they might be worried or anxious about. It’s very important to foster open conversation and communication between parents and children. Let them express their emotions.  

Scheduled awakenings

This is a technique that might help prevent night terrors. Although its effectiveness hasn’t been sufficiently confirmed, it’s believed to help some children. However, it is also possible that doing this could actually trigger an episode. It’s best is to try and see if scheduled awakenings prove effective.

Scheduled awakenings are done by writing down the time that your child usually has an episode, and then waking them up 15 or 20 minutes before they would usually have one. Keep them awake for about 5 minutes, they can use this time to go to the bathroom. If they keep this routine for about a week, your child will end up waking up automatically before having a night terror and avoid having an episode.

When should I start to worry?

It’s always recommended to talk to to your pediatrician to rule out any medical problem that could be contributing to night terrors.

You should definitely see a specialist when:

  • Night terrors occur multiple times during the same night and/or almost every night.
  • Other symptoms are present.
  • There is the risk that they could harm themselves.
Night terrors

Night terrors

Any questions? Leave me a comment below 🙂

This post was originally written in Spanish by Andrea García Cerdán, psychologist