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Night Terrors in Toddlers and Children

While most of us have experienced scary nightmares at some point in our lives, night terrors refer to a different type of sleep disorder that occurs in children between the ages of 4 and 12 years old.

Night Terrors versus Nightmares

We go through two types of sleep at night, rapid eye movement (REM) and non-rapid eye movement (non-REM). While REM sleep has only one stage, non-REM has four stages:

Stage 1: Lasting about 5 to 10 minutes, stage 1 sleep occurs as you are drowsy and first start to fall asleep.
Stage 2: During stage 2 sleep, your body cools down, your eyes stop moving and your heart rate drops. This is your light sleep stage.
Stage 3: During Stage 3 sleep, you are in deep sleep.
Stage 4: Stage 4 sleep is also a deep sleep stage.

If you wake up during Stage 3 or Stage 4 sleep, you will generally feel very groggy and confused. Because our bodies alternate between REM and non-REM sleep cycles every 90 to 110 minutes, people usually have about 4 to 5 complete cycles of REM and non-REM sleep each night.

The primary difference between nightmares versus night terrors lies in when each occurs. While nightmares occur during REM sleep, night terrors occur during non-REM deep sleep. In addition, a person who has night terrors does not completely wake and may not remember the incident in the morning. This contrasts nightmares, which are usually vivid experiences that people remember clearly the mornings after which they occur.

Children's Night Terrors

Night terrors affect a small percentage of toddlers and children up to about 12 years of age. Fortunately, most children outgrow night terrors.

Night terrors generally occur sometime between one to three hours after falling asleep. Symptoms of night terrors might include:

confusion
crying
fast breathing
fast heart rate
kicking
screaming
staring
sweating
thrashing.

After a night terror, your child may not recognize you and may resist you if you try to hold him or her. Your child might also get up and run. You must realize that your child is actually asleep, despite what he or she is doing. These episodes can last anywhere from a few minutes to as long as 45 minutes.

Causes of Night Terrors

Causes of night terrors include:

extreme fatigue
fevers or other illnesses
medications
stress.

Side Effects of Night Terrors

Most of the time, night terrors are going to be harder on you than on your child. However, if night terrors affect your child's overall sleep, he or she may become tired during the day. Sometimes, being overtired can lead to bad behaviors or an inability to concentrate at school.

Another possible side effect associated with night terrors is injury during an episode. Because your child is not aware of what he or she is doing during a night terror, your child may get hurt while experiencing a night terror episode.

Night Terror Treatments

While there is no specific treatment for night terrors, keep in mind that this is a sleep disorder that most children will outgrow. As a result, the most common treatments for night terrors revolve around keeping your child safe during an episode and soothing him afterwards. Here are some things you can do to help your child safely get through and eventually overcome his night terrors:

Act calmly during an episode: If your child is having an episode, speak calmly. If you can, try to gently prevent your child from getting out of bed. If your child is up, try to get him or her back into bed. Do not try to wake your child during an episode, as this can cause further disorientation and confusion.
Make a bedtime routine: Put your child to bed at the same time each night. Some parents create a bedtime routine that helps their children calm down before sleeping. Some good options for bedtime routines include reading a book together or giving your child a warm bath. Regardless of what routine you choose, be sure to stick to it, as much as possible, each night.
Make sure that your child's room is safe: Because children can wander during night terrors, take measures to help your child avoid injury. You may consider getting a removable, childproof gate for his doorway to prevent him from leaving his room or going down a stairway. Similarly, don't keep sharp objects (like scissors) in his room that he may accidentally grab and injure himself with during a night terror.
Note when night terrors occur: Keep track of how often and at what time your child experiences night terrors. Try waking up your child about a quarter of an hour before he or she usually has an episode.

Make an appointment with your child's pediatrician if your child:

experiences night terrors more frequently
gets hurt during an episode
seems overly tired.

These factors could indicate that your child suffers from some underlying condition that is upsetting his sleep. The pediatrician will likely perform tests to check for the presence of any other conditions that may be contributing to night terrors.

Resources

Associated Counselors and Therapists (n.d.). Sleep Problems in Children. Retrieved January 17, 2008, from the BeachPsych.com Web site: http://www.beachpsych.com/pages/cc10.html.

De Benedictis, Tina Ph.D (2007). Understanding Sleep: Sleep Needs, Cycles and Stages. Retrieved January 17, 2008, from the HelpGuide.org Web site: http://www.helpguide.org/life/sleeping.htm.

Iannelli, Vincent MD (2003). Night Terrors Pediatric Basics. Retrieved January 18, 2008, from the About.com Web site: http://pediatrics.about.com/cs/sleep/a/night_terrors.htm.

Mayo Clinic (n.d.). Night Terrors. Retrieved January 17, 2008, from the MayoClinic.com Web site: http://www.mayoclinic.com/health/night-terrors/DS01016/DSECTION=1.

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