NIGHT TERRORS: When It's More Than a Nightmare

This is a very real and frightening sleep disorder that children experience. Night terrors are characterized by extreme terror and a temporary inability to regain full consciousness. Night terrors are totally different from nightmares.

The night terror usually includes screaming, moaning, gasping, kicking and flailing of arms. It is often impossible to fully awaken the child. It's important to differentiate night terrors from nightmares. Night terrors are not the same. The child is not fully awake when aroused, and even during the efforts to awaken the sleeper, he may continue to experience the terror for another 10 or 20 minutes.

Night terrors occur during the transition between deep sleep and another level of sleep and it is thought that the child gets 'stuck' momentarily between levels. Even if it is possible to awaken the victim, he often can not remember the episode except for a sense of severe panic and experiences partial or total amnesia. In comparison, nightmares are easily recalled when awakened.

Children between the ages of four and six are most prone to night terrors. About 3% of all children are affected. The terrors usually occur during the first 2 hours of sleep. They occur for a couple of weeks, then suddenly disappear. Research has shown that a predisposition to night terrors can be passed genetically. There are multiple triggers that may set off an episode, but the most common trigger seems to be emotional stress during the previous day. Also, apnea and breathing disorders seem to have something to do with night terrors. Night terrors are considered normal until the child reaches age 6.

When having a night terror, the heart rate and breathing rate increase and the child's eyes are wide open. There have been some cases of children getting out of bed and running around the house. Since night terrors generally happen at the same time each night, parents should try to awaken the child each night a few minutes before the night terror happens. Also, children who have night terrors should not have bunk beds and should have gates on their doors so they don't harm themselves.

The following are characteristics of a night terror:

The child is frightened but cannot be awakened or comforted.

The child's eyes are wide open but he/she does not know that you are there.

The child may think objects or persons in the room are scary.

The episode lasts from 10 to 30 minutes.

The child often does not remember the episode in the morning.

The following things should be done during a night terror:

Try to help the child return to normal sleep. You will not be able to awaken the child, so do not try. Turn on the lights so that the child is less confused by shadows. Make soothing comments and hold the child if it seems to help him feel better. Shaking or shouting at the child may cause the child to become more upset.

Protect the child against injury. During a night terror, a child can fall down a stairway, run into a wall, or break a window. Try to gently direct the child back to bed.

Prepare babysitters for these episodes. Explain to people who care for your child what a night terror is and what to do if one happens.

Try to prevent night terrors. A night terror can be triggered if the child becomes overly-tired. Be sure the child goes to bed at a regular time, and early enough to give him enough sleep. Younger children may need to return to a daily nap.

For several nights, note how many minutes it is from the time the child falls asleep until the start of the night terror. Begin to awaken the child every 15 minutes before the expected time of the night terror.

Keep the child fully awake and out of bed for 5 minutes. Continue waking your child like this for seven consecutive nights. If the night terrors return when you stop waking the child, repeat as needed

Night terrors don't seem to have harmful effects, but the things children do while they are having a night terror may be very dangerous.

Call your child's physician if you notice any of the following:

The child drools, jerks or stiffens

Night terrors continue even after the seven nights of waking (see above)

The terrors last longer than 30 minutes

The child does something dangerous during the episode

You feel family stress may be a factor

The child has daytime fears