Night Terror

A night terror is a sleep disorder characterized by extreme fright and a temporary inability to fully wake up. Although this happens mostly in children 3 to 12 years of age, with the peak at 4 to 6 years, any age can be affected. The terrors usually begin about 90 minutes after falling asleep.

Night terrors are different than nightmares. Nightmares are scary dreams. Most children have them occasionally. Some children have them more than once a week. Nightmares usually happen late in the sleep period towards morning. Night terrors are frightening episodes that disrupt family life. They usually only last a couple minutes. These short episodes seem extremely long because they are terrifying to those around them. When the episode is finished, your child will normally settle back to sleep without really waking up. Unlike nightmares, most children do not usually remember a night terror episode the next morning. Your child may come to you for comfort. Usually they can tell you about a dream, and why it was scary.

CAUSES

  • A stressful physical or emotional event.

  • Fever.

  • Lack of sleep.

  • Medications that affect the brain.

Children eventually outgrow these terrors as they reach adolescence. They are usually not caused by mental or physical illness.

SYMPTOMS

  • Your child will appear to suddenly wake from their sleep with gasping, moaning or screaming.

  • It is often impossible to fully wake the child. Although they may seem awake, your child will remain dazed or confused.

  • Your child may thrash around in bed and be unresponsive to you.

  • Your child will not seem to be aware of your presence and usually will not talk.

  • The terror may also cause a rapid heart rate and breathing along with sweating.

DIAGNOSIS

Usually, a complete history and a physical exam are enough to diagnose night terrors. Your caregiver may order other tests if other problems are suspected.

TREATMENT

Treating night terror episodes requires gentleness.

  • Remove anything in the sleeping area that could hurt your child.

  • Avoid loud voices or movements that might frighten your child further. Remember, your is not aware they are having a night terror.

  • Your child may become more agitated if told that "it was just a dream." They feel it is very real. Calm your child by telling him/her, "I am here" or "I love you."

  • It is best if one parent stays with the child until the episode passes and the child is calm again and ready to go back to sleep.

Medical Treatment

  • Adequate treatment does not exist for night terrors. In severe cases, tricyclic anti-depressants may be used as a temporary treatment. They are usually only prescribed when waking behavior is being affected.

  • Educate your family about the disorder. Reassure them that the episodes are not harmful.  

HOME CARE INSTRUCTIONS

  • Prevent your child from being injured during an episode.

  • Be sure your home and child's room is safe (use toddler gates on staircases).

  • Do not use bunk beds for children who often have nightmares or night terrors.

  • Talk to your caregiver if your child ever gets hurt while sleeping. They may want to study your child during sleep.

  • Eliminate all sources of sleep disturbance.

  • Keep bedtimes and wake-up times routine.

If your child has several night terrors, you can try to interrupt their sleep in order to prevent the night terror.

  • Keep track how many minutes the night terror begins from when your child falls asleep.

  • Then, awaken your child 15 minutes before the expected night terror. Then keep them awake and out of bed for 5 minutes.

  • Continue this trial for a week.

SEEK MEDICAL CARE IF:

  • The problems continue and medications or other measures are not working.