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Night terrors

These are dramatic awakenings of the child during the night. They usually happen during the first hours of sleep, that is, during deeper sleep. They make parents anxious and concerned, because the child seems to be in a state of agitation and cannot be comforted.

How common are night terrors?

About 5% of children experience night terrors.

At which age do they appear?

Usually during pre-school age and early childhood, but they can also appear during the primary school years.

What are the symptoms?

Usually the child suddenly awakes from a deep sleep screaming, and then seems to be very scared. He can make intense, sudden movements with his arms or legs, or even walk anxiously around the house, as if he’s looking for something he can’t find. During night terrors the child breathes quickly and has a rapid heart-beat. He shows symptoms of an increased adrenaline rush, resulting in sweating, dilated pupils, and wide-open eyes. During this period the child has no contact with the environment, does not recognize his parents, and cannot be comforted. The night terror lasts 5 to 10 minutes, usually once during the night, but in some cases episodes may be repeated during the same night.

What are the causes of night terrors?

A child experiencing a night terror is not awake, but is between being asleep and awake. He is awake enough to get out of bed, to shout, or to have his eyes open, but is asleep enough in order not to respond to the parent who is trying to comfort him. In the morning, the child doesn’t remember anything about the experience, unlike with a nightmare.

It is common to have a history of night terrors in the family. It should be emphasized to the parents that night terrors happen to normal children, and that they usually don’t reflect any important emotional or psychological problems. Sometimes however, night terrors may occur more frequently when the child is ill or is anxious or concerned about something.

How do we distinguish night terrors from nightmares?

Night terrors are completely different from nightmares.
• Nightmares are bad dreams that tend to take place during the second half of the night, when sleep is lighter and we dream the most.

• With a nightmare, the child completely wakes up, is conscious, and can respond, meaning that he can also receive comfort from the parent.

• Usually the child is able to remember the nightmare in the morning.

• Night terrors tend to take place at a younger pre-school age than nightmares.

How should night terrors be treated?

Parents should remain calm and relaxed, and not touch the child, or try to hug him in order to comfort him, unless the child is at risk of getting hurt. In fact, parents’ attempts to help or quieten the child frequently make the episode worse and longer.

If a child experiences night terrors, it is important to ensure his safety at home and during sleep, e.g. so that he doesn’t stumble and hurt himself while getting out of bed.

Sleep routine may help, as well as a certain bed time. On the other hand, overtiredness of the child during the late hours of the day may invoke more frequent night terrors.

Parents should not show their anxiety about the issue to the child in the morning, neither should they discuss the incident in front of the child, unless he wants to talk about it, or asks by himself. The reaction of the parents may embarrass the child and make him anxious when going to bed.

What is the outcome of night terrors?

Parents should be reassured that night terrors don’t cause any developmental or other damage to the child, and that sometime the child will outgrow them. They are frequent in children, and they are part of healthy psychomotor development.

When should I visit a specialist?

If the frequency of night terrors becomes worrying, if they are so intense that there is a risk of the child getting injured, if the sleep of the entire family is disturbed systematically, or if the child seems to be affected by drowsiness during daytime.

 

Stelios Papaventsis MRCPCH DCH IBCLC 2012

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