You’ve put the kids to bed and you’re relaxing on the couch, but just a couple hours later you hear a blood-curdling scream. Your rush to your child’s bedside to find him crying, inconsolable and unable to calm down. What […]
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Nervous About Night Terrors?

by Jill Taylor on August 26, 2014

in Medical Information

nightYou’ve put the kids to bed and you’re relaxing on the couch, but just a couple hours later you hear a blood-curdling scream. Your rush to your child’s bedside to find him crying, inconsolable and unable to calm down. What is going on? Is my child having a nightmare?

It can be disturbing to find your child upset in the middle of the night, and you may not know what to do. It turns out that some children may experience night terrors, which are different than nightmares.

Pediatric neurologist and sleep medicine provider Patricia Ritch, MD, PhD with McLane Children’s Scott & White helps us understand more about night terrors.

Differences between Nightmares and Night Terrors

“Most parents who come to attend to them in the middle of the night report that their child is not actually awake and that they cannot get them to calm down,” says Dr. Ritch. “Most night terrors happen only once a night and usually happen in the first two to four hours of the night.”

Dr. Ritch says night terrors:

  • Are episodes of crying inconsolably during sleep.
  • Usually last less than 20 minutes.
  • Can be accompanied by sweating, turning red, crying, drooling or vocalizations that express fear.
  • May appear that your child is awake with eyes open.
  • Are classified as a parasomnia, which means it happens during sleep (just like sleep talking, sleep walking and even nighttime accidents).
  • Most often affect children under the age of 8 but rarely before age 1.
  • Usually occur during deep sleep, stage three and stage four.

“The child eventually stops crying on their own regardless of the parents actions, and close their eyes and return to peaceful sleep,” says Dr. Ritch. “They usually do not recall the episode the next morning and we think this is because they are not awake during the episode.”

One of the main differences between night terrors and nightmares is the stage which they occur. Nightmares are bad dreams that occur during dream sleep or rapid eye movement (REM) sleep. Nightmares can be so stressful that they actually wake the child up. The next morning they may recall part of the dream or talk to you about what they went through. On the other hand, children do not remember if they experienced a night terror.

How to Help with Night Terrors

As a parent you may feel helpless. No matter what you do, your child is still in stress. Dr. Ritch says most parents who attend to children during the night report that their child is not actually awake and they can’t get him or her to calm down.

The best thing you can do is stay calm and make sure your child is safe while they are going through the terror.

“Night terrors do not indicate an underlying neurological problem and do not disrupt the child’s sleep (unless the parent wakes them) so they do not really require treatment other than reassurance,” says Dr. Ritch.

Some possible triggers for night terrors include:

  • A change in circumstances (transitioning to a different bed, moving rooms, moving homes) but a trigger is not always identified.
  • If there’s a change in deep sleep or the child is placed on a medication that causes sedation. Dr. Ritch says they see this most often in children placed on clonidine or guanfacine for other conditions such as ADHD.
  • Consider changing the time you give the medication or adjust the dosage.

“Children who have night terrors are those with typical development and do not indicate an underlying neurological disorder,” explains Dr. Ritch.

Need a Sleep Study?

If you’re still unsettled about your child’s night terrors, consider a sleep study. Providers can analyze your child’s activity during sleep to make sure he stays healthy and safe. Consider talking to your doctor if your child has two or three night terrors per night or is very tired the next day. These may be signs that the terrors are causing poor sleep quality or other problems.

“Sometimes a sleep study is needed to determine if the episode that the family reports may actually represent a seizure disorder or epilepsy,” says Dr. Ritch.

This is especially concerning if the child has a risk for developing seizures (family history, prior head trauma, prior brain infection, significant developmental delay) or if the child exhibits seizure-like activity during the episode such as rhythmic jerking of the extremities in a synchronized (at the same time) manner.

“Anytime a parent has a concern, we are happy to see them in the sleep center and discuss the possibilities,” says Dr. Ritch.

Still have questions or want your child evaluated? Check out more information about our sleep specialists.

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