Night Terrors and Children

OVERVIEW:
Night terrors or sleep terrors is a sleep disorder that occurs most commonly in children between the ages of 3-12 years. Usually, this condition will appear when a child reaches 3 ½ – 4 years of age. Of the entire population, only 1% – 6% of all children will frequently experience a clinical version of night terrors. Both genders and all ethnicities have been shown to develop this condition. Typically, this problem will resolve itself by the time the child becomes an adolescent.

An episode will begin about 90 minutes into the sleep cycle of a child. Typically, this occurs in the non-rapid eye movement stage of sleep.

CAUSES:
The following conditions may cause night terrors:

  • Fever or illness
  • Certain medications
  • Lack of sleep
  • Stressful events

SYMPTOMS:
The most common symptoms of night terrors include crying and screaming during sleep and difficulty waking from sleep. Sleepwalking is often linked to this condition. In addition to these concerns, a child may also experience one or more of the following:

  • Excessive sweating
  • Increased rapid breathing
  • Increased heart rate

Unlike the traditional nightmare, a child will often not remember their night terror episodes. However, parents will certainly remember witnessing the child sitting up and wailing in the night or suddenly waking up, while being disorientated and possibly unresponsive to stimuli. An affected child might not speak once awoken from an episode. Children with advance cases may not respond to the comfort parents provide and instead, thrash to escape the reassurance being provided to them.


In the majority of episodes, the entire experience may last a minute or two. In extreme cases, an episode can last more than 30 minutes until the child is able to return to a normal sleep pattern. Should a child wake during an episode, there is a chance they will remember a small portion of the night terrors they had, but as previously stated, will generally not remember anything when waking in the morning.

TREATMENT:
While most parents are understandably concerned about their child’s sleeping disorder, it usually isn’t connected to a serious medical condition. Your child’s pediatrician will be able to do an evaluation to determine if there are additional medical concerns which need to be addressed. Some of these tests include:

Once these tests have ruled out the possibility of any other medical complications, your physician may have you make simple changes to your child’s routine. This is done to help prevent future night terrors from occurring and to avoid treatments with medication. These treatment options may include:

  • Safeguarding the room of a child to prevent injury
  • Eliminating potential sources of sleep disruption
  • Having child consistently go to bed and get up at the same time every day
  • Awaking child 15 minutes before their night terrors cycle begins

If this process doesn’t work, tricyclic antidepressants can be used. These drugs are typically a short-term solution and provide no long-term benefits for your child. Since most night terrors episodes are short lived, many doctors will avoid prescribing this medication, unless school performance or interpersonal relationships become impaired.

RESOURCES:
American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL 60007-1098
(847) 434-4000

American Academy of Sleep Medicine
1 Westbrook Corporate Center
Suite 920
Westchester, IL 60154
(708) 492-0930

National Sleep Foundation
1522 K Street, NW
Suite 500
Washington, DC 20005
(202) 347-3471

National Center for Sleep Disorders Research
National Heart, Lung, Blood Institute
PO Box 30105
Bethesda, MD 20824-0105
(301) 251-1222

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