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Understanding Night Terrors

It isn’t paranormal, but it is “parasomnia”. Parasomnia is scientific word for night terror and nightmare or other unusual sleep behavior. All children have nightmares at some point and many children have at least one episode of night terrors. 

What are nightmares and why do children have them?  

Daytime anxiety or a scary movie  can cause nightmares. Nightmares are most common in children ages 3-6 with approximately 30-90% experiencing nightmares “sometimes”  and up to 30% of children in this age  group have them “often.” Night terrors can happen as early as 18 months but that is a rare phenomenon.

Night mares happen in the REM stage of  sleep. REM is very near to actual  consciousness and it happens right  before we come to the waking end  of our sleep cycles. Children’s sleep  cycles are between 30 minutes and an hour long and most adult sleep cycles are about 70-120 minutes. 

Children tend to remember their dreams more vividly and for a longer period of time. 

Night terrors, on the other hand, can be really spooky for parents and caregivers. Your child is technically between the worlds of the sub-conscious and conscious. The marker for a night terror is when it seems like your child cannot see you, though their eyes are wide open, and violently responds to your attempts to comfort them. They are usually in a panic or very angry. They may shout, punch, slap and kick and hit themselves or any one near. Though common and totally normal, in both medieval and puritan times, night terrors were thought to be demon possessions! Still, your child wakes their sweet little self. They have no memory of these events later, which is an identifying marker to help you tell nightmare from night terror.

Night terrors occur in the short wave sleep before REM occurs. A night terror can last as long as 30 minutes whether they are consoled or not and eventually, the child comes to the end of the sleep cycle, wakes up, and is so tired they immediately go back to bed with little help — where simple nightmares may need a more consoling because of what the child remembers.  

Night terrors are much more common in children who have anxiety in other areas of life, other sleep disorders and in children who have family history of sleep disorders like apnea, and the other parasomnias: restless legs and sleep walking.  

What Can You Do? 

Night terrors are simply grown out of.  The best thing you can do is sit nearby your child (not touching or talking too loudly) and be there to protect them. Make sure their room and bed are safe. Sleep walking can be part of night terrors so make sure the room is picked up  before bed and there is a baby gate at the top of the stairs. If you notice  that your child ever has more than one night terror in a night, wake the child after the first night terror subsides and keep them up for a bit to fully reset the sleep cycle.  

There is little that can be done for nightmares from a medical stand point unless they are being caused by a different sleep disorder in which case they are likely to have other sleep-related symptoms. If you suspect an apnea or if there is also sleep walking, get a referral to your  local pediatric sleep specialist (usually a pediatric pulmonologist) for an overnight sleep test called a polysomnography.

For straight up nightmares, a talented children’s psychologist can help your child rehearse the situations and fears that are coming up in dreams and help them find ways to put the mind at rest.  

The things I recommend to all families as a sleep consultant are also tips that help decrease both nightmares and night terrors. They are:  

1. Regular bedtime routine that is short and predictable and thereby calming. My favorite? One book, one song, no arguments.

2. No sugar before bed. If a before – bed snack happens, it should be a whole carb or protein. There should  be at least 20 minutes between that snack and sleep. There is conflicting evidence about eating before bed. Some evidence shows eating before bed harms sleep for adults, some shows it helps. Low blood sugar can  also cause nightmares. This may be something to just watch and tweak in your own unique child.  

3. No screen time 1.5 hours before bed. Make sure any evening screen time is calm and free from violence or confusing themes. 

4. Get as close to circadian rhythms as possible. Up in the morning, don’t sleep in too late, get as much outdoor time as you can during the day, get a short walk together or sit on the porch at dusk in spring/summer so your bodies feel the sun go down.  Gradually dim the house lights for an hour before bed during the winter.

5. Don’t let naps get too close to night time sleep. This can definitely cause  more nightmares. All naps should  end before the sun goes down. This might mean the the nap (one per day at this age) is short or needs to be earlier. (A tip for waking a child  out of a late nap without them being cranky is to find their REM sleep.  Whisper their name 6 inches from  their ear. If there is no eye movement or body movement, they are  in a deeper sleep- leave them alone  and try to find REM again in 5 minutes.) 

6. Meditation. I highly recommend the Indigo Dreams audio recording series for kids to help them let go of anxieties and relax for bed. Sweet Dreams Bedtime Visualizations by Maryam Gates is also awesome to read before bed.

7. Bedsharing. Is it right for your family? Children have less frequent nightmares and less night terrors when sleeping next to a parent. This likely has to do with generally lower anxiety levels in toddlers and preschoolers when they are near a parent.


Note: Some sleep disturbance that might look like a night terror, especially at bedtime or after a wake up that started more peaceful – is just a tantrum related to something around sleep. Use the above cues to tell a night terror from a tantrum. Tips 1-7 above are all helpful for preventing overtiredness, under-tiredness and tantrums as well! Ending tantrums requires the utmost consistency from parent behavior and the child knowing what is expected from them at night and knowing over time what to expect for parent response to various kid behaviors.

Sources: 

Sleep Foundation

Nemours Foundation

National Health Institute

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