by: Joanna Robnik, M.D.
You finish reading a bedtime story, tuck your sleepy child in, give a goodnight kiss and turn off the lights. In a few minutes you peek in and see she is sleeping soundly. Then, an hour-and-a-half later, you’re startled by screaming. You rush to her room and see she is sitting up in bed with her eyes wide open. She doesn’t seem to hear you when you talk to her. She is crying and appears confused and afraid. She may have increased heart and breathing rates and may be sweating.
We all have dreams when we sleep, and most of us experience the occasional nightmare. For some children (and rarely adults) sleep brings on something very different from a dream in an occurrence known as a night terror.
Sleep is divided into two stages: rapid eye movement (REM) sleep and non-REM sleep. Dreams – good and bad– occur during REM sleep.
Non-REM sleep can be further broken down into four stages. Night terrors occur during the transition from stage 3 non-REM sleep to stage 4, usually about 90 minutes after a child first falls asleep.
While most of us can identify with having a nightmare, night terrors are relatively rare. An estimated 1 to 6 percent of children experience them. They usually occur between 3 and 12 years of age and equally affect boys and girls. Typically the disorder resolves prior to or during adolescence.
Most episodes are short, lasting just a few minutes, but they can go on for up to 30 minutes, ending when the child simply goes back to sleep. Usually child will have no recollection of the episode the next morning.
Night terrors may be caused by stressors in a child’s everyday life. Stressful life events such as moving to a new house or school may increase the frequency. Other possible causes include: fever, sleep deprivation, certain medications and having had recent anesthesia for surgery.
There is no cure for night terrors and no medications to prevent them. However, there are steps you can take to enhance your child’s sleep. They include:
• Create a relaxing, unhurried bedtime routine.
• Avoid giving your child food or drinks that contain caffeine less than six hours before bedtime. The same goes for items high in sugar content.
• Avoid large meals right before bedtime.
• Make sure the temperature in the room is comfortable and your child has adequate blankets.
• Turn off the TV, video games and music. Create a quiet environment.
• Make sure the child’s room is safe, in case an episode does occur.
• Make sure the room is dark.
• Note the amount of time between when your child goes to sleep and a night terror begins. On following nights (for about a week) wake your child 15 minutes before the expected night terror. Keep him awake for five minutes and then return to bed.
While night terrors can be difficult and frightening to watch, they typically do not bring any harm to a child. If your child experiences a night terror, try to help her to return to normal sleep. Your child will not be able to respond to you, so don’t shout or shake your child in an attempt to rouse her. This could be perceived as frightening. Make soothing comments. Turn on the lights so you child will be less likely to be confused by shadows. Protect your child against injury and gently direct her back to bed.
A good night’s sleep is important for children and adults. Most often, night terrors are brief and do not significantly disrupt a child’s sleep. If your child seems to be experiencing night terrors, an evaluation by his or her primary care physician may be useful. Your doctor may be able to rule out other possible disorders that could be causing the night terrors.
Dr. Robnik is a board certified family practice physician at Raiter Clinic in Cloquet.