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Night Terrors
by Teresa Shaw

Night terrors is a sleep disorder that typically occurs in children aged three to twelve years, with a peak onset in children aged three-and-a-half years. It is estimated that one to six percent of children experience night terrors. They occur equally as often in boys and girls, and all races seem to be equally affected.

To understand why night terrors occur, it’s important to first understand the science of sleep. Sleep is divided into two categories: rapid eye movement (REM) and non-rapid eye movement (non-REM). Non-REM sleep has four stages, progressing from stages one through four. Night terrors occur during the transition from stage three to stage four of non-REM sleep.

When Do Night Terrors Occur?

A typical night terror episode will usually begin about ninety minutes after the child falls asleep. The child will sit up in bed and may scream, kick, panic, thrash, or mumble, and he or she will appear awake but be confused, disoriented, and unresponsive to stimuli. The child may not respond to comforting by the parents; in fact, his or her eyes may be wide open but the child will not seem to be aware of the parents’ presence in the room.

Most episodes last for one to two minutes, but may extend to up to thirty minutes before the child relaxes and returns to normal sleep.

What Are the Signs of Night Terrors?

Night terrors stand apart from the much more common nightmares, which occur during REM sleep. Night terrors include frequent, recurrent episodes of intense crying and fear during sleep. A child experiencing night terrors will be difficult to waken.
Other signs include the following:

• Tachycardia (increased heart rate)
• Tachypnea (increased breathing rate)
• Sweating during episodes

Unlike nightmares, most children cannot remember their dreams after a night terror episode, and usually do not remember experiencing the terrors the next morning.

If the child does awake during a night terror, he or she might remember only small pieces of the episode.

What Causes Night Terrors?

There are many possible causes for night terrors, including the following:

• Stressful life events
• Sleep deprivation
• Fever
• Medications that might affect the central nervous system

Safety at Home

At home, parents can take the following precautions to keep their child safe during an occurrence of night terrors:

• Ensure that the child’s room is safe so that no injuries will occur during an episode. If your child leaves his or her bed, gently redirect him back to bed so no injury can occur.
• Eliminate all sources of sleep disturbance, such as loud noises or bright light.
• Maintain a consistent bedtime routine and wakeup time.

Parents may also wish to incorporate a change in bedtime routine, such as moving bath time from evening to morning to reduce the amount of stimulation before bedtime. Gently stroking a child’s skin or hair with a soft brush may also help him or her to relax and feel comforted before bed.

When a night terror occurs, turn on the lights to rid the room of any strange shadows that might scare your child. Speak in a soothing voice and, if your child allows it, stroke or gently rock him or her.

Chronicling Night Terrors

Night terrors are disruptive to a child’s sleep. In fact, half of all children affected develop a disrupted sleep pattern serious enough to warrant physician assistance.
The first step may be to chronicle your child’s nighttime events in a sleep journal and see if there is a pattern between night terrors with troublesome daily events. Note how many minutes it is from the time your child falls asleep until the start of the night terror. Start to wake up your child every fifteen minutes before the expected time of the night terror, and keep him or her fully awake and out of bed for five minutes. Continue waking your child like this for seven consecutive nights. If the night terrors return when you stop waking your child, repeat as needed.

When to Seek Medical Care

Children who have nightly occurrences of sleep terrors for a month or more, or who have multiple episodes in one night, should be evaluated by both a pediatrician and a sleep disorder clinic.

If think your child is experiencing night terrors, an evaluation by your family’s pediatrician may be useful. During this evaluation, the pediatrician may also be able to exclude other possible disorders that might cause night terrors.

For more information on night terrors, visit the Night Terrors Resource Center