Sleep Terrors

Sleep terrors, or night terrors as they are often called, are dramatic and can be upsetting to watch. A child having a sleep terror may have their eyes open, but usually appears very agitated, frightened and even panicked. They can also seem confused and dazed during an episode. A child will often cry out or scream at the beginning of the sleep terror and may mumble or give inappropriate answers to questions. A child having a sleep terror is often clumsy and may flail around, push a parent away, or behave in other strange ways. As disturbing and frightening as these events appear to the observer, children having them usually are totally unaware of what they are doing.

In fact, sleep terrors are much worse to watch than to experience. For the child, a sleep terror is less traumatic than a typical nightmare or bad dream.

Sleep terrors almost always occur within 1 to 2 hours after falling asleep, last anywhere from a few minutes to an hour, and children have no memory of these events (sleep terrors can also occur during a nap). In addition, during these events most children avoid being comforted. They may get more upset if you talk to them and try to calm them down. This can be the hardest part for parents. Although a child having a sleep terror may appear awake, they are really asleep. A child who is having a sleep terror is basically stuck halfway between asleep and awake.

Finally, sleep terrors are not nightmares. The child is not dreaming during these events, although it may look like it. Sleep terrors are not a sign of psychological problems or the result of a traumatic event.

Sleep terrors are benign (not harmful) sleep behaviors, but they may cause a great deal or anxiety for parents. We do not know what exactly causes sleep terrors or why children look frightened during them. They are actually the same thing as sleepwalking, but just more dramatic.

Sleep terrors are fairly common in children and usually occur in preschool-aged and elementary school-aged children. Most children outgrow sleep terrors by adolescence. In addition, sleep terrors and sleepwalking often run in families.

There are certain things that make it more likely for someone who is prone to sleep terrors to have an episode. These include:

• Not getting enough sleep
• An irregular sleep schedule
• Fever, illness
• Some medications
• Sleeping with a full bladder
• Sleeping in a different environment
• Sleeping in a noisy environment
• Stress

• Keep your child safe. The most important thing that you can do if your child has sleep terrors is to keep them safe. Make sure that all outside doors are secure. Put up gates at the door of your child’s bedroom and at the top of stairs. An alarm can signal you when your child is up and about and help to ensure that they don’t leave the house. Any type of alarm will do, even a simple bell hung on the door. Be sure that windows, especially second story or higher, do not open wide enough that your child can jump out of them. Finally, remove things that are in the way. If your child may walk or run around during a sleep terror, clear away anything that they can step on or trip over.
• Don’t wake your child. Generally, nothing is gained by trying to awaken a child during a sleep terror, and sometimes doing so can make a child more agitated.
• Guide your child back to bed. To encourage return to normal sleep, guide your child gently back to bed. If they resist, let them be.
• Try not to interfere too much. The normal response of parents is to try and comfort their child during one of these episodes. Try to resist doing this. Most children will just get more agitated. However, if your child is about to come to harm, be sure to keep them safe even if they fight you.
• Ensure enough sleep. Increase the amount of sleep that your child is getting and try to not let them become sleep deprived. These events are much more likely to happen when your child does not get enough sleep.
• Maintain a regular sleep schedule. Sleep terrors are more likely to happen on nights when your child goes to sleep at a different time than usual.
• Don’t discuss sleep terrors the next day. The morning after an event, do not make a point of discussing the episode with your child. Discussing the event is likely to worry them. However, if they bring it up, simply reassure them.

Additional treatment. In most cases, sleep terrors require no treatment. But, in severe cases, when these behaviors involve injury, violence, or serious disruption to the family, treatment may be necessary. Treatment may include medicine or behavior modification techniques. Be sure to speak to your child’s doctor if your child has frequent or severe sleep terrors and you are concerned.