• Children and Sleep Terrors

    Children's Health/Pediatrics

    December 27, 2018

    When the kids don’t sleep well, no one sleeps well. Lots of things can interrupt a child’s sleep, but two that parents find quite troubling — especially the first time they happen — are sleep terrors and nightmares.

    Sleep terrors are so dramatic that they can cause parents to worry about their child’s emotional well-being. Also called night terrors, they are most common in children between 4 and 12 years old. A child having a sleep terror typically wakes up screaming and thrashing about two to three hours after falling asleep. He or she might even try to get out of bed and run away from an unseen threat. Moreover, while the child may appear at least partially awake, he or she will be unresponsive to attempts to console.

    Sleep terrors often run in the family. Triggers include things that interrupt deep sleep, like obstructive sleep apnea, restless legs syndrome, or even fever. Sleep deprivation can also play a role. Sleep terrors can last as long as 45 minutes, but most are much shorter. As scary as they are, though, sleep terrors are typically not associated with emotional problems, and most children do not remember them in the morning.

    A nightmare, on the other hand, will wake the child, and he or she will remember the disturbing content of the dream. While sleep terrors tend to happen during the first third of sleep, nightmares usually happen during the final third, in the early morning hours.

    While nightmares can arise spontaneously in any child, there is some evidence to suggest that children with post-traumatic stress disorder, anxiety or a history of being bullied may have more frequent or intense nightmares.

    Most children will outgrow sleep terrors (and other sleep disturbances like sleepwalking and tooth grinding), by their early teens. That’s little comfort, though, to the parent dealing with them at 2 a.m.


    Here are some tips for managing sleep disturbances when they happen, and for minimizing their frequency of recurrence:

    For sleep terrors, make sure the child cannot leave the house or hurt himself on stairs or furniture. Do not restrain the child, however, unless he or she is in immediate danger. Trying to hold or wake a child having a sleep terror can actually make the episode worse. When the sleep terror has passed, look for triggers. Does the child have a fever? Has his or her sleep schedule been disrupted lately? Does he or she snore and gasp for breath while sleeping?

    For nightmares, sometimes simple reassurance is all the child needs. If he or she has bad dreams involving a recurring scenario, “rescripting” it by having the child imagine a more pleasant, or even silly, ending to the dream can be helpful. If the nightmares are more persistent, writing down or drawing pictures of their content can make them less scary.

    You might also try making a “dream catcher” with your child. Explain the belief that it will catch the bad dreams and let good ones through, and then hang it by the child’s bed. Alternatively, devise your own bedtime ritual that helps your child feel safe and secure.

    If you are concerned that your child’s sleep disturbances are more frequent or intense than normal, or that there might be a medical condition behind them, talk to your pediatrician. Before you visit the office, keep a sleep diary for a week or two and track these things:

    • Where your child sleeps;
    • How long it takes to fall asleep;
    • How often the child wakes up during the night;
    • How much sleep he or she normally gets each night;
    • What the child needs to help fall asleep;
    • What you do to comfort him or her if he or she wakes during the night;
    • Duration and timing of any daytime naps;
    • Any changes or stressors at home or in school.

    Bring this journal with you to the doctor’s appointment. It could reveal patterns and clues that might help your child, and the rest of the family, get back to sleep.

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