Night terrors

Definition

Nightmares are a nearly universal experience for young children. A few kids experience more-intense scary dreams known as night terrors.

Kids who have nightmares typically wake up frightened and look for reassurance, eager to share vivid details of their scary dreams. Kids who have night terrors may scream and thrash about, but remain sound asleep. They probably won't remember anything about the night terrors in the morning.

Night terrors are relatively rare, affecting only a small percentage of kids — often between ages 4 and 12. However frightening, night terrors aren't usually cause for concern. Most kids outgrow night terrors by adolescence. In the meantime, your calming presence and gentle reassurance can help your child get a good night's sleep.

Symptoms

Night terrors occur during deep sleep, usually two to three hours after a child goes to sleep. Your child may shriek loudly, sit up in bed, thrash about or even charge blindly around the bedroom or through the house. Your child may be sweating or breathing fast. Still, your child is fast asleep. If you try to hold or comfort your child, he or she may fight you.

Night terrors often last for a few minutes, or sometimes longer. When your child wakes, he or she probably won't remember anything about the episode.

Causes

Various factors can contribute to night terrors, including:

• Fatigue. Night terrors are more likely when a child is overly tired.
• Stress. For some kids, problems at home or school or other stressful events trigger night terrors. Sleeping in a different room or away from home may have the same effect.
• Illness. Sometimes being sick triggers night terrors, especially if the illness is accompanied by a fever.
• Medications. Medications that affect the brain or spinal cord might trigger night terrors.

Risk factors

Night terrors tend to run in families.

When to seek medical advice

Occasional night terrors aren't usually cause for concern. You can simply mention your child's night terrors at a routine well-child exam. Consult your child's doctor earlier if the night terrors:

• Become more frequent
• Routinely disrupt your child's sleep
• Appear to follow a nearly identical pattern
• Lead to dangerous behavior or injury
• Are accompanied by other signs or symptoms

Tests and diagnosis

Night terrors are usually diagnosed at home. The doctor may do a physical or psychological exam to identify any conditions that may be contributing to the night terrors. If your child hurts himself or herself during night terrors, the doctor might want to observe your child in an overnight sleep lab.

Complications

Night terrors themselves aren't necessarily a concern, but sometimes a child having a night terror can hurt himself or herself. If frequent night terrors disrupt your child's sleep, excessive daytime sleepiness might be a problem. Sometimes sleepiness leads to school or behavior problems.

Treatments and drugs

Treatment for night terrors isn't usually necessary. If your child has a night terror, simply wait it out. You might gently restrain your child and try to get him or her back into bed. Speak softly and calmly. Shaking your child or shouting may only make things worse.

If the night terrors are associated with an underlying medical or mental health condition, treatment is aimed at the underlying problem. If stress or anxiety seems to be contributing to the night terrors, your child's doctor may suggest meeting with a therapist or counselor.

Medication is rarely used to treat night terrors. If necessary, however, short-term use of benzodiazepines may help reduce night terrors. If night terrors are affecting your child's performance in school or other daily activities, an antidepressant may help.

Lifestyle and home remedies

If night terrors are a problem for your child, be patient while you get to the root of the problem — or simply wait it out.

• Safety counts. If your child has frequent night terrors, make sure his or her bedroom is safe. Skip the bunk beds, and consider blocking doorways or stairways with a gate. Place any sharp or fragile objects out of reach.
• Put stress in its place. If your child seems anxious or stressed, talk about what's bothering him or her.
• Encourage relaxation. Do quiet, calming activities — such as reading books, doing puzzles or soaking in a warm bath — before bed.
• Take bedtime seriously. Fatigue can contribute to night terrors. If your child isn't getting enough sleep, try an earlier bedtime or a more regular sleep schedule.
• Look for a pattern. Night terrors tend to occur at the same time of night. To disrupt the cycle, it might help to wake your child about 15 minutes before you expect a night terror.

Above all, be positive. However disruptive, night terrors aren't a serious condition — and they usually go away on their own.