Nightmares and night terrors

Nightmares and night terrors are both common in preschool-aged children and then become less common over the first decade of life, so you’ll be able to make it through the night without reaching for your monster repellent spray eventually. If bedtime has been scary lately, there may be a few strategies that can help your family get through the night a little more fright-free.

Nightmares

Nightmares are vivid dreams with scary subjects, and they usually wake the child who’s having them. He can often remember the nightmare in detail. Since children don’t have much to compare them to, they may not understand that a dream’s events didn’t actually happen, which can make nightmares very upsetting even long after they wake up. When your child has a nightmare, you can take the following steps to help them:

  • Comfort and cuddle your child to reassure him that he is safe.
  • Encourage him to talk about the dream.
  • Assure him that none of what happened was real.
  • Ask him to imagine a happy ending to the dream instead.
  • Provide a security blanket or animal for him to cuddle.
  • Let him go back to sleep in him own bed, but offer him the chance to leave the door open or light on if it helps him feel safer.

Not all nightmares are preventable. Many are a normal part of growing up and are associated with a child’s developmental age (for example toddlers often have nightmares about separation from their parents). They can also be related to something that upset the child during the day,- whether it was a real-life situation or something make-believe (like a scary movie). Avoiding scary movies or scary video games can help to prevent some nightmares. Keeping a quiet and soothing night time routine can also help prevent nightmares. You may also want to make it a point to talk about fun or happy things with your child during his bedtime routine. In addition, some kids might benefit from a security object like a blanket or stuffed animal that accompanies them to sleep. For other children, a soft night-light can make a difference as well.

You may want to call your child’s healthcare provider if

  • The nightmares occur every night or interfere with your child’s daytime activities.
  • Nightmares that cause significant distress.
  • The content of the nightmares reflects a real-life trauma, or causes you to worry there may be a real-life problem at school or home.

Night terrors

Night terrors (also called sleep terrors) are usually seen between the ages of 4 and 12. They are episodes that occur when children have physical reactions to their dreams, so that they may scream, cry, kick, thrash, and appear panicked. Night terrors occur during deep sleep, usually in the first third of the night. Although they may appear awake, children with night terrors are actually in deep sleep. Episodes can last between 10 and 30 minutes, and although they’re hard to watch, children don’t generally remember them in the morning.

Interestingly, genetics may play a role in night terrors and usually parents the parents of children with night terrors also have a history of night terrors. They are most common between the ages of 4 to 12, and are rare after age 15. There is no association between night terrors and behavioral or psychiatric problems.

If a night terror occurs:

  • Without waking your child, help him return to normal sleep if you can. If holding him seems to calm him down, then do so. Avoid shaking or shouting at your child, as this could make him more upset.
  • Keep your child safe from physical harm. During a night terror, he isn’t aware of his surroundings, and could fall or otherwise hurt themselves.

Unfortunately, night terrors are not preventable. Management is focused on ensuring a good sleep routine.

When to call your child’s healthcare provider

Sometimes night terrors are the symptom of an underlying medical problem and sometimes what looks like a night terror may actually be a different medical condition. Consult your child’s healthcare provider if you have concerns or questions or if you notice:

  • The night terror involves drooling, jerky motions, stiffening, or (for older children) loss of bladder control.
  • You notice your child snoring a lot or stop breathing as they sleep, which could be a sign of sleep apnea.
  • Terror episodes interrupt sleep on a regular basis (several times a week).
  • The episodes last longer than half an hour.
  • Your child is at risk for self-harm during the episodes.
  • Your child exhibits stress symptoms during the day, or you feel a situation at home or school may be the root cause.

Nightmares and night terrors can be disturbing for a child, and for parents and caregivers, too, but with a bit of understanding and support, everyone should be back to sleep before you can say “night night!”


Sources
  • Kotagal, S. “Sleepwalking and other parasomnias in children.” In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. Retrieved June 6 2017.https://www.uptodate.com/contents/sleepwalking-and-other-parasomnias-in-children?source=search_result&search=nightmares&selectedTitle=2~150#H27172885.
  • “Nightmares and Night Terrors.” Standford Children’s Health. Stanford Medicine. 2017. Retrieved June 6 2017. http://www.stanfordchildrens.org/en/topic/default?id=nightmares-and-night-terrors-90-P02257.
  • “Nightmares and Sleep.” National Sleep Foundation.  National Sleep Foundation 2017. Retrieved June 6 2017. https://sleepfoundation.org/sleep-disorders-problems/abnormal-sleep-behaviors/nightmares-and-sleep.

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