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Night terrors: a childhood sleep disorder

George Skarvinko, M.D. [February 26 2013]

Your child screams and thrashes, or may even shout your name with eyes wide open, but no amount of reassurance can calm him. The next morning you wonder about what happened. If the child is old enough to understand, you ask about what seems to have been a bad dream, but he can't recall anything. A few days later, the episode repeats itself and you wonder what is going on. Such a scenario may very well be a childhood sleep disorder known as night terrors. From 1 to 6 percent of children experience night terrors before adolescence, with peak age at 3 ½ years old.

There are two stages of sleep: REM (rapid eye movement) and non-REM (non- rapid eye movement). This second stage of sleep, non-REM, is further divided into four stages or progressions. Night terrors occur during transition from stage 3 to stage 4, about 90 minutes after your child has fallen asleep. Nightmares occur during REM sleep. Other features of night terrors include:

• frequently recurring episodes of intense fear and/or crying
• inability to recall the episode
• inability to recall a dream after the episode
• difficulty rousing the child from the night terror
• sweating
• increased heart and breathing rates
• episodes lasting 1- 2 minutes, sometimes up to 30 minutes

The biological reason as to why a child may experience night terrors is unknown. However, factors identified as possible contributors include:
stressful life events like moving, changing schools, a death, or a divorce

• stressful life events like moving, changing schools, a death, or a divorce
• fever
• sleep deprivation
• medication affecting the central nervous system
• recent anesthesia given for surgery

If your child is experiencing night terrors, seek advice from your pediatrician. While your pediatrician will not be able to provide medicine to “cure” your child from night terrors, he or she may be able to perform an evaluation ruling out other possible sleep disorders. At-home precautions are also valuable in aiding your child. Some precautions might be:

• make the child's room safe to prevent injury during an episode
• eliminate sources of sleep disturbance, like a blinking light or jarring sounds
• maintain a consistent, pleasant bed-time routine and a consistent wake-up time

Night terrors are frightening and disruptive to the whole family. Take comfort that these episodes are transient and usually resolve spontaneously as the child grows. Children who have experienced night terrors do not suffer permanent or lasting emotional, mental, or physical damage. You will have peaceful nights again.

Dr. George Skarvinko is a member of The Hospital of Central Connecticut (HOCC) medical staff. For referrals to HOCC physicians, please contact our free Need-A-Physician referral service by phone at 1-800-321-6244 or online, www.thocc.org.