Night Terrors

What Are Night Terrors?

During a typical night, sleep occurs in several stages. Each is associated with particular brain activity, and the rapid eye movement (REM) stage is the stage when most dreaming occurs.

Night terrors happen during deep non-REM sleep. Unlike nightmares (which occur during REM sleep), a night terror is not technically a dream, but more like a sudden reaction of fear that happens during the transition from one sleep phase to another.

Night terrors typically occur about 2 or 3 hours after a child falls asleep, when sleep transitions from the deepest stage of non-REM sleep to lighter REM sleep, a stage where dreams occur. Usually this transition is a smooth one. But rarely, a child becomes agitated and frightened — and that fear reaction is a night terror.

During a night terror, a child might suddenly sit upright in bed and shout out or scream in distress. The child's breathing and heartbeat might be faster, he or she might sweat, thrash around, and act upset and scared. After a few minutes, or sometimes longer, a child simply calms down and returns to sleep.

Unlike nightmares, which kids often remember, kids won't have any memory of a night terror the next day because they were in deep sleep when it happened — and there are no mental images to recall.

What Causes Night Terrors?

Night terrors are caused by over-arousal of the central nervous system (CNS) during sleep. This may happen because the CNS (which regulates sleep and waking brain activity) is still maturing. Some kids may inherit a tendency for this over-arousal — about 80% who have night terrors have a family member who also experienced them or sleepwalking (a similar type of sleep disturbance).

Night terrors have been noted in kids who are:

• overtired or ill, stressed or fatigued
• taking a new medication
• sleeping in a new environment or away from home

Night terrors are relatively rare — they happen in only 3–6% of kids, while almost every child will have a nightmare occasionally. Night terrors usually occur between the ages of 4 and 12, but have been reported in kids as young as 18 months. They seem to be a little more common among boys.

A child might have a single night terror or several before they cease altogether. Most of the time, night terrors simply disappear on their own as the nervous system matures.

Coping With Night Terrors

Night terrors can be very upsetting for parents, who might feel helpless at not being able to comfort or soothe their child. The best way to handle a night terror is to wait it out patiently and make sure the child doesn't get hurt by thrashing around. Kids usually will settle down and return to sleep on their own in a few minutes.

It's best not to try to wake kids during a night terror. Attempts usually don't work, and kids who do wake are likely to be disoriented and confused, and may take longer to settle down and go back to sleep.

There's no treatment for sleep terrors, but you can help prevent them. Try to:

• reduce your child's stress
• establish and stick to a bedtime routine that's simple and relaxing
• make sure your child gets enough rest
• prevent your child from becoming overtired by staying up too late

Understanding night terrors can reduce your worry — and help you get a good night's sleep yourself. But if sleep terrors happen repeatedly, talk to your doctor about whether a referral to a sleep specialist is needed.