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This article originally appeared in the Nov. 24, 2010, edition of the St. Louis Post-Dispatch. 

Most parents have comforted their child after the occasional nightmare. But if your child has ever experienced what's known as a night terror, his or her fear was likely inconsolable, no matter what you tried.

A night terror is a sleep disruption that seems similar to a nightmare, but with a far more dramatic presentation. Though night terrors can be alarming for parents who witness them, they're not usually cause for concern or a sign of a deeper medical issue.

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 rapid, 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.

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 children 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 children 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.

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.

The primary strategy for parents to try to cope with night terrors is prevention. You can help your child avoid night terrors by:

  • reducing your child's stress
  • establishing and sticking to a bedtime routine that's simple and relaxing
  • making sure your child gets enough rest
  • preventing 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 night terrors happen repeatedly, talk to your doctor about whether a referral to a sleep specialist is needed.

Dr. Bob Wilmott is Chief of Pediatrics at SSM Cardinal Glennon Children’s Medical Center and is a Professor of Pediatric Medicine at Saint Louis University School of Medicine. If you have a question about your child’s health, go to the “Ask Dr. Bob” section of the Cardinal Glennon Web site at www.cardinalglennon.com.

11/24/2010