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Recognising and dealing with your child's night terrors

Often confused with nightmares, but night terrors is a different kind of sleep disorder that really can be a nightmare for parents. Learn how to recognise a night terror and a confusional arousal, and how to deal with them.

Night terrors and confusional arousals are something we never are prepared for and a shocking surprise when they occur. Not every child has night terrors and some might also have them at nap times during the day. The first time your child has a night terror will be a confusing and even frightening experience for you as a parent.

Confusional arousals are most common with infants and toddler and the child will mainly show signs of confusion. Night terrors on the other hand are most common in older children and young adults, from age eight and up. With a night terror a child will show intense fear and might also sleep walk or run. Both sleep disorders are commonly called night terrors, even though confusional arousals affect between 5-15% of infants and toddler, according to Dr. Richard Ferber's research on sleep, while true night terrors affect only 1% of older children.

 

Night terror or nightmare?

On any given night your child might bolt up suddenly from her bed, be panicked and terrified. She might scream and get up, roaring at everything and anything. Your first instinct will be to comfort and hold her, but she might just lash out physically or even verbally, screaming her head off like a banshee. Or she might run around her room or the house, she might be calling for you but not acknowledge your presence even though you are there with her and you won't be able to wake her. It can be a truly frightening experience for any parent that can leave you feeling utterly helpless and worried.

- When a child has a nightmare they will wake up very easily and will be able to tell you about their fears. With a night terror they will tell you they're scared but not why, says Dr. Catherine Crowe at the Mater Private Hospital Sleep Clinic.

Night terrors, also referred to as Pavor Nocturnus, are often confused with nightmares or even seizures, but are actually quite easy to distinguish if you know what to look for. The primary clue is that your child is behaving aggressively in a situation you would expect her to seek comfort. Your child might look awake, even be standing and walking, but will seem not fully there, almost as if she doesn't see you. The reason is that during a night terror the child is actually asleep. Night terrors are closely related to sleepwalking, it is also common that both types of sleep disorders run in the family and are inherited.

They occur during deep sleep, also called stage 4, unlike nightmares that are more common during REM-sleep, which is the dreaming time and a lighter type of sleep. Night terrors happen during the shift from deep sleep to REM, the child would be half way to waking and not passing all the stages to lighter sleep in a usual calm order.

A night terror will usually occur after 1-4 hours after your child goes to sleep, and might last from 5-30 minutes. When it passes your child will most likely return to immediately to regular sleep without really waking. Your child could have night terrors regularly for a few weeks and then never again, or a couple times a month for a couple of years, it is very individual. The same happens with a confusional arousal.

Most experts will agree on that children grow out of night terrors, but it's not always the case since even adults can suffer from them. Ask members of your family if there is any history of sleep disorders as night terrors, sleepwalking, sleep talking and a bedwetting.

A nightmare is just that, and the child wakes up looking for comfort from the parent. They will usually remember the dream the day after and talk about it, whereas with night terrors the child might be completely oblivious to what she was dreaming or doing the night before.

There is no real medical treatment or cures for night terrors. It is also important to understand, as a parent, that night terrors are not a psychological problem or disorder. In reality there is little your GP or a psychologist can do, you will probably just be told that your child will grow out of it…eventually. In rare cases sleep medication is given to alter the depth of sleep.

- Night terrors and confusional arousals can occur in clusters, and there can be months or weeks that are bad and then just settle down. If it runs in your family you might want to ask your parents or in-laws on how they dealt with them. You might seek help if the episodes are disturbing or disrupting the whole family, says Dr. Crowe.

 

Triggers

The most common triggers for a night terror are over tiredness, being too hot during sleep, eating late and poorly planned bedtime routines.

A child that is too tired will not automatically sleep better and if she suffers from night terrors an afternoon nap or quiet time might be a good idea to introduce. It is also important that your child is relaxed and calm when going to bed, particularly if the day has been hectic or stressful.

Things that affect your child's sleep, and thereby making her overtired should also be considered. Like illnesses, such as fevers, cold and flues, but also emotional stress and upsets that can make it hard to fall asleep or get good quality sleep.

- Good sleep routines give good quality of sleep and also a sense of security to the child, says Dr. Crowe. See if there is any predisposition towards sleep disorders in the family, review your child's sleep patterns and routines, and rule out temporary night disturbances, such as sickness and emotional stress

 

What to do, how to cope

You will not hurt your child if you try to wake her, but it can be very hard to do, it can also prolong the situation and but mainly because you might end up frantic. Your child might wake up to a worried and frightened parent without understanding why.

It might be impossible to communicate with your child at all and at three in the morning and they don't seem to want anything and just keeps on screaming in anger, it's easy to start scolding or yelling if you feel frightened yourself.

Try talking quietly and reassuringly, about anything, since she might react to the soothing tone of your voice. Don't restrain her or keep trying to hold her, she might just become more aggravated. The best approach is to just be there and see that she doesn't hurt herself by bumping into. Get her to lie down and sleep as soon as she is willing to.

- When your child is having an episode of sleep terror or confusional arousal they are best left a lone. Your main function as a parent is to remain calm and see to that no injury occurs. It's important to not get too worried, says Dr. Crowe. If you intercede it likely will prolong the episode.

Most important is to try to be calm and control your own fear, she'll most likely not remember a thing in the morning. Turn on the lights if it makes you feel better. If your child doesn't remember the incident it might only upset them if you talk to them about it the day after.

- If your child walks during his terrors consider putting chimes or sensors on the doors. Consider sleep extension, getting them to bed about half an hour earlier. Any sort of sleep deprivation should be avoided, stick to the sleep time you've set, says Dr. Crowe.

If your child is potty trained you can try getting her to sit on the toilet. The need to go might have triggered the night terror. The body I sending signals to go, but it is during deep sleep and the brain won't fully wake to carry out the command.

You can try keeping a sleep diary, logging the date and time your child has a night terror, what might have triggered it and how long they lasted. You can then try waking your child about fifteen minutes before you think he might have a night terror. It is not a fool proof system, since you might just be delaying the night terror and your child could have one later that night. It can be useful with children that suffer with terrors regularly, rather than ones that might have them a couple of times a month.

Some parents will swear by multivitamins, mineral and fish oil supplements. Even though there might not be any scientific research done to prove their effect on night terrors, it's worth a try for parents that are dealing with them regularly.

- There's no scientific proof that oils of multivitamins do anything for sleep disorder, but perhaps parents are calmer because they feel they've done something, says Dr. Crowe.

 

How to prevent night terrors and confusional arousals

Apart from identifying possible triggers and waiting till your child grows out of it, there are few things you can do.
· Work out a calm bedtime routine, where the child gets plenty of time to ease into sleep and relax beforehand. A good routine can include a bath, calm play, a massage, brushing her teeth and bedtime story. See what works for you both, since some children might get more active with a bath.
· Have a regular sleep pattern for your child, and try not to change their bed time.
· Try not letting your child watch television to close to bedtime. It can make them active, even though they might not express it physically.
· Do not feed or give to much liquid too close to bedtime, especially if she's potty trained.
· Try keeping your child's bedroom at a cool but comfortable temperature.
· Let your child have a nap or quiet time in the afternoon, to avoid over tiredness.

 

Spot a night terror

· Occurs mainly in young adults and adolescents
· Agitated and uncommunicative
· Looks awake but seems unreachable
· Crying and screaming
· Shows intense fear
· Sweating
· Might walk or run blindly

 

Spot a confusional arousal

· Occurs mainly in infants and toddlers
· Unresponsive or aggressive to you, uncommunicative
· Looks awake but seems unreachable
· Looks confused rather than afraid
· Does not recognise you
· Shows resistance when you try holding or cuddling

More help…

www.nightterrors.org

About the Author

Barbara Finucane is the Editor of the online parenting magazine Parenthood.ie, which follows parents from the very beginning, covering all parenting needs from the first stages of conception, through pregnancy, parenting your baby and toddler.

Barbara Finucane has a background in magazine publishing, having managed a fashion and women's magazine in Sweden as executive editor. She has also worked with publishing in Canada and public relations for Viasat broadcasting, a television network in the UK.

Barbara is the mother of twin girls and is voracious in her quest to aquire and spread information on pregnancy and parenting.

http://www.parenthood.ie/

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