Night terrors, or sleep terrors, are a type of sleep disorder that primarily affects children ages 3 to 7, although some older children and adults suffer from it. Signs that someone is experiencing night terrors include screaming, crying, moaning, increased heart rate, panting, and other signs of anxiety. Although children can open their eyes, speak, and even run around during a nighttime horror, they do not fully wake up. Watching a child have a nighttime horror can be unsettling, but it’s important to understand that most children go back to full sleep afterward and usually don’t remember it the next day. Since only a few long-term effects are observed in children with night terrors, the condition is usually viewed as harmless and manageable with measures such as regular sleep planning. In rare cases, medication can be prescribed.
Estimates of the prevalence of night terrors vary. Some studies show that 56% of children experience at least one.
Despite some similarities, night terrors are not the same as nightmares. Children who have nightmares are easy to wake up and able to respond to caregivers, while children who experience night terrors may appear inappropriative or even combative. Since they are not fully awakened, they are usually unable to interact with others. Night terrors often occur in the first half of the night, or about one to four hours after falling asleep, and coincide with deep, non-REM sleep. Most only take a few minutes, some longer.
Symptoms of night terrors can include:
- Screw upright in bed
- Crying, often heartbroken
- Increased heart rate
- Panting or rapid breathing
- Glassy eyes
- Other symptoms of anxiety or panic
- Confusion when fully awakened
- Missing dream memory
Sleepwalking, while not a direct symptom, can also be linked to night terrors.
Sleep terrors seem to occur when deep sleep is fragmented. This may be more likely during periods of stress characterized by lack of sleep or irregular sleep patterns, or it may be secondary to other sleep disorders such as sleep apnea.
It is important to distinguish these episodes from sleep seizures, as seizures can also cause unusual behaviors and are often triggered by sleep transitions.
There can be a genetic component in both night terrors and sleepwalking. Fever, certain medications, head trauma, and stress may also be related.
The characteristics of a night terrier are relatively obvious and unique. If you seek advice from your child’s pediatrician, they will likely review your child’s medical history, do a physical exam, and ask you to describe the frequency and intensity of symptoms. To provide accurate information, it may be helpful to keep a journal to record your child’s episodes. Your child’s pediatrician may also do an EEG to determine abnormal brain activity related to seizures, or do a sleep study to look for apnea or an associated sleep disorder.
Most children do not have severe or persistent symptoms that require treatment, and the condition tends to resolve on its own as the child ages. Helpful practices include keeping a regular bedtime and avoiding fatigue. However, if symptoms are disturbing sleep on a regular basis, there are some treatment options.
To do this, the child must be woken up about 15 minutes before they tend to sleep – usually during the first one to four hours of sleep.
Keep a sleep diary
Keeping a record of factors that appear to coincide with or contribute to a child’s nighttime anxiety can provide helpful information that can be used to develop a plan for coping with them. Helpful things to note in a sleep journal for your child include bedtime, the nap routine, and everyday stressors.
The Lully Sleep Guardian is a Bluetooth-enabled device the size of a hockey puck that is placed under a child’s pillow. It vibrates to gently bring the child out of the deep, non-REM sleep associated with night terrors. Ask your child’s doctor about the potential benefits and risks of using such a device.
Night terrors are generally considered non-traumatizing as most children do not remember them in the short term and have a tendency to outgrow them. Because of this, drugs are rarely required for treatment. When medication can help, the most common prescriptions are benzodiazepines (sleeping pills) or antidepressants.
If a child experiences a sleep scare, stay calm. Since you are unlikely to be able to wake them up, focus on making sure they are safe, be comforting and reassuring even if the child seems unresponsive, and do whatever you can to calm them down to get them back to fall asleep. Let babysitters and other caregivers know your child may be prone to night terrors, describe what an episode looks like, and provide instructions on what to do.
A word from VeryWell
If your child has recurring night terrors it can be scary to watch and stressful to live through. Have your child screened to make sure that nothing else is responsible for these episodes, then develop strategies to cope with them until your child outgrows them, which is very likely to happen. Above all, you should be assured that your child will not be injured or traumatized by their night terrors and will eventually become a thing of the past.