Night Terrors!

It is quiet and still in your house and you are just getting ready to fall asleep when all of a sudden, out of nowhere, your little one screams bloody murder. You jump out of bed, race to their room only to see them thrashing about in their crib or bed. You reach to grab them and offer comfort but they want nothing to do with it. After a few minutes they stop and return quietly to sleep. Your heart is racing so fast you know that sleep will elude you a while longer. The next day you mention this episode to your friends and they all agree it sounds like a night terror. But what is a night terror and why is it terrorizing our children?

First off let me explain that there is a difference between “night terrors” and “confusional events.” True night terrors don’t usually happen until a child is at least 4 years of age. But many children younger than this will have episodes that seem to mimic night terrors but are actually referred to as confusional events. Both confusional events and night terrors are not to be confused with dreams Nightmares and dreams occur during REM sleep, when our body is in a paralyzed state. This is how we know for certain that it couldn’t possibly be a bad dream. When we dream, our bodies in a sense protect themselves and we can’t move to sit up, thrash, sleep walk or act out our dreams. Night terrors and confusional events usually occur a couple hours after falling asleep when our children’s bodies are making their way out of a deep stage of sleep. When our children fall asleep, they descend pretty quickly into what is called stage IV Non-REM sleep. This is the deepest stage of sleep. You have probably witnessed it in your child if you have ever gotten them out of the car when they are asleep and have been able to transfer them to bed with out waking them up. People in this stage of sleep have very slow, steady breathing, may sweat a lot and are very hard to wake. If you are awoken from this stage of sleep it might take you a few minutes to become aware of where you are and what is happening. After about 60-90 minutes our children’s body’s  will transition out of this deep stage and into a lighter stage and they may even wake up for a minute. But then they will once more descend into stage IV sleep.

Confusional events usually occur when your child is making their way out of one of these deep stages of sleep. During these transitional periods, the bodies “drive to wake” and its “drive to sleep” meets head on. Most of the time they can  make these transitions smoothly, they might just moan, roll over, grab their blanket etc. But sometimes when these two drives meet, they collide head on and in a sense create a collision with the brain and body and this creates a sleep terror or confusional event. The body is basically stuck for a short time, exhibiting characteristics of both sleeping and waking. There are varying degrees of confusional events and only the most severe are labeled as true night terrors. Some confusional events you might not even be aware of. Your child might roll around a bit, moan, sit up looking around, sleep talk, or calmly sleep walk. They may also be a bit more obvious such as screaming or crying out, thrashing, agitated sleep walking or kicking. A true sleep terror will have your child screaming with a look of terror on their face, running around with thrashing which may lead to them hurting themselves.

The one good thing about sleep terrors and confusional events is that our children won’t ever remember them. After going through a confusional event your child will either wake themselves or return to sleep. Either way, they will not be aware of what just happened.

So what causes the body to have these events and what can we do to help eliminate them? As we talked about above, the body experiences night terrors or confusional events when it can’t make the transition from one sleep stage to another in a smooth fashion. This can be caused by many things;

1. Being over tired. This is the most likely case for children who have them periodically. Being over tired or behind on sleep keeps the bodies “drive to sleep” very strong and unwilling to yield at all to the “drive to wake.” But our bodies must wake ever so slightly when we change from one sleep stage to another. No one sleeps a solid 8 hours straight. We have slight waking’s all night long but we usually never remember them. Children are very susceptible to becoming over tired and this will put their body at odds with itself and doesn’t create a peaceful atmosphere for sleep. Usually by adjusting your child’s bedtime, even moving it earlier by 30 minutes, you can help keep the body in a well-rested state.

2. Sickness and medication can also cause confusional events. It is very common to see these events in children who are running a fever. Usually once the sickness passes these events will disappear.

3. Another reason for confusional events is strong sleep associations. If you child is used to having you pat his back to sleep, he thinks he needs this in order to fall and stay asleep. So when his body has a small awakening during the changing of sleep cycles, his body will force itself awake to make sure that you are still there patting his back. When he sees that you are not, he will force himself awake and call you back, since this is how he associates sleep. So because of this it is good to make sure that our kids have their own set of self-soothing skills that don’t require intervention in the middle of the night.

4. Upsets in the normal schedule is another reason for night terrors. It is quite common to see these types of events happen when the normal schedule has been changed or big events are happening. Things such as school starting, a birthday, the holidays, vacation, and having company or family in town can cause night terrors.These types of activities, while fun, can be extra stimulating to your child. Having a slightly earlier bedtime to compensate for these fun events can a lot of times ward off night terrors.

5. Genetics do play a part in night terrors. If you grew up having night terrors, sleep walking or talking there is a good chance you child will too.

6. Lastly, not having a set schedule and proper wind down routine can also contribute to confusional events or night terrors. Our bodies function best on a set routine and schedule. This allows our body to regulate itself. We become hungry at proper meal times and we become sleepy at proper bedtimes. If we keep up with this consistency our body is much less likely to fight itself. Also making sure we have proper time to wind down at the days end will help us fall into a peaceful sleep.

Even with proper consideration for everything mentioned about our children will still sometimes experience some sort of confusional event at some point. So what are we, as parents, supposed to do during a night terror? The best plan of action is to interfere as little as possible. I realize this is completely the opposite of what our instincts tell us to do. We want to run in and soothe our child and let them know nothing is wrong. The problem with this approach is that our children are not fully awake during these events and by interfering we run the risk of completely waking them up. Most confusional events don’t require any action on our part, except to watch and make sure they are okay. For more drastic night terrors you might need to interfere if your child is going to hurt themselves or break something. If you child is calmly sleep walking you can usually calmly and quietly walk them back to bed or even ask them to return to bed. The next day, it is best to not even mention these events to your child as they won’t remember them.

Sleep terrors are definitely more terrorizing for parents than children. I hope this article gave you a basic understanding of what a night terror is and what it isn’t. Most confusional events and night terrors will pass on their own. But if they become very regular or violent in nature please discuss them with your child’s pediatrician. Even if the events are fairly mild, it can be reassuring to discuss them.