How to deal with night terrors?

sleep-moonQ: We found our four-year-old son sitting up the other night screaming and shouting. He looked really upset and agitated, yet seemed to be still asleep. It was very upsetting to see and we didn’t know what to do. In a few minutes he settled down and went back to sleep soundly. My sister says it was probably a night terror. Is that the case, and is there anything we need to worry about?

A: What you describe does indeed sound like a night terror. Though very upsetting to witness, night terrors are a common disturbance in young children’s sleep. During a night terror, the child might sit bolt upright screaming and shouting, breathing very fast and appearing very upset, almost in a fearful or panicked state. They may thrash around with their eyes open, yet, strangely, still asleep. Usually after a few minutes the child calms down and settles back to a relaxed sleep.

A night terror differs from a nightmare in a number of ways. Whereas children usually awake from a nightmare and can remember the details, children tend not to remember a night terror as they are usually in a deep sleep at the time and aren’t dreaming.

In addition, whereas most children have an occasional nightmare, night terrors are relatively rare (some studies say 3-6 per cent of children experience them). While night terrors can happen at any age, they tend to be most common between the ages of four and 10 years old. A child might have a single night terror, or several, before they grow out of them as they mature. While there are no specific causes to night terrors, they can be more common when children are overtired, or whose routine has been changed.

No harmful effects
The good news is that night terrors are generally considered benign and, although they are distressing to witness as a parent, they have no harmful effects and children tend to grow out of them over time.

The best way to handle a night terror is to wait it out patiently and make sure your child doesn’t get hurt by thrashing around. Sometimes it can be helpful to hold your child gently and to say comforting, relaxing things. Children usually will settle down and return to a relaxed sleeping state on their own within a few minutes.

Generally, it is not recommended that you wake a child who is having a night terror. It usually doesn’t work, and if you do succeed in waking your child, he is likely to be disoriented and confused, and may take longer to settle down and go back to sleep.

You can also help to prevent night terrors by ensuring your child does not get overtired or stressed, and by creating a relaxing routine before bedtime.

For the relatively few children who get frequent night terrors, it might help to wake your child up before the time that he usually has a night terror. This is thought to interrupt or alter the sleep cycle and prevent night terrors from occurring.

If this continues to be a concern for you, consult your GP about whether a referral to a paediatrician or sleep specialist is necessary.

Dr. John Sharry, Irish Times Newspaper, May 2014. John writes in The Irish Times Health+Family every Tuesday.