Night terrors are a common issue in preschool-aged children. Most of the time, they go away on their own before puberty, but sometimes they need a little extra help. Dealing with night terrors can be challenging, especially for kids, so having support from parents is super important.
Night terrors are a sleep disorder that mainly affect preschool-aged children.
During an episode, the person may scream or jump while unaware of their surroundings.
After the episode, the person doesn’t remember having had a night terror. This characteristic helps differentiate night terrors from nightmares.
Triggering factors include fever, sleep disorders, medications, stress, and poor sleep hygiene.
Treatment involves avoiding triggers and improving sleep hygiene.
What are night terrors?
Night terrors, or sleep terrors, are a type of parasomnia that primarily affect preschool-aged children. Parasomnias are sleep disorders in which the individual experiences unusual behaviors before sleep onset, during sleep, or upon awakening. While parasomnias can occur at any sleep stage, night terrors usually occur during non-rapid eye movement (NREM) sleep. This is called the arousal state, a transition between sleep and wakefulness.
What happens during a night terror
The child's behavior can be very dramatic during a night terror episode. They may scream and exhibit vigorous movements while completely unaware of their surroundings. They may also experience physical symptoms such as:
- Rise in heart rate
- Increased breathing rate
- Dilated pupils
Waking up a child in the midst of a night terror episode can be extremely challenging. Children experiencing night terrors are unresponsive to external stimuli, making them unable to hear someone trying to comfort them. The episodes typically occur within the initial 3 to 4 hours of the night. They typically last 10–20 minutes but can continue for up to 90 minutes. After the episode, the child quickly goes back to sleep. Most children do not recall experiencing a night terror.
Night terror vs. nightmare
Although they may sound similar, nightmares and night terrors are distinct from each other. Nightmares are vivid and distressing dreams that happen during sleep. They frequently involve negative emotions like fear and anxiety, and they can lead to waking up. Unlike night terrors, individuals who have nightmares can remember the dream’s content. See the principal differences between nightmares and night terrors below:
|Primarily affect children, rarely affects adults||Are common in children but can happen at any age|
|Symptoms include screaming, shouting, and jumping out of bed||It involves intense feelings of fear or anxiety|
|The individual is unable to wake up and doesn’t remember the episode.||The individual may wake up and remember the dream.|
|It happens in the first third of the night.||It occurs later in the night.|
Causes of night terrors
Scientists still don’t know the exact causes of night terrors. Like other parasomnias, night terrors happen when the boundaries between sleep stages are blurred. There is some evidence that night terrors run in families. One study found that the number of people with night terrors among first-degree relatives was at least ten times higher than the general population. The study also revealed that when both parents had night terrors, the chances of their children having night terrors increased up to 60%.
Who has night terrors?
Approximately 1 to 6.5% of children experience night terrors, with most of these incidents happening between the ages of 4 and 12. Fortunately, these episodes tend to resolve on their own before puberty. Night terrors are much less frequent during adolescence and adulthood. About 2.2% of adults have reported experiencing it. Among children, night terrors are more prevalent in boys than girls, whereas in adults, this condition affects both genders equally.
Triggers and risk factors
Certain factors and conditions can make someone more likely to experience night terrors. These include:
- Attention deficit hyperactivity disorder (ADHD)
- Sleeping in a noisy environment
- Sleeping with a full bladder
- Sleep disorders such as restless leg syndrome or obstructive sleep apnea
- Being tired
- Excessive physical activity
- Separation anxiety
- Certain medications, such as sedatives or stimulants
- Lack of sleep
- Alcohol abuse
- Excessive caffeine intake
Prevention and treatment
There is no one-size-fits-all treatment for night terrors. The doctor will assess each case individually and suggest an appropriate treatment based on the patient's needs. If the condition is causing significant distress, a combination of therapy and coping techniques may be recommended to reduce the frequency of episodes. Treating underlying medical conditions and avoiding triggering factors may also help.
People who experience night terrors should maintain good sleep habits, which include:
- Waking up and going to bed at the same time every day.
- Avoiding alcohol, caffeine, and heavy foods before bedtime.
- Sleeping in a quiet, dark, and cozy environment.
- Avoiding stress before going to bed.
- Exercising and getting some sunlight exposure during the day.
- Removing electronic devices from the bedroom.
- Getting enough sleep.
It can also be helpful to avoid situations that may disrupt sleep, such as going to bed with a full bladder or sleeping with a pet that might jump on the bed during the night. Doctors may prescribe sedatives or antidepressants to manage persistent night terrors in children.
Tips for coping with night terrors
Children who experience night terrors will need love and support from their parents. Parents should learn as much as possible about the condition to ensure the child stays safe during the episodes. Always seek information from a reliable source, such as a healthcare professional. Don’t try to wake up the child during the episode. It’s best to stay close and ensure the child doesn’t fall or harm themself. Removing any objects that could potentially cause harm and securing all doors and windows is essential.
When to see a doctor
Most cases resolve spontaneously without treatment. However, it’s recommended to seek medical advice in the following scenarios:
- Episodes occur more than two times a week.
- Episodes result in injury.
- Night terrors occur together with sleepwalking or sleep talking.
- The patient experiences daytime sleepiness or problems functioning.
- Episodes begin later, in adolescence or adulthood.
Night terrors are relatively common among small children. These episodes can really upset them, but the good news is that things usually get better as they grow up. By the time they reach adolescence, most children tend to outgrow these episodes. In most cases, all they need is love and support from their parents, but sometimes medical attention might be necessary.