Night Terrors Are Terrifying — for Parents
Night terrors are aptly named: They are terrifying.
During a night terror, your child will bolt upright, wide-eyed and screaming. Their heart and breathing rates increase, their pupils dilate and they may thrash about wildly or even try to get out of bed as if to escape something or someone.
If you speak to your child by name, they won’t respond. If you try to comfort them, they are likely to pull away or kick and flail. They are unreachable and inconsolable.
To your eyes, your child may seem to be in the midst of a panic attack or hallucination or, if you’re an extreme worrier, something even worse, like a seizure or psychotic episode.
Yes, night terrors are that scary.
Night terrors are common in children
About 1.5 million children each year in the United States will develop night terrors. That’s a lot of terror.
But as a parent it may help you to know that night terrors are more terrifying for you than for your child. That’s because during a night terror, while your child seems to be awake and frightened, in truth, you are the only one who is awake.
Your child is experiencing parasomnia, an unusual behavior in sleep that occurs because of a mixing of sleeping and waking states: a behavior they won’t even remember in the morning.
“It’s as if your child is stuck between being asleep and awake,” says Vishesh Kapur, M.D., M.P.H., founder and co-director of the UW Medicine Sleep Center.
Night terror signs and symptoms
Night terrors usually occur in children between the ages of 3 and 6, though for some they can persist into early adolescence. Very few adults experience night terrors.
Individual episodes can last anywhere from a few minutes to half an hour, and usually resolve on their own when your child falls back asleep. A child may suffer only a few episodes of night terrors or they may develop into a persistent problem.
You should not rouse a child during a night terror, but if you were to try, it would be very difficult to do so. And if you were to succeed, your child would be disoriented and groggy.
And then there’s the terror part of night terrors. Your child can act so very frightened that it’s difficult to believe there isn’t something seriously wrong. Even though they may move about and seem to interact with you, they are inconsolable (because they are asleep, after all).
Even knowing all this ahead of time, night terrors are still an unsettling experience for any parent.
Night terror causes
When your child first falls asleep, they enter a sleep cycle known as non-REM sleep (non-rapid eye movement sleep). Their body, stimulated by hormones, is busy repairing itself and growing, while their heart rate and breathing both slow.
Non-REM sleep has stages, and it is during stage 3 (deep sleep) that night terrors typically occur, probably during a transition from the deepest stage of sleep to a lighter stage of sleep.
It’s because children are sleeping deeply that they are so difficult to wake up.
Though the cause is not exactly understood, the tendency for night terrors — and other parasomnia events — does run in families, which suggests a genetic predisposition.
Night terrors are different from nightmares
While nightmares and night terrors might seem to share similar characteristics, in fact, they are quite different.
During a nightmare, your child is in rapid eye movement (REM) sleep — the dream stage of sleep that predominates near the end of the sleep period. Night terrors usually begin earlier in the sleep period after a child has been asleep for anywhere from one to three hours — in the non-REM stage of deep sleep. This is one way to differentiate night terrors from nightmares.
When a child awakens from a nightmare — or recalls it the next day — they will usually remember being scared, as well as details of the nightmare. But after a night terror, your child will have no recall of what happened the night before.
While children are in between sleep cycles, they are not really awake; they just look that way.
“That’s a big part of what makes night terrors so distressing for parents,” says Kapur.
What to do — and not do — during a night terror
Your biggest concern during a night terror should be your child’s safety.
“Make sure that the bedroom environment is as safe as possible and remove furniture that is close to the bed,” says Kapur.
Some children remain in bed while others get out and thrash about. And while they may look like they know what they’re doing, they don’t, which is why you need to watch out for them.
Do not try to wake your child during a night terror. Doing so only confuses and disorients your child, and makes it likely that it will take them longer to settle back down and return to sleep.
Also do not block or restrain your child unless it is absolutely necessary to do so to protect them, as this could trigger aggressive behavior.
Night terror prevention
There are some behaviors that can help to prevent or minimize night terrors. And others, best avoided, that tend to bring night terrors out.
- Establish a predictable routine. A regular routine signals to your child that sleepy time is coming, and helps them to wind down in preparation for it.
- Make sure your child gets enough sleep. Sleep deprivation creates a sleep deficit that may make night terrors more likely for your child. “It matters less what your routine is than that you are consistent with it,” says Kapur.
- Engage your child in relaxing behaviors before bedtime. Choose relaxing activities for your nighttime routine, such as having your child take a bath before bedtime or reading a story to them every night.
- Make sure that your child is not consuming too much caffeine during the daytime, which can contribute to poor sleep. Caffeine can be hidden in food and beverages where you might not expect them — like snack bars, non-cola sodas and even some trendy bottled waters.
- Limit screen time before bed. Screen time close to bedtime exposes your child to blue light, which can disrupt your child’s natural circadian rhythm, or internal clock.
- Avoid stimulating your child close to bedtime. No Nerf wars, wrestling matches, tickling fests or spirited games of anything. And no recitation of multiplication tables or spelling bee prep either.
- Beware of increased stress. If a child has experienced a recent increase in stress (such as a move, a new sibling or a divorce), this can trigger night terrors. Do what you can to relieve their stress and find appropriate stress-relieving outlets for them.
- Keep it cool. Anecdotal evidence suggests that a room — or clothing — that is too warm may contribute to night terrors, but that hasn’t been proven by science.
“These are all modifiable factors that may reduce the occurrence of night terrors and are certainly worth trying,” says Kapur.
When to see a sleep specialist
What you decide to do about night terrors will depend, in large part, on their impact on you and your family.
If you have a child who has only a few episodes, that’s one thing. But other children may have repeated episodes that disrupt the entire family.
If you’ve cleaned up your child’s sleep hygiene habits — with no improvement — or if their behavior puts them at risk of injury or if you just can’t take it anymore, then it’s time to bring your child in to see a sleep specialist.
“The biggest downside of night terrors is the distress to parents,” says Kapur. “I would tell them not to wait too long.”