More than Just a Bad Dream: Helping Your Child Cope with Night Terrors

If you’ve ever been woken at night by your child screaming and thrashing in bed only to realize they’re still asleep, chances are your child is experiencing a night terror. While these episodes are alarming to witness, they are usually not cause for concern.

“It is much harder on the parent to watch [a night terror] than it is on the child to experience it,” says Katie Lockwood, MD, MEd, an attending pediatrician at CHOP Primary Care, South Philadelphia.

Dr. Lockwood, who is also Director of Behavioral Health Education in CHOP’s Pediatric Residency Program and Director of Education for the CHOP Care Network, offers insight into what causes night terrors in children and suggests ways parents can best support their children who are experiencing them.

What are night terrors?

Night terrors are a fear reaction that disrupts sleep. They generally occur during the first third of the night as your child transitions from the deepest stage of sleep to a lighter one.

During a night terror, your child may:

• Sit upright
• Shout or flail
• Be unaware of their surroundings
• Not respond when spoken to
• Sweat, breath very fast, have a rapid heart rate and dilated pupils

How are night terrors different from nightmares?

Night terrors are often confused with nightmares. A key difference is that children often wake up during nightmares and remember each scary detail. That’s because nightmares occur during the rapid eye movement (REM) stage of sleep when your child is dreaming.

During night terrors, children remain in a deep, non-dreaming stage of sleep, even though they may appear to be awake. They have no memory of the night terror when they wake up the next morning because night terrors have no mental images associated with them.

Dr. Lockwood points out that because children don’t remember these episodes, it’s best not to describe or reenact them, either to your child or within their earshot.

“Night terrors do not create a visual memory, so your child cannot describe what triggered the episode,” Dr. Lockwood says. “But children are observant and if their caregiver retells a scary nighttime event, it can scare the child.”

What triggers night terrors?

Night terrors are most common in children ages 4-12 and often disappear entirely by the time a child reaches their teens. While night terrors tend to happen randomly, the tendency to have them may run in families.

Night terrors may be triggered by:

• Caffeine
• Medications
• Illness
• Being overtired
• Sleeping in a new environment

What should I do while my child is having a night terror?

As a parent, your natural instinct may be to console your child. But waking your child from a night terror may disorient and confuse them. Remember, your child is in a deep sleep and will have no memory of the episode.

Instead, Dr. Lockwood recommends staying nearby your child – to ensure they are safe – until the night terror passes. Most episodes don’t last more than a few minutes.

Children with night terrors may also sleepwalk. If your child sleepwalks (or has in the past) make sure all entryway doors and windows are locked and that the sleeping environment is safe each night before bedtime.

Is there anything I can do to prevent night terrors?

Being overtired or feeling stress are known triggers for night terrors. Dr. Lockwood recommends that parents try the following to calm and relax their children before bedtime:

• Make time for young children to nap during the day so they don’t get overtired.
• Create a calming and simple nighttime routine, such as a warm bath and a book or puzzle before bed.
• Stick to a consistent bedtime for your child.

If your child experiences repeated night terrors or other sleep-related issues, such as snoring, sleepwalking or bedwetting, Dr. Lockwood encourages families to talk with their pediatrician.

Rest assured: Most children outgrow night terrors. And when that happens, the entire household will sleep more soundly.