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Night Terrors

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Pediatric Basics

Night terrors are a common sleep problem among children. By some estimates, about 15% of younger children have occasional night terrors. Although most common in children between the ages of 2 and 6 years, they can occur at almost any age.

Although usually considered to be normal or benign, they are often very scary and distressing to parents who often overreact, especially during a child's first night terror.

Symptoms

When you hear how most experts describe night terrors, it is easy to see why parents find them distressing. Children who have night terrors are usually described as 'bolting upright' with their eyes wide open, with a look of fear and panic, and letting out a 'blood curdling scream'. These kids will usually also be sweating, breathing fast and have a rapid heart rate (autonomic signs). And although it will seem like they are awake, during a night terror, children will appear confused, will not be consolable and won't recognize you.

Typical night terrors last about 5 to 30 minutes and afterwards, children usually return to a regular sleep. If you are able to wake your child up during a night terror, he is likely to become scared and agitated, mostly because of your own reaction to the night terror, especially if you were shaking or yelling at him to wake up. Instead of trying to wake up a child having a night terror, it is usually better to just make sure he is safe, comfort him if you can, and help him return to sleep once it is over.

Diagnosis

The diagnosis of night terrors is usually made by the history of a child 'waking' early in the night screaming and being inconsolable. Night terrors are most often confused with nightmares, but unlike night terrors, a child having a nightmare is usually easily woken up and comforted.

The other worry for many parents is that these episodes are a type of seizure. Although different types of partial seizures, including temporal lobe and frontal lobe epilepsy, can appear similar to night terrors, they are usually brief (30 seconds to a few minutes) and are more common in older children and adults.

Treatments

No treatment is usually necessary for routine night terrors. Since they are often triggered in children who are overtired, sticking to a good bedtime routine and making sure your child is getting enough rest can help to prevent them.

For 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 occuring (it also works for sleepwalking).

Rarely, sleep medications might be used for a short time if your child gets very frequent night terrors.

What You Need To Know

  • Night terrors are also called sleep terrors or pavor nocturnus.

  • Similar to sleepwalking and sleeptalking, night terrors are considered to be a disorder of arousal and are a partial arousal from non-REM sleep.

  • Unlike a nightmare, children usually don't recall having a night terror.

  • Also unlike nightmares, night terrors usually occur in the early part of the night, about 1 to 4 hours after going to sleep.

  • If your child gets night terrors, make sure that baby sitters and other caregivers are aware of them and know what they should do if one occurs.

  • Most children outgrow night terrors as they get older.

Updated: March 26, 2003

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