Sleep Care

Nightmares and Night Terrors

Night terrors are parasomnias associated with arousals from slow wave sleep, the deepest non-REM sleep. Night terrors are most common in children 5-7 years old, but is still found in children as old as 12 years old, and can still be found in about 1% of adults. Age, medications, a noisy or stressful environment, fevers, sleep deprivation, and underlying sleep disorders (such as obstructive sleep apnea) can affect the frequency and intensity of night terror episodes. Screaming and a look of fear on your child’s face accompany night terrors. Generally, children do not remember specifics of what happened during the event, but can recall a need to defend themselves from a threat. Confusion

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upon awakening is common. If you take your child to be evaluated for night terrors, the physician may suggest the following: Keep a sleep diary for your child – keeping sleep and wake times for your child will reduce the amount of sleep deprivation Do not wake your child – it is difficult and may drag out the episode Do not remind your child of the event if they do not remember it. This causes increased anxiety and stress, and may lead to more night terrors. If night terrors are frequent, the physician may suggest an overnight sleep study to determine if any underlying sleep disorders may be the cause. Unlike sleep terrors, nightmares occur in REM sleep (or dream sleep), and children can usually give vivid descriptions of what happened in the dream. These dreams are usually described as “scary,” and will wake your child (as opposed to “bad dream” which will not cause a child to wake up). These dreams usually occur in the second half of the night, when REM is the predominant sleep stage. Nightmares can be caused by anxiety, post traumatic stress from witnessing or being a victim of violence, and a noisy or stressful sleep environment. Statistically speaking, nightmares occur often in up to 30% of children age 3-6, and occasionally in up to 90% of children in the same age group. As children reach adolescence, nightmares are more frequent in girls than boys. Nightmares can continue into adulthood, with one study showing weekly or monthly nightmares in about one-third of adults. Treatment for nightmares varies greatly. If nightmares are infrequent, a physician may not pursue treatment. However, if nightmares occur frequently, a physician may suggest psychiatric counseling or medicine for an underlying issue. If you think your child may be suffering from night terrors or nightmares, do not hesitate to contact your physician. Your physician will give you the knowledge needed to properly treat these disorders.

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