If you've ever seen a young child in the grip of a night terror, you'll never forget it. He'll wail in panic, scream, and thrash about like a small animal. His eyes are wide open but he doesn't recognize or even see you. A child with a night terror is caught in a zone between sleep and wakefulness, and it's impossible to wake him up or give him much comfort; he is inconsolable. Night terrors usually happen within the first couple hours of sleep, and they tend to last for 10 to 30 minutes. They're especially common from preschool to first grade, but they can strike younger and older kids, too.
As alarming as these episodes are to anyone on the outside, night terrors aren't dangerous, and they aren't a sign of any hidden mental illnesses. Children seem to forget completely about night terrors by morning.
Fortunately, night terrors usually don't become a habit. If your child has had one or two episodes, he may only have a few more in his entire life. Or he may not have any more at all. Still, you should do what you can to help your child have a comfortable, peaceful night's sleep for your sake as well as his.
What causes night terrors?
Nobody knows what sets off night terrors, but genetics definitely play a role. If one of your children has night terrors, there's a fairly good chance that your other children will, too. Stressful events, exhaustion and medications that affect the central nervous system can also play a role.
What should I do when my child has a night terror?
A child with a night terror cant wake up, so don't bother trying. Instead, you should do what you can to keep him comfortable and safe. Turn on the lights so he won't be frightened or confused by darkness and shadows. Lights will also help you keep an eye on him. Talk in soothing tones. (Trying to gently shake him awake or shouting will only agitate him more.) You can try holding him, but only if he'll let you and if it seems to calm him down. If he's walking around, gently guide him back to his bed. You'll definitely want to keep him away from stairs, windows or any other dangerous places.
How can I prevent night terrors from happening?
You may not be able to completely prevent night terrors, but a healthy approach to sleep can definitely help. For one thing, try not to let your child get over-tired. Young children who get a good nap in the afternoon are less likely to have terrors at night. An early bedtime is a good idea, too, as well as a calming routine that includes lots of cuddling.
If your child has regular night terrors, try waking him up 15 minutes before an episode would typically start. (Most kids who have frequent terrors stick to a fairly predictable schedules.) Get him out of bed for about five minutes. Do this for a week straight, and you can probably disrupt the sleep patterns that were causing the terrors. According to some reports, this strategy works about nine times out of 10.
When should I call the doctor?
Some parents may need extra help calming night terrors. If your child still has two or three episodes a week even after you've tried the waking method, or is stiffening and drooling during the episodes, you should consult with a doctor. You should also call a doctor if the episodes last more than 30 minutes, if they happen during the second half of the night, or if your child does something dangerous during the fit. In some cases, a doctor may prescribe sleep medications to help avoid terrors. In most cases, though, it's better to just wait until they disappear on their own.
Lucille Packard Children's Hospital at Stanford. Nightmares and night terrors. 2010. http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/growth/ntmares.html
American Academy of Pediatrics. Nightmares and night terrors. 2010. http://www.healthychildren.org/English/ages-stages/preschool/pages/Nightmares-and-Night-Terrors.aspx
Thiedke C. Sleep disorders and sleep problems in childhood. American Family Physician. 2001. 63(2): 277-285.