Night terrors can be easily identified and typically happen within the first few hours of sleep, during deep “non-REM” sleep. During an episode, the child jolts awake from deep sleep, wide eyes, frightened, screaming/shouting and possibly sweating with a racing heart. As this is a partial arousal disorder, your child is not awake, will not recognise you or realise you are there; he/she may push you away while at the same time call for you. Unfortunately, this can last for up to 15 minutes and then end. Your child usually will not even remember having the night terror. It can be very upsetting for us parents to witness our children so distressed; thankfully, they are not a representative of a psychological disorder.
Commonly Night terrors will happen within 2 hours of the onset of sleep, but I have experience in my practice of them happening throughout the night and/or the early part of the morning, but this is extreme and commonly a child who is not efficient at sleeping independently.
The single biggest cause of night terrors is being over-tired. Ensuring that your child gets enough sleep, can in some instances diminish significantly and sometimes eliminate the phenomenon. As little as an extra 30 minutes of sleep at the start of the night can make all the difference, this means bringing forward bedtime and do not under-estimate the value of addressing sleep time earlier for a child who has routinely experienced night terror episodes. They may be in a cycle of over-tired that encourages the night terror, but also by its very nature adds to the overtired dynamic. Do not be afraid of an early bedtime, as in aiming to be asleep by 7pm and then gradually adjusting the time that you offer bedtime at, based on the time that keeps appearing as the time your child is routinely asleep by.
Another key factor may also be room temperature, or that your child becomes too warm, and this may trigger an episode, so keep the room cool and make informed decisions on the sleepwear and bedding that you are using.
Keeping an eye on the diet and avoiding high sugar foods also seems to make a difference.
Further Recommendations for parents
- Do not try to wake your child, there is no benefit for them to be roused and they may be more upset on wake up, as they are not officially awake during the night terror
- Avoid touching or picking up your child as this can sometimes prolong the terror
- Sometimes singing gently can help
- Ensure that your child is safe and cannot come to harm during his/her thrashing about
- After the episode, guide your child back to bed
- Stay with your child and reassure them afterwards until they are calm/have gone back to sleep
- Avoid discussing the night terror in the morning, as your child will not remember the event
- Ensure that you have regular sleep and wake up times for all the days of the week
If by observing an earlier bedtime- and remember the earlier the better- does not help the presentation, then you could introduce a wake to sleep strategy:
If there is regularity to the night terrors, by keeping a sleep diary you may be able to see a pattern. So, if they are happening 2/3 times a week at the same time, you can try to pre-empt the partial arousal by gently rousing your child 15 minutes before the episode typically happens; enough to make them roll over, mumble for example, and then go back to sleep. When this is implemented for up to 10 nights, it may help to break the cycle.
If you are in any doubt about your child’s sleep disturbances it is advisable to seek medical advice.