What do they look like?
It can be very unnerving for a parent to witness their child having a night terror. Here's an example of what a parent may see during a night terror.
You can see the child is screaming for mommy but doesn’t really seem to acknowledge his mom’s presence in the room. That’s because he’s not truly awake and although his eyes are open, he’s not seeing her. Nor can the little boy process what his mom is saying. He also becomes more agitated the more his sister touches him. These are classic signs of a night terror. Another key indicator is the timing of the episode.
When do night terrors happen?
Night terrors happen during the first four hours of sleep, usually when the child is transitioning from Stage IV (non-REM) sleep into another sleep cycle. Because these episodes happen between a very deep state of sleep and a partial awakening, the body is essentially on autopilot. This why the child can still thrash about, sit up or stand, and have full range of motion.
Parents of children who have night terrors should take some comfort in knowing their child is not experiencing a scary dream during these episodes. In fact, if they were to awaken, they would most likely be disoriented (why is mom in my room?) but would have no memory of what they were experiencing. I would not recommend asking your child what they were dreaming about the night before because they weren’t actually dreaming during the night terror. It might even distress the child further to know they were screaming or acting out while having no recollection of the event.
Why do they happen?
A night terror is a physiological response, often related to stress. As an example, an overtired child has a much higher likelihood of experiencing a night terror than a child that is getting adequate sleep. A child that has sleep debt (hours of missed sleep built up over the course of a few days/weeks/months) is also prone to night terrors.
Some children experience night terrors because they feel they “have a job to do.” Sometimes there can be a push and pull between the child’s body and the child’s brain. An example of this would a child that feels they need a parent present in order to sleep. This child may fight sleep because they know that when they do fall asleep, mom leaves the room. In this instance, the child will fight sleep until their body finally collapses from exhaustion. As the child sleeps, their body falls quickly into Stage IV sleep, but their brain is telling them to awaken to make sure mom is still in the room. This could easily transition into a night terror as there are two competing forces at work. It could be any number of sleep associations, this is just one example.
These are not the only reasons behind night terrors, but they are the most common.
How should parents respond?
The most important thing to recognize is that the child is not fully awake during the episode and so your response should be very hands off. If you try to awaken the child, comfort them, or hold them, it will only agitate them more. It’s best to let the child finish the night terror and you will witness how the terror eventually subsides, and the child falls back into a calm state of sleep. Although interaction is discouraged, being in the same room with your child is encouraged. Parents should make sure that the child does not cause harm to themselves or to others during a night terror.
How can night terrors be prevented?
1. Make sure your child is getting an adequate amount of sleep. This is one of the most important things you can do as a parent.
2. Have a nightly routine prior to bedtime. The consistency of the routine helps the child’s mind and body relax prior to sleep.
3. Do not expose your child to screens before bed. The bright lights and activity on the screen stimulate the child’s brain, which is not conducive to sleep.
4. If your child is having sleep terrors, take note of what was happening the night before. Do they have feel they have a job to do? How can you lessen the burden they feel to awaken?
5. Sometimes night terrors come when there has been a significant change in a child’s life. If you know your child is prone to sleep terrors, be sure to address changes before they happen. This way, they will be better mentally prepared for the changes coming.
6. Keep the room cool, dark, and quiet during the night time hours.
If you are confident your child is suffering from night terrors and you still aren't sure where to go from here, contact me for a personal consultation.