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Night Terrors in Children or Nightmares?

Abstract: Night terror disorder manifests itself in periods of extreme terror and loud screaming during the night. Night terrors are different from ordinary nightmares and occur mainly in children of preschool age. The attacks in themselves are harmless and do not usually require treatment.

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Night Terrors in Children or Nightmares?

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Written by: Daniel Rautio, psychology student, Umeå University, with guidance from , licensed psychologist and licensed psychotherapist, psychotherapy teacher and tutor. Translated to English by Ingrid Lang.
First version: 22 Jul 2008.
Latest revision: 20 Nov 2008.

My 7-year old son ran a fever for two to three days. After the fever resolved, he started screaming very loudly in his sleep. He is very difficult to awaken so we don't know what he is dreaming about. I have a friend in the United States whose son suffers from so called night terrors. Are my son's symptoms consistent with this, and what can we as parents do to help him?

Answer:

It is possible that your son's symptoms as you describe them are due to so called night terrors or sleep terrors.

Night terrors, or Pavor Nocturnus, are characterized by extreme fear, sudden awakening and reactions such as loud screaming, sweating, rapid pulse and confusion. During the attack which usually lasts between five and 15 minutes, the child is usually unresponsive and very difficult to awaken even though his eyes may be open. Afterward, he or she often do not remember what happened, but may experience a lingering sense of fear.

Night terrors are most common in preschool-age children but can also occur in later stages of life. The symptoms can be very frightening for those who witness them, but the night terror itself is benign.

Night terrors differ from nightmares. Nightmares occur during the latter part of the night's sleep, in the dream phase, or REM-sleep. The dreams frighten the child who usually wakes up with a clear memory of the dream and seeks comfort and reassurance from the parents.

Night terrors, on the other hand, occur during a deeper phase, the first third of the night's sleep, usually about an hour after the child goes to bed. This is not about dreams with scary topics, but about a true sense of fear, and the absence of dream images makes the night terror seem worse and more confusing than ordinary nightmares.

The best thing you as parents can do for your son if he suffers from night terrors is to remain calm. Treat him gently, sit close to him and wait for the attack to pass. Singing a song he likes, or holding him may also help. Avoid speaking loudly and other sharp sounds and try not to shake him in order to wake him up. This is likely to make the attack worse. Remove any items that could harm him and be observant that he does not hurt himself, even though this is very rare. When the attack has passed, he will wake by himself or resume sleep. At this time, there is no need to talk to him. It is best to just put him to bed, because he will be tired and most likely not remember anything of what transpired.

The attacks usually return about the same time during the night. One way to reduce the risk for attacks may be to waken the child about one-half hour before the expected attack. Pick him up, keep him awake and talk to him for a few minutes and then let him go back to sleep. This method is a way to attempt to get past the most critical phase of sleep.

Night terrors are believed to be hereditary, just as sleep walking. Numerous factors could play a role; for example if the child is stressed, anxious or overly tired; if the child has or has had a high fever, or has experienced an especially stressful event during the day. There may also be a connection with an illness; for example epilepsy, although this is rare.

If you suspect that your child suffers from night terrors, first consider any medical, psychological or social problems that could affect sleep. Monitor if there are any particular incidents that tend to upset the child and try to avoid these events if possible. You may also want to look at your child's sleep pattern to see if it could be improved.

Night terror is a common facet in many children's development and usually does not require treatment. The attacks typically end before puberty.

If the attacks occur very frequently (almost every night) and last for a long period of time, you can seek help at a children's clinic or the school nurse. You should contact a physician if you are concerned about something else, such as that the child may suffer from an illness or medical problem that could contribute to the night terrors, or that the child is at risk for hurting himself during an attack.

Finally, you should seek help if the problem remains during puberty. Adults suffering from night terrors may be helped by stress-reducing treatment and psychotherapy. Treatment with medication is an alternative, but seldom recommended.

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