Nightmares and Night Terrors

Happy September everyone. I apologize for contributing so infrequently recently. My mother passed away from metastatic breast cancer in June, and as the primary caregiver for my children and her, it has been an epic roller coaster. But as our children constantly remind us, life marches along – and alas, so do sleep challenges!

I’ve had a lot of questions recently about nightmare and night terrors. Knowing how to differentiate between them is essential to figuring out how to tackle them.

Nightmares are common, particularly in children between 2-3 years old when their imaginations are developing but the lines between reality and fantasy are blurred.

·      Occur during REM sleep
·      Child will seek comfort from parent and recognize you
·      Child can recall nightmare, or parts of it
·      It may take time for them to get the frightening thoughts of their mind and fall back asleep
·      Can occur during times of stress or when a child is reliving a traumatic experience, but also normally occur in well-adjusted, happy children every once in a while

What you can do:

·      Avoid playing scary or stressful games
·      Avoid exposing your child to potentially frightening shows, videos, books, and stories (children are far more sensitive than we often think)
·      Make sure room decorations are sleep-friendly and calming
·      During episode, respond quickly and sensitively, calmly reassuring them of their safety
·      Make sure your child is getting enough sleep (11 uninterrupted hours at night, plus a nap, is typical for most young children) as sleep deprivation can increase nightmares
·      Avoid high-dose vitamins prior to bedtime and check with your pediatrician to make sure medications are not interfering with your child’s sleep
·      Don’t lead the witness! If your child learns that night awakenings elicit overly sympathetic reactions from you (“Oh no! Did you have that scary nightmare again?! Oh my poor baby…!”), you may be inadvertently feeding a much larger behavioral pattern.

Night Terrors look (and are) very different from nightmares.

·      Occur during NON-REM sleep, usually within 2 hours of falling asleep
·      Child may scream, appear anxious and/or have a racing heartbeat
·      Child may be inconsolable
·      Child often does not recognize you and may seem frightened by you and/or push you away
·      Episode usually lasts 5-15 minutes
·      Child usually doesn’t remember it (though parents sure do!)

What causes night terrors?

·      Occur more often in boys
·      Child more likely to experience them if either parent had a parasomnia disorder such as sleep walking, sleep talking, or night terrors themselves
·      Commonly triggered by sleep deprivation or a disturbance in the child’s sleep pattern (jetlag, sickness, obstructive sleep apnea, stress)

What you can do:

·      Ensure your child is physically safe during the episode but avoid interfering, which can make things worse
·      Consistently put your child to bed earlier at night
·      Keep your child on a regular sleep schedule
·      Do not discuss the terror with (or in front of) your child
·      If the night terrors are persistent, keep a log to help identify any patterns (occurring at the same time each night or during weeks when bedtime was late)
·      If you find the night terrors are happening at the same time, rouse your child 15 minutes beforehand so that she mumbles or rolls over, every night for 7-10 days.

As upsetting as nightmares and night terrors can be for parents, it’s important to know that they are normal experiences and not necessarily signs of major stress or unhappiness. The calmer and more reassuring you can be in the heat of the moment, the less disruptive the episodes will be for everyone.