Night terrors: why they happen and what to do about them

What are night terrors?

Night terrors are sleep disturbances in which a child may suddenly sit bolt upright in bed, cry, scream, moan, mumble and thrash about with her eyes wide open, but without being truly awake. Because she's caught in a sort of a twilight zone between being asleep and being awake, she's unaware of your presence and isn't likely to respond to anything you say or do. An episode can last anywhere from two to 40 minutes, and when it's over your child falls back to sleep abruptly with no memory of the incident.

How are night terrors different from nightmares?

Unlike a night terror, a nightmare leaves your child truly awake – she can remember her dream and sometimes talk about it, and she'll seek out and feel comforted by your presence. Also, children have nightmares during dream (REM) sleep, often in the early morning hours between 2am and 6am. They commonly have night terrors, on the other hand, in the first few hours of the night, during deep non-dream (non-REM) sleep.

The easiest way to tell the difference between a night terror and a nightmare, is to ask yourself who's more upset about it the next morning. If your child is more agitated, she had a nightmare. If you're the one who's disturbed, she probably had a night terror. Rest assured, the "terror" of a night terror lingers far longer in the parent who watched it than in the child who lived it.

What should I do if my child has a night terror?

Don't try to wake her. And expect that your efforts to comfort her will be rebuffed – a child having a night terror really can't be calmed down, and if you try to hold her it may make her wilder. Unless she's in danger of hurting herself, don't attempt to physically comfort her. Just speak calmly, put yourself between her and anything dangerous (the headboard of her bed, for instance), and wait for the storm to pass. Before you go to bed, take the same precautions you would for a sleepwalker, since children in the grip of a night terror often stumble out of bed: pick up any toys or objects on the floor that she could trip on, fasten a gate at the top of the stairs, and make sure windows and outside doors are locked.

What causes night terrors, and can they be prevented?

There's no definitive way to prevent night terrors because no one knows exactly what causes them. Night terrors can result from an erratic or insufficient sleep routine or any type of sleep deprivation. They may be caused by stress experienced during the day or over-tiredness. There is even some evidence that night terrors run in families. What is known is that, on their own, night terrors do not mean a child has a psychological problem or is even upset about something.

Solving any other sleep problems your child has (such as getting up in the middle of the night) and making sure she has a regular bedtime with a calming routine and gets enough hours of sleep can help ward off night terrors. In certain cases, night terrors can be triggered by sleep apnoea, a serious but correctable disorder in which enlarged tonsils and adenoids (normal tissue in the throat) block airway passages during sleep, making it difficult to breathe and prompting a child to partially awaken.
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