Nigtmares & Night Terrors

Night Terrors, Sleep Talking and Sleepwalking

Night Terrors, sleep talking and sleepwalking are relatively rare sleep phenomenon known as parasomnias. They tend to occur in families and are more common in boys than girls. Most children outgrow parasomnias by adolescence.

In children prone to parasomnias, they occur more frequently when they are stressed or:

  • Not getting enough sleep
  • Have an irregular sleep schedule
  • Have fever or illness
  • Taking some medication
  • Sleep with a full bladder
  • Sleeping in a different environment
  • In a noisy sleep environment

Parasomnias occur during slow wave deep sleep. This sleep stage is most frequent in the early part (first third) of the evening. Although a child having a night terror, sleep talking episode or sleep walking may appear awake, they are actually asleep.

During a parasomnia, the child may have their eyes open. They typically appear confused and often will mumble or give inappropriate answers to questions. Occasionally, the child may appear agitated, clumsy and act in bizarre ways.

Sleep walkers can injure themselves or leave the house during an episode. The sleeping environment should be made as safe as possible to avoid accidental injury. Floors should not be cluttered, objects should not be left on the stairs, and hallways should be lit. By tying bells to the child's bedroom door, you can be alerted to the sleep walking incident.

Then child who is found sleepwalking should be led back to bed. Talk quietly and calmly to your child. Generally, nothing is gained trying to awaken a sleepwalking child, but nothing bad will happen if she does awaken.

If she spontaneously awakens after the sleepwalking episode (which older children and adolescents often do), avoid teasing. Sleepwalkers are not aware of their behavior and will not remember sleepwalking the next morning. Don't mention it in then morning, unless asked by the child.

Children with nightly or frequent sleepwalking may benefit from a treatment called scheduled awakening. The technique involves fully awakening your child 30-45 minutes before the time sleepwalking usually occurs. This seems to interrupt the sleep cycles and decrease the chances of sleepwalking.

Relaxation techniques, including relaxation tapes at bedtime may also help prevent sleepwalking.

Rarely, medication is needed to interrupt frequent parasomnias.

Nightmares

Nightmares are frightening dreams that can wake a child and leave them feeling upset and in need of comfort and support. The child remembers the dream upon waking. Because young children are unable to recognize that a dream is not reality, they may believe something scary is still happening. Nightmares are a very common, if not universal, childhood experience. For a few children, nightmares are serious, frequent and interfere with restful sleep.

The content/themes of nightmares change with development. Because of toddlers' normal developmental concerns about abandonment, their nightmares typically involve being lost or something happening to their parents. As a child matures, their nightmares frequently incorporate monsters and scary things related to daytime experiences (e.g. scary movie, traumatic events).

Thing to do to minimize nightmares:

  • Avoid scary things before bedtime
  • Help your child deal with stressors
  • Make sure your child is getting adequate sleep

Things to do if your child has a nightmare:

  • Reassure and comfort
  • Provide a security object (e.g. blanket)
  • Leave a light on. Use the dimmest setting possible
  • Discuss it the next day
  • Use imagination (e.g. dream catcher, draw a picture of nightmare and throw it away)