Stages of Sleep and Night Terrors
Human sleep patterns are divided into two stages: rapid eye movement (REM) and non-rapid eye movement (non-REM). Non-REM sleep is further broken down into 4 sub-stages. Night terrors occur approximately 90 minutes after a child falls asleep, during the transition from stage 3 to stage 4 in non-REM sleep.
Approximately 1 to 6 percent of children between the ages of 3 and 12 years will experience night terrors. The frequency of occurrence in boys and girls of all races is fairly even and the episodes usually subside completely when the child reaches adolescence.
Night terrors are characterized by frequent events in which the child screams, cries, and appears to be experiencing intense fear. Parents often have difficulty arousing them from the night terror. During these episodes, the child may sweat, take quick and shallow breaths, and have enlarged pupils. They often scream and cry with their eyes open, seemingly awake, are still asleep and do not respond coherently or at all to questioning by parents or other stimuli.
Unlike with most normal nightmares, children cannot remember their episodes of night terror. Most events last only 2 minutes or less, but can last longer in some cases. These episodes can frighten parents and siblings as well as disrupt sleep quality.
Parents or other caregivers attempting to console the child should talk gently, never screaming or shaking the child. Children who have night terrors often sleepwalk. Caregivers should take measures to protect the child in the event he sleepwalks while they are sleeping. A child who experiences night terrors should never sleep on a bunk bed. The movement and activity that often occurs with these episodes could cause the child to fall, resulting in injury or death. If the child sleeps upstairs, a gate across the stair entrance will protect him from dangerous falls if he sleepwalks during an episode.
Stressful life events, too little sleep, certain medications, and other medical issues can cause night terrors. Parents should keep in mind that a life event that seems insignificant to an adult may feel intensely stressful to a child.
Children under 3 1/2 years of age who have more than one weekly night terror event should undergo medical evaluation as should older children who have more than one to two episodes per month. These episodes occur during a critical stage of sleep and the sleep disruption they cause may affect the child's ability to function during waking hours.
The pediatrician will ask the parents about the frequency and onset of the episodes, the child's behavior and physical state during the episodes, and inquire about any changes in routine or lifestyle that may have caused the child stress. If the doctor feels he must rule out other medical conditions, he may order additional tests for the child, such as electroencephalogram (EEG) and a polysomnography. The EEG measures brain activity and is usually prescribed if the doctor suspects a seizure disorder. A polysomnography measures the child's breathing activity during sleep to verify that he receives adequate oxygen while sleeping.
No official treatment exists for night terrors. Parents should take measures to keep the child safe during sleep and remember to never shout at or shake the child in an attempt to elicit a response. Following up with your pediatric clinic and keeping careful notes on frequency and duration of occurrence can assist the physician in determining if further investigation is necessary.
Human sleep patterns are divided into two stages: rapid eye movement (REM) and non-rapid eye movement (non-REM). Non-REM sleep is further broken down into 4 sub-stages. Night terrors occur approximately 90 minutes after a child falls asleep, during the transition from stage 3 to stage 4 in non-REM sleep.
Approximately 1 to 6 percent of children between the ages of 3 and 12 years will experience night terrors. The frequency of occurrence in boys and girls of all races is fairly even and the episodes usually subside completely when the child reaches adolescence.
Characteristics of Night Terrors
Night terrors are characterized by frequent events in which the child screams, cries, and appears to be experiencing intense fear. Parents often have difficulty arousing them from the night terror. During these episodes, the child may sweat, take quick and shallow breaths, and have enlarged pupils. They often scream and cry with their eyes open, seemingly awake, are still asleep and do not respond coherently or at all to questioning by parents or other stimuli.
Unlike with most normal nightmares, children cannot remember their episodes of night terror. Most events last only 2 minutes or less, but can last longer in some cases. These episodes can frighten parents and siblings as well as disrupt sleep quality.
What to Do During a Child's Night Terror Episode
Parents or other caregivers attempting to console the child should talk gently, never screaming or shaking the child. Children who have night terrors often sleepwalk. Caregivers should take measures to protect the child in the event he sleepwalks while they are sleeping. A child who experiences night terrors should never sleep on a bunk bed. The movement and activity that often occurs with these episodes could cause the child to fall, resulting in injury or death. If the child sleeps upstairs, a gate across the stair entrance will protect him from dangerous falls if he sleepwalks during an episode.
Causes and When to Seek Help
Stressful life events, too little sleep, certain medications, and other medical issues can cause night terrors. Parents should keep in mind that a life event that seems insignificant to an adult may feel intensely stressful to a child.
Children under 3 1/2 years of age who have more than one weekly night terror event should undergo medical evaluation as should older children who have more than one to two episodes per month. These episodes occur during a critical stage of sleep and the sleep disruption they cause may affect the child's ability to function during waking hours.
What to Expect From Your Physician
The pediatrician will ask the parents about the frequency and onset of the episodes, the child's behavior and physical state during the episodes, and inquire about any changes in routine or lifestyle that may have caused the child stress. If the doctor feels he must rule out other medical conditions, he may order additional tests for the child, such as electroencephalogram (EEG) and a polysomnography. The EEG measures brain activity and is usually prescribed if the doctor suspects a seizure disorder. A polysomnography measures the child's breathing activity during sleep to verify that he receives adequate oxygen while sleeping.
Treatment
No official treatment exists for night terrors. Parents should take measures to keep the child safe during sleep and remember to never shout at or shake the child in an attempt to elicit a response. Following up with your pediatric clinic and keeping careful notes on frequency and duration of occurrence can assist the physician in determining if further investigation is necessary.
SHARE
