Elementary

Night Terrors

By: Charise Ebersole, FNP

The screaming started again. This time it was coming from the bedroom across the hallway. As I jumped up to help, the nursing care plan I was working on scattered in 10 directions. My youngest brother was now sobbing, padding into the hallway in his little sleeper…sound asleep.

Night after night, something similar to the above narrative would transpire. My little brother would wander around in a dream-like state alternating between screaming and crying and flailing his little arms. My job was to prevent him from falling down the stairs and to guide him back to bed.

Sleep terrors, or night terrors, are a sleep disorder that commonly occurs in young children during the first third of the night. Unlike a nightmare, a child will not waken from a sleep terror and does not remember the episode. Sleep terrors are thought to be a parasomnia disturbance of the third portion of the non-rapid-eye-movement stage of sleep.

While they are reported to occur between the ages of 4-12, my brother’s sleep terrors started at the age of 2 ½ years old and continued until he was about 5 years old. Night terrors have also been reported in adults.

Symptoms typically include crying and screaming but can also include flailing of arms and/or thrashing in bed. In some cases, like my brother’s, a child will appear to be awake and wide eyed but is visibly scared and unresponsive to calming.

Diagnosis is made based on history of the episodes, timing of the episodes, difficulty waking the child during the episodes, inability to remember the episodes, and a child’s age. Often times, the terrors are caused by disruptions in family patterns or routines, stress, or even severe tiredness.

While there are no specific treatments or medications for night terrors, there are some general guidelines to remember when caring for a child that is having an episode…

  • Keep the environment safe. This is by far the most important thing you can do for a child in the midst of a sleep terror. I would even recommend putting up gates and picking up any objects on the floor that may cause tripping.
  • Develop comforting but strict bedtime routines. Consistency is always helpful for a child to develop positive routines but the more calculated you are, the better you can assess what is going on (see following point).
  • Keep a sleep journal. Note the time the episodes begin as much as possible. If a pattern emerges, wake the child 15 minutes before the night terrors typically start and keep them awake for a few minutes before going back to sleep. If no pattern is evident, try waking the child 45-60 minutes after they fall asleep to break the sleep cycle.
  • Consider giving the child a nap. A mid-day nap could help to prevent extreme fatigue from occurring.
  • Evaluate any disruptions in the family routines and patterns. Obtain a child counselor as needed.

If the symptoms persist or change, we recommend a visit to the pediatrician to have the child evaluated and to determine if they need a sleep study completed or if they need to explore other preventive measures.

For whatever it is worth, my little brother is now a teenager. We found that waking him within an hour of falling asleep, broke the pattern of the night terrors and helped all of us get some much needed rest. He has no recollection of those scary nights and has grown into a handsome and smart guy.

Until next time,

Charise Ebersole

Parkside Provider, globe trotter, and singer on the side

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