Witnessing your child scream, thrash around in extreme panic, or wander all over the house only to wake up the next morning and not remember what happened can be confusing and potentially stressful. Was it a nightmare? Why weren’t they responsive?
Also known as sleep terrors, these episodes are a parasomnia sleep disorder. Meaning: While you are asleep, you display abnormal, disruptive behaviors like talking and moving. Sleepwalking (or somnambulism), which is commonly associated with night terrors, is also a parasomnia.
“Sleepwalking and night terrors are childhood sleep disorders [or parasomnias] that start in toddlerhood and go away by adolescence,” says Angelique Millette, Ph.D., a pediatric sleep consultant. New parents or people witnessing night terrors for the first time might feel upset or distressed, but they’re actually common. When they happen, they also often tend to last for a few minutes — although those minutes can feel like forever to a parent who’s disoriented from being woken up and concerned about a child’s wellbeing.
What Causes Sleepwalking and Sleep Terrors?
The exact reasons are unclear but both disorders generally happen during non-rapid eye-movement (NREM) sleep, says Carla Picolli, a licensed psychologist and certified sleep coach for adults and children. And in both situations — sleepwalking and night terrors — your child’s brain partially rouses from deep sleep.
She notes, too, that sleep deprivation and overtiredness are the biggest culprits, but they can also be caused by other factors, like fevers, stress, strong medication, or a disturbance in your child's sleep patterns — like a new home, a later bedtime, a missed nap, or traveling to different time zones.
Common causes of night terrors and sleepwalking:
- Sleep deprivation
- Stress, such as time away from parents or the start of school
- Change of environment (e.g. a new move or family vacation)
- A full bladder or a child working on nighttime bladder control
- Illness or allergies
- Reactions to some medicines
How Do Night Terrors Differ From Nightmares?
“The interesting thing is that night terrors look like nightmares,” says Picolli. But she stresses the importance of differentiating between them, as many parents tend to confuse the two. “At first glance they may look similar, but they are two totally different things.”
Nightmares generally take place during REM sleep, and are a way of manifesting anxieties and troubled thoughts in the typical dream process; they usually happen later in the night. But night terrors — which occur during non-REM sleep — are a disruption from sleep, and tend to occur in the first few hours of the night.
To put it more simply: “Night terrors are a sleep disorder and nightmares are not,” Millette emphasizes.
“When a child has a nightmare, they will wake up and have a recollection of the bad dream,” she adds. “They may also verbalize fears with their parents of the scary dream that woke them.” An easy way to tell these apart is that your child won’t remember a night terror or sleepwalking incident the next day.
Symptoms of Sleep Terrors and Sleep Walking
Symptoms for this parasomnia episode can be broken into the categories of while its happening and after. These generally happen in the beginning of the night within two hours of going to sleep. “The episode usually lasts five to 15 minutes and then subsides,” Picolli says.
During a sleep terror: Your child might cry, scream, or even have bodily reactions like a racing heart or intense sweating. They may also kick at you when you try to help soothe them. You’ll also notice that they are either inconsolable no matter what you try, or they take a long while to calm down.
“Kids may not recognize you when you approach them,” Picolli explains. They may also have a terrified or glassy-eyed look. Keep in mind that, although your child may seem awake and have their eyes open, they’re still asleep.
Symptoms of a sleepwalking child, on the other hand, can look like your kid wandering around their room or the rest of the house, or doing normal daytime activities like getting dressed. They’ll usually have slowed speech and they likely won’t know where they are.
After a sleep terror: Since your child is still asleep, they won’t actually remember what happened the next morning. “Night terrors may feel stressful for a parent, but the child doesn't remember the episode the next morning,” says Picolli. They may however be more tired or irritable from the night of disrupted sleep.
How Do You Treat Night Terrors?
Overall, experts agree that the best treatment for both disorders is to prevent overtiredness. If, for example, you have a day full of activities planned, make sure to not overdo it. Take plenty of breaks and try to put your child to bed earlier.
For recurring night terrors, keep a sleep diary on behalf of your child to monitor patterns that trigger night terrors, and track the timing each night. For predictable night terrors, you may want to try a technique called “anticipatory awakening.” Mayo Clinic recommends waking up a person 15 minutes before the night terror is set to happen and then encouraging them to fall back asleep.
To help your child sleep better, follow these tips:
- Create a comforting bedtime routine. Helping them unwind and relax is key. Try preparing a calming bath or reading a special book together that your child can look forward to at the end of each day.
- Reduce sleep deprivation. Ensure your child has adequate sleep hours for their age group.
- Practice healthy sleep habits. Maintain a relaxing and consistent bedtime routine, and try to make bedtime earlier by 15-30 minutes.
- Have them use the bathroom before going to bed. Try to reduce how much liquid they have before bedtime for successful nighttime potty control.
- Monitor room temperature. Make sure their bedroom is fairly cool and avoid putting on too many blankets.
- Sleepwalk-proof your home. Lock windows and doors, keep dangerous objects out of reach, and don’t let your child sleep in a bunk bed or lofted bed. If you have stairs, consider a gate.
- Encourage self-care and de-stressing. Work through anxieties and stress before bedtime, so that your child isn’t lingering on unaddressed issues. For more serious stress, you may want to set them up with a child psychologist.
Should I Wake Someone Up From a Night Terror or Sleepwalking Episode?
If you do find that your child has an episode during the night, Millette recommends parents keep their cool. “When a night terror or sleepwalking event occurs, try to remain calm,” she explains. Rather than wake your child, instead, she suggests speaking softly and guiding them back to their bed. “You can use reassuring words like ‘this is your room, you are safe, I’m here.’”
When these events do occur, it’s typically best to interact with your child as little as possible, says Susan Crane, Psy.D., a licensed psychologist with expertise in children’s sleep issues. “This goes against most parents’ natural inclination — when you see your child screaming you want to comfort them,” she says.
So when this does happen, in the case of night terrors, in particular, Crane advises parents to remind themselves “that the child is sleeping through the event, even though they may look distressed.”
Crane also stresses that interacting with your child won’t calm them down because they aren’t conscious — they’re sleeping. “If interaction eventually wakes children in these states, it is often confusing, can be more upsetting, and they end up with less sleep in the long-run.” And this also applies to a sleepwalking kid who is likely to become combative if someone touches them or tries to control their movement.
When to Be Concerned About Sleep Terrors
The good news is night terrors don’t cause long-term harm and they aren’t triggered by psychological disturbances. In fact, research shows that they’re a common preschool-aged sleep disorder, and generally occur from age 4 till puberty. It’s also equally prevalent in both girls and boys, and affects approximately 30% of children. Other studies have found about 29% of kids experience sleepwalking at least once during childhood.
There’s usually a hereditary component in the mix. “Night terrors and sleepwalking almost always run in families,” Millette says. One 2015 study found that kids were more likely to sleepwalk if one or both of their parents had a history of sleepwalking. Other research also shows evidence of a hereditary link to sleep terrors.
If trying the above recommendations doesn’t work, then you may want to reach out to your pediatrician, particularly if episodes are becoming more frequent, leading to issues of safety, or causing an excess of daytime sleepiness.
That said, sleep terrors that lasting into adulthood are also rare. “Night terrors are especially much less common in adolescence,” Crane emphasizes, as both of these conditions generally trail off early in grade school or by puberty. Patience from parents and caregivers, she advocates, is the key to working through night terrors in kids.
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