Let’s Talk Night Terrors
If you’ve experienced night terrors with your children, you’ve likely been violently woken from your own sleep with screaming. Let’s talk about it, because I’ve been there. No I mean I have literally been there having both experienced night terrors as a child and as an adult who has had children in her care.
Your blood runs cold, your adrenaline starts pumping and the worst things go through your mind when you hear that first scream. So let’s arm ourselves with some tips and tricks to dealing with night terrors as well as some theories and information.
What is a night terror?
A night terror is an “episodes of screaming, intense fear, and flailing while still asleep, often paired with sleepwalking” according to Google.
What ages experience night terrors?
Typically children aged 3-7 both male and female (with some studies suggesting higher incidents in females) are the population that experience night terrors and good news parents- most children will grow out of them. However, we’re here to talk about how to manage the night terrors while they’re happening.
What causes night terrors?
The full answer is it depends. Night terrors have been attributed to psychological trauma in some instances however, the majority of children are not diagnosed with any pathological conditions that can be identified as the root cause.
I would like to preface the rest of this discussion with this: Unless otherwise stated this conversation will be surrounding my personal and clinical experience dealing with night terrors and may not have formal research behind it.
Before we talk about the night terrors themselves, let’s talk about when they occur, specifically what stage of sleep.
There are 4 stages of sleep: this photo is from sleepfoundation.org I am not taking credit for them. In fact please check the link out to read more on the stages of sleep.
Night terrors occur in the non-REM (Rapid Eye Movement) stages of sleep. Why is this an important distinction? During REM sleep the body utilizes specific chemicals- neurotransmitters- to impede muscle movement. This means that the entire body, except for the eyes, are unable to move. This is a protective mechanism to prevent the body from potentially acting out actions of dreams like walking, talking, and running. If this sounds similar to sleep paralysis it is but that’s a whole different conversation.
During non-REM sleep the body does not utilize these chemicals to prevent movement. This means that when night terrors occur the person is able to run, scream, etc. So when your child is experiencing a night terror it is important to note- they are NOT awake. They may appear awake, moving about with their eyes open and glassy and seem to not recognize you.
Now that we’ve established what stage of sleep night terrors occur in and why that stage of sleep enables such animated movement while the person is not awake, let’s talk about why they happen, at least my theory as to why they happen.
In my personal and clinical experience night terrors are rooted in the need to urinate. What do I mean by that? Well let’s talk it through. As adults if we need to get up in the night to use the bathroom we come out of sleep, recognize the need to go, and take ourselves to the bathroom. For children, this developmental skill isn’t there yet. Their brain is trying to wake them up to go to the restroom but being in such a deep sleep it is not successful. The brain knows it needs to wake up to pee and that peeing in the bed is not appropriate and so it does its very best to wake them up by any means necessary. This means night terrors.
The brain has tried to rouse them from sleep with the night terror but all it has accomplished is sending their body into fight or flight response where they are screaming and being terrorized by whatever form their night terror takes.
So knowing this theory how do we apply that?
Before bed, children should use the restroom as always. Then I recommend a dream pee. For parents that know about dream feeding during breast feeding the idea is the same. You take your child gently out of bed without fully waking them, have them sit on the toilet, pee and then return to bed.
What time do you do this? This depends on your child but a good starting point is when you are getting ready for bed. I tell my patients families if their child goes to bed at 8pm and they go to bed at 10pm then they do the dream pee then. Sometimes that second bathroom break is enough to get them and you through the night peacefully without a night terror. Some children will require an extra dream pee around 12-1am, it just depends on the child.
For parents that sleep through the night it is a sacrifice to have to potentially schedule a midnight wakeup but most find that the trade off for not having night terrors is extremely worth their while.
It is always prudent to have children evaluated by a trusted licensed healthcare professional to rule out other causes. Most children outgrow this around 7 or 8 years old, but I have seen it go as long as 12 years of age. If ever you are concerned about something as a parent and you feel that something is just not right, take your child in. I have clinically never been led wrong by a parent’s intuition.
Now if they are already in a night terror what do you do?
Do not try to wake them up, instead do your best to safely get them to the toilet to pee. Thus far, I have not had a single child continue in their night terror once they have urinated. That’s not to say that it’s foolproof, just that I have not had this method fail me yet. Knocks on wood.
As a child, I actually do remember what my night terrors were about which as far as research can tell me is not common. So in light of that personal experience I still think it is a good idea to ask your child if they had any dreams the night before and if they’d like to talk about them. Talking about things often demystifies them and makes it a little less scary.
Have you or your children ever experienced night terrors? How did you handle them?
References:
https://www.mayoclinic.org/diseases-conditions/sleep-terrors/symptoms-causes/syc-20353524
https://www.sleepfoundation.org/stages-of-sleep
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1834533/?page=1
https://www.hopkinsmedicine.org/health/conditions-and-diseases/primary-sleep-disorders-parasomnia