Question - My toddler woke up screaming during the night. He looked terrified and half asleep and had a lot of trouble settling back down, despite my efforts to comfort him. Was he having a nightmare? What should I do if this happens again? Concerned mum, NSW

120103165012Nicole's Answer - it sounds like to me that your toddler was having a night terror from your brief description.

With a nightmare I find it often happens after a really busy and exhausting day. Children wake during the night screaming or with really bad dreams. Children dream just as adults do. The tireder they are the more their dreams seem to be scary. Nightmares also happen if children have heard a conversation that is scary or have seen a TV show or video that is scary. With older children it is often to do with books they have read that have scared them during the day and at night their imaginations take hold and they certainly have nightmares as a result. Children can remember having a frightening dream. Once they have their parents comfort, they may want to stay close and cling onto you but soon fall asleep again. Nightmares occur during the dream phase of sleep known as REM sleep. Most people enter the REM stage of sleep sometime after 90 minutes of sleep.

The night terrors on the other hand are when they wake gasping, crying, moaning but more often they are screaming and screaming, sweating, confused and with a rapid heart rate. Breathing rapidly they will sit up in bed with a wide eyed terror filled stare. This panic will often last anywhere from five to twenty minutes. Children also seem to still be asleep while in extreme distress even though their eyes may be open.   Your comfort does not seem to make much of a difference. He may even be pushing you away. When he does wake fully he will have no recollection of the terror and is likely to just remember the fear.   It then may take him more like an hour to settle down.

Night terrors usually occur fifteen minutes to one hour after going to sleep. The longer the child is in NREM (the stages before REM) before the night terror strikes, the more petrified they will be when it occurs. Keep in mind though not everyone falls to sleep in the same amount of time as others.

We know night terrors run in families, although they are not dangerous and they can happen at any age from 1 hour old to 100 years old. The most common age however is children between 3 – 5 years of age.

Why Night Terrors occur is still a mystery! At the moment the common thought among researchers is that a chemical trigger in the brain causes your son’s brain to "misfire" and cause a Night Terror. These misfires can be caused by many factors such as stress and various other medical ailments. We also know that night terrors occur in stage 4 of the sleep cycle.

Some things that can help bring out a night terror are stress, medications that affect the brain, being over-tired or eating a heavy meal before going to bed. Combining all of the above can usually guarantee an occurrence. The listed items DO NOT cause night terrors; they just seem to put your body into the state where a night terror can manifest itself. People without night terrors will not have a night terror just by having a combination of these factors.

Your question was if this happens again, what should you do?   The best way to handle this with your son is to hug and reassure him and tell him that everything is alright. Agree with what he is saying or doing. If you can’t hug him or he is pushing you away then don’t force physical contact. Stay with him. Do not yell at him or tell him he is only dreaming as this seems to upset children even more.

Move anything that you think may injure him out of the way. The most important thing to remember is that he doesn’t know what he is doing as he is asleep. It is perfectly safe to wake someone who is having a Night Terror. Just be gentle.

It is also interesting to note that two other disorders, sleepwalking and bed wetting, are experienced during stage 4 of sleep. Even more interesting is the fact that all three of these sleep disorders often run in families.

Occasional night terrors DO NOT signify psychological problems. It is recommended not to tell children the next morning if they do not remember.

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