Night Terrors and Nightmares

Dreaming and nightmares occur in REM sleep and night terrors occur during non-REM (rapid eye movement) sleep. These two types of sleep disruptions are called sleep disturbances.

Night or sleep terrors are episodes of fear or agitation, panic and confusion with repetitive behaviors. They can occur in children and adults. During a night terror (pavor nocturnus) the child often seems partially awake and frantic. It often begins with a panicked scream and is associated with signs of fear and autonomic arousal. Speech may be difficult to understand or words and phrases may be repeated over and over. The child is not responsive to efforts to comfort the child. There may be some sleep walking and talking and children during a night terror are difficult to arouse. When the child wakes up they do not remember a dream or nightmare.

Night terrors are usually benign in nature and no specific treatment is required other than education and trying to keep a consistent bedtime routine. Children who are overtired are more prone to night terrors. The best management focuses on allowing the child to pass through the night terror without trying to wake the child up. Night terrors are most common in children between the ages of 3 and 12 years and most occur within 1-2 hours of falling asleep.

Children who are having a “bad” dream wake much easier and usually recall the dream. The best treatment is support and reassurance. Most nightmares occur in the second half of the night. Nightmares tend to decrease after age 10 years. Children under stress in or out of the home or children with separation anxiety and attachment difficulty are more prone to nightmares.

 

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