— For the last several years, Dorian Lake, 8, occasionally awakes at night, bolts up in his bed and begins shrieking loudly. When his parents rush to his bed, "he’ll be screaming like we’re not there, almost fighting me off, says his mother Belinda Edmondson, Montclair, N.J. "He’ll say ‘there are snakes, there are snakes.’ He’ll push the bedcovers off. Then he’ll fall back asleep.”
The next morning, the third grader -- who isn't afraid of snakes during his waking hours -- remembers nothing about the scary event. It's also unpredictable -- when he goes to bed, his parents don't know if it'll be a quiet night or more like a scene from "Paranormal Activity."
“They’ll go in waves,” says Edmondson..“He won’t have them for several months, but then have them with some regularity in the period that they happen.”
Dorian is experiencing night terrors. While they don’t seem to harm children, night terrors can be absolutely bone-chilling for parents who witness their child awaken suddenly, screaming with open eyes, sweating or pacing around the room. An estimated 15 percent of kids experience night terrors, which can begin in infancy.
There may be a genetic component, but child sleep experts don't know exactly why night terrors occur.
"We go through different stages of sleep, deep to REM. The night terrors happen in the transition," says Dr. Shelby Harris, director of the Behavioral Sleep Medicine Program at the Sleep-Wake Disorders Center at Montefiore Medical Center, New York. "It’s almost like a stall.”
Nightmares are more common
They're usually not a cause for concern, except for the lost sleep for both the child and parents. Most kids outgrow them by about age 12 and only a small percentage of adults experience them. Parents should first determine whether their child is having a nightmare or a night terror before trying to help them, Harris says.
Nightmares are far more common. “The way to tell the difference between a nightmare and a night terror is to determine who is more distressed,” says Harris. “If it is the parent, it is a night terror. If it is the child, it is a nightmare.”
Night terrors typically occur in the early part of the night. Nightmares tend to occur between 2 a.m to 6 a.m.
For nightmares, reassure, hold, and comfort the child. Provide a dim light if they are afraid of the dark (a bright one may interfere with sleep). Check under the bed for monsters. “Give them quick reassurance,” she says. “But don’t let them come into your room. That sends a subtle signal that there is something to be afraid of."
If the nightmares are recurrent, she suggests teaching the child to visualize a way to change the nightmare. For example, a child that Harris treated turned a monster into chocolate and ate him, and the nightmares went away in a week or two.
But during a night terror, don’t talk to the child. Attempts to comfort, hug or wake him or her could prolong it. “While it looks like a child is in distress, crying and screaming and their heart is racing, they are really asleep,” says Candace Alfano, Ph.D., director, Child and Adolescent Anxiety Program at Children's National Medical Center in Washington D.C. "So, as hard as it can be to just sit and watch while your child seems terrified, the best thing to do is stay close by and make sure they are safe.”
There is no real treatment for night terrors, but triggers can include a change in environment, stress and inadequate sleep. “Create a consistent and relaxing bedtime routine,” Alfano advises. Encourage quiet activities like reading and soft music, and no TV.
When night terrors happen periodically they are considered normal. When they happen recurrently -- once or twice a week for up to three months -- parents should see a sleep specialist to see if there is a breathing problem or some kind of anxiety, Alfano suggests.
“A lot of anxious children have trouble sleeping independently,” she says. “We think that anxiety increases night terrors.”
Parasomnias, or sleep disorders, are more common in children with anxiety than the general population, says Alfano who researches children ages 6 through 11. In her ongoing research on children's sleep, participants wear a wrist actograph, a device that measures movement, to help capture objective numbers on total sleep time. Subjects also fill out a sleep log and children and parents are asked about overall anxiety and the family's pre-sleep routines.
But night terrors are difficult to capture. “You can study kids for three months in a sleep lab and never get a single night terror,” Alfano.
Meanwhile, Edmonson is hoping her son will soon grow out his night terrors. “We just keep dragging ourselves to the children's bedroom in the middle of the night,” she says. “It's a part of our routine at this point.”