If your child has short episodes of screaming and thrashing about in their sleep, they may be having what’s known as night terrors.
Night terrors - also called sleep terrors - are a common problem that tends to affect children between the ages of about 3 and 12. Night terrors are usually not serious, do not harm your child, and stop happening as children get older.
While night terrors can seem frightening, your child is asleep throughout and will not remember the night terror the next day.
Occasionally, adults can be affected by night terrors.
What does a night terror look like?
Night terrors usually happen early on in the night, when your child has been asleep for an hour or 2. This is when they are in a phase of non-dreaming, deep sleep.
Night terrors come on suddenly, and usually last only a few minutes (or even just seconds), but may go on for 10-15 minutes.
Children having night terrors may:
- suddenly and abruptly sit up in bed looking terrified and confused;
- scream or cry or appear to be in an agitated state;
- seem very afraid;
- have flailing, kicking or thrashing movements;
- start breathing fast or heavily;
- have a racing heartbeat;
- have their eyes wide open; and
- get out of bed and move around in a distressed way.
Although your child may appear awake during a night terror, they are actually asleep.
During the night terror, they won’t recognise you and cannot respond to you and your settling as they normally would. Children having night terrors often refuse to be comforted and may even push their parents away. After the night terror is over, children usually return to a peaceful sleep quickly, and in the morning they don’t remember what happened.
Night terrors can occasionally happen more than once in a night. Sometimes they happen every night for several weeks, and then stop again for a while.
Sometimes night terrors are accompanied by sleepwalking.
Triggers for night terrors
If your child has night terrors, they may be more likely to occur when your child:
- is tired or overtired due to lack of sleep;
- has a fever or is unwell;
- is sleeping in an unfamiliar environment; or
- has been worried about something.
What is the difference between night terrors and nightmares?
Night terrors are not the same as nightmares. See the table below for the differences between night terrors and nightmares.
|Difference between night terrors and nightmares|
|Night terrors (sleep terrors)||Nightmares|
|Night terrors occur when your child is in a deep, non-dream sleep, usually at the start of the night when your child has been asleep for a few hours or less.||Nightmares (scary dreams) tend to happen in the second half of the night, when your child is in dream sleep (REM sleep).|
|The child remains asleep during a night terror, and it is not usually possible to comfort the child.||Children wake up during or after a nightmare. They may be distressed, but they usually respond to your settling.|
|In the morning, children usually have no memory of the night terror.||Children generally remember waking up after having a nightmare. They also usually remember some details of their nightmare.|
Why do night terrors occur?
Children who experience night terrors usually have no particular emotional or psychological problem. Your child may be more likely to experience night terrors if there is a family history of night terrors or nightmares.
Occasionally, sleep terrors may be associated with an underlying medical condition such as obstructive sleep apnoea, enlarged tonsils, or other disorders that result in abnormal breathing patterns during sleep.
Adults with sleep terrors may sometimes also have anxiety or depression.
When to see your doctor about night terrors
It’s a good idea to see your doctor about night terrors if:
- you are concerned about the night terrors;
- the night terrors are becoming more frequent;
- your child also snores or has noisy breathing while asleep;
- sleep disruptions are causing distress for your child or other household members; or
- your child accidentally hurts themselves or others while having a night terror.
Your doctor will ask about your child’s night terrors, ask about any sleep problems in the family, and perform a physical examination.
It is usually possible to make a diagnosis of night terrors based on the description of the events. In some situations, tests such as a sleep study may be recommended to see whether there is also an underlying sleep disorder such as obstructive sleep apnoea.
In most children, self-care measures are the only treatment that is needed. Sometimes, medicines or counselling may be recommended by your doctor.
What to do when your child is having a night terror
You can help your child when they are having a night terror by following these tips.
- Don’t try to wake your child during a night terror episode. This can actually make it worse and they may become more agitated and confused.
- Stay with your child during the episode to make sure they are safe. You may want to try talking to them calmly, but remember that children having a night terror generally won’t recognise you or respond to comforting.
- When they settle down, you can gently direct them back to bed (if necessary) and stay with them until they return to a peaceful sleep.
It can be distressing watching your child have night terrors. Try to stay calm and patient - episodes are usually short and your child shouldn’t remember the episode in the morning.
If you decide to discuss the night terror episodes with your child or their siblings in the morning, stay calm and don’t go into detail about the episodes. If you seem stressed by the incident, your child may become worried and anxious about going to sleep.
If your child is going for a sleepover, make sure that the person responsible for your child knows what to do if they have a night terror.
Preventing night terrors
Children who have night terrors may be more likely to have them at times when they are very tired. You may be able to help prevent night terrors by making sure your child has regular amounts of restful sleep and a regular bedtime. A relaxing bedtime routine may also help.
If the night terrors have been happening around the same time each night, you could try partially waking your child about 10 or 15 minutes before this time for about a week. Try keeping him or her semi-awake for a few minutes and then let him or her drift back to sleep. This may help prevent further night terrors.
It’s also important to make sure your home is safe, especially if your child is likely to get out of bed during a night terror, by:
- using toddler gates on staircases;
- not letting your child sleep in a bunk bed;
- making sure the floor of the bedroom is clear of toys and other objects; and
- closing and locking windows and doors to the outside, if necessary.
Remember, night terrors affect many healthy children, but usually become less common as children get older. Most children outgrow night terrors by the time they are in their teens.
2. Mayo Clinic. Sleep terrors (night terrors) (updated 12 Aug 2014). http://www.mayoclinic.org/diseases-conditions/night-terrors/basics/definition/con-20032552 (accessed Feb 2017).
3. Royal Children’s Hospital Melbourne. Night terrors (night-time wakings) (updated Nov 2010). http://www.rch.org.au/kidsinfo/fact_sheets/Night_Terrors_nighttime_wakings/ (accessed Feb 2017).
4. NHS Choices. Night terrors and nightmares (updated 4 Oct 2015). http://www.nhs.uk/conditions/night-terrors/Pages/Introduction.aspx (accessed Feb 2017).