Sleep Terrors (Night Terrors)

What are Sleep (Night) Terrors?

Sleep terrors, or night terrors as they are often called, are dramatic and can be distressing to witness. A child having a sleep terror may have her eyes open, but usually appears very agitated, frightened and even panicked, as well as confused and dazed during an episode.

A child will often cry out or scream at the beginning of the sleep terror and may mumble or give inappropriate answers to questions.

A child having a sleep terror is often clumsy and may flail around, push a parent away, or behave in other strange ways.

As disturbing and frightening as these events appear to the observer, children having them usually are totally unaware of what they are doing. In fact, sleep terrors are much worse to watch than to experience.

For the child, a sleep terror is less traumatic than a typical nightmare or bad dream.

Sleep terrors almost always occur within 1–2 hours after falling asleep, last anywhere from a few minutes to an hour, and children have no memory of these events (note that sleep terrors can also occur during a nap). In addition, during these events most children avoid being comforted.

They may get more upset if you talk to them and try to calm them down. This can be the hardest part for parents. Although a child having a sleep terror may appear awake, she is really asleep. A child who is experiencing a sleep terror is basically stuck halfway between asleep and awake.

Finally, sleep terrors are not nightmares. Your child is not dreaming during these events, although it may look it. Sleep terrors are also not a sign of psychological problems or the result of a traumatic event.

What causes Sleep Terrors?

Sleep terrors are benign (not harmful) sleep behaviours, but they may cause a great deal of anxiety for parents. We do not know what exactly causes sleep terrors or why children look frightened during them. They are actually the same thing as sleepwalking, but just more dramatic.

Sleep terrors are fairly common in children and usually occur in preschool-aged and primary school-aged children. Most children outgrow sleep terrors by adolescence. In addition, sleep terrors and sleepwalking often run in families. There are certain things that make it more likely for someone who is prone to sleep terrors to have an episode.

These include:

• Not getting enough sleep

• An irregular sleep schedule

• Fever, illness

• Some medications

• Sleeping with a full bladder

• Sleeping in a different environment

• Sleeping in a noisy environment

• Stress

How should you respond to your child's Sleep Terrors?

Keep your child safe

The most important thing that you can do if your child has sleep terrors is to keep her safe. Make sure that all outside doors are secure. Put up gates at the door of your child’s bedroom and at the top of stairs. An alarm can signal you when your child is up and about, and help to ensure that she does not leave the house. Any type of alarm will do, from a fancy and expensive burglar alarm to a simple bell hung on the door. Ensure that windows, especially second story or higher, do not open wide enough that your child can jump out of them. Finally, remove things that are in the way. If your child may walk or run around during a sleep terror, clear away anything that she can step on or trip over.

Don’t wake your child

Generally, nothing is gained by trying to awaken a child during a sleep terror, and sometimes doing so can make a child more agitated.

Guide your child back to bed

To encourage return to normal sleep, guide your child gently back to bed. If she resists, let her be.

Try not to interfere too much

The normal response of parents is to try and comfort their child during one of these episodes. Try to resist doing this. Most children will just get more agitated. However, if your child is about to come to harm, be sure to keep her safe even if she fights you.

Ensure enough sleep

Increase the amount of sleep that your child is getting and try to let not let her become sleep deprived. These events are much more likely to happen when your child does not get enough sleep.

Maintain a regular sleep schedule

Sleep terrors are more likely to happen on nights when your child goes to sleep at a different time than usual.

Don’t discuss sleep terrors the next day

The morning after an event, do not make a point of discussing the episode with your child. Discussing the event is likely to worry her. However, if she brings it up, simply reassure her.

Additional treatment

In most cases, sleep terrors require no treatment. However, in severe cases, when these behaviours involve injury, violence, or serious disruption to the family, treatment may be necessary. Treatment may include medication or behaviour modification techniques. Be sure to speak to your child’s doctor if your child has frequent or severe sleep terrors and you are concerned.

Sleep handout from from A Clinical Guide to Pediatric Sleep: Diagnosis and Management of
Sleep Problems. Philadelphia: Lippincott Williams & Wilkins.
© Mindell JA & Owens JA (2003).