Night Terrors – A guide for parents to support their child’s sleep journey

As parents, we all want our children to enjoy restorative and peaceful sleep. However, when night terrors disrupt their sleep (and yours), especially the first time, there are many questions we want answers to. Night terrors can be a terrifying experience for any parent but they aren’t harmful or distressing to your child. Night terrors, often referred to as sleep terrors, can occur during any sleep situation (night or daytime sleep) and are common in childhood so if you’re experiencing this challenge with your child, you’re not alone. 

What you’ll learn from this blog:

• What is a night terror? 
• How does a night terror differ from a nightmare?
• What are the causes of night terrors? 
• How common are they?
• Practical strategies to manage them.
• When to seek professional help.

What Are Night Terrors?

Night terrors are a type of parasomnia, which refers to temporary and abnormal behaviours during sleep. Any sleep disruption (e.g., sleep terror, nightmare) can occur either during non-REM sleep (non rapid eye movement sleep) or during REM sleep (rapid eye movement sleep). Night terrors typically occur during non-REM and most often occur during 1-3 hours after sleep onset and almost always in the first half of the night. 

During a night terror episode, your child may suddenly sit up in bed, scream, thrashing and appear panicked. They will be inconsolable (this is the hardest part!) and they won’t recognize you, they will likely appear quite “out of it” as they aren’t fully conscious. They may have a physiological response also such as sweating, increased heart rate, faster breathing, dilated pupils, etc. 

After the episode, your child will fall back asleep and in the morning, they won’t remember the event at all – but you definitely will. 

How does a night terror differ from a nightmare?

A nightmare occurs during a different part of their sleep, during REM sleep and they often occur in the later part of the night. When your child has a nightmare, they are well aware of it and can recall vivid details about their nightmare. They will be able to answer questions you may ask, they will recognize you during the event and they can be comforted by you in the moment. 

Causes and Risk Factors 

Understanding the root causes of night terrors can help in managing them effectively. Several factors can be risk factors for night terrors in children but the exact cause of night terrors is unknown for many cases. 

1. Genetics: A family history of sleep disorders, including night terrors, sleepwalking, and sleep talking, can increase the likelihood of a child experiencing night terrors.
2. Sleep Deprivation: Consistently poor or inadequate sleep can increase the chances of night terrors (and sleep deprivation can negatively impact many other aspects for your child). Not every child who is sleep deprived will have a night terror either. 
3. Stress and Anxiety: Emotional stress and anxiety can trigger episodes for some children. Changes in routine, starting school, or moving are common life events that can be stressful for children. Note: just because your child starts school or you’re moving houses doesn’t mean they will suddenly have a night terror. 
4. Fever: Illnesses and fevers can also contribute to night terrors for some children. 
5. Sleep Environment: An uncomfortable sleep environment, such as a noisy sleep environment, can exacerbate night terrors for some children.
6. Sleep health: obstructive sleep apnea, restless leg syndrome and periodic limb movements may increase the frequency or occurrence of night terrors for your child. 

How common are night terrors?

The specific stats for exactly how common night terrors are is difficult to access because they predominantly rely on parent report to gather the information.

Night terrors may occur 1-2 times for your child and then never again. For some, they have them more frequently and will be more predictable based on some of the risk factors above (e.g., for some, the combo of sickness and sleep deprivation may always bring on a night terror). 

From what we do know, night terrors are more common in boys than girls, are generally uncommon after puberty and typically occur in children 4 to 12 years of age, however can impact children as young as 18 months, and one study indicated they peak between 5 to 7 years old. Sleep terrors are estimated to impact 1 to 6.5% of children 1 to 12 years old, and one study noted up to 14% of children were impacted. 

Practical strategies for managing night terrors

Of course, treating and supporting any underlying risk factors (e.g., sleep health, anxiety, etc.) would be essential to managing this sleep challenge. 

The first time your child has a night terror can be extremely alarming and your instinct as a parent will be to intervene and try to help them calm down – which in some situations, may make things worse. 

While night terrors can be alarming, there are a few strategies you can employ to help manage and potentially reduce their occurrence:

1. Sleep Hygiene: Having a calming bedtime routine, cool and comfortable sleep environment, and ensuring your child is getting adequate sleep consistently. 
2. Manage stress: Being attentive to your child’s emotional well-being. Encourage open communication about any worries or fears they may have. Activities like drawing, journaling, or talking can help them process their emotions.
3. Safety measures: If your child frequently has sleep terrors, ensure their room is free of objects that they may harm/trip on if they have an episode. For some children, sleep terrors progress into sleep walking, so having a gate or door lock on your house doors may be helpful to prevent an accident. 

When to seek professional help

While most children outgrow night terrors, there are instances where professional help may be necessary. You may consider consulting your child’s primary care provider, an airway focused dentist or myofunctional therapist if you have concerns about your child’s night terrors for the following reasons:

• Night terrors are frequent and disrupt your child’s daily life.
• The episodes result in injury or pose a safety risk.
• There are additional symptoms, such as daytime sleepiness, snoring, or breathing difficulties during sleep.
• You suspect underlying medical conditions, such as sleep apnea, might be contributing to the night terrors.

Next steps

Night terrors can be a challenging and distressing experience for many families. However, with a better understanding of what they are, their causes, and how to manage them, you can create a supportive environment that promotes restful sleep for your child. While night terrors are often outgrown with time, providing a consistent, calming sleep routine and addressing any underlying stressors can make a significant difference in the short term.

 If you have questions or concerns about your child’s sleep quality or quantity, or if the night terrors persist, please consider booking a free connection call where we can discuss your child’s sleep and offer you an action plan (that may not even be working with me!). 

Wishing you peaceful nights,

Chelsea

Chelsea is Mom of 2 and a Certified Baby, Toddler and Child Sleep Consultant. She has advanced certification in Infant and Early Mental Health and Pediatric Sleep Health and a Masters of Professional Education with a specialization in Applied Behaviour Analysis. She supports families within Hamilton and beyond with hands-on, no cry-it-out, responsive methods towards longer naps and better nights. Chelsea works collaboratively with families to empower them with the confidence and tools they need to reach their unique sleep goals. Hear from rested families here and book a free call with Chelsea here to discuss how she can support your family’s journey to more sleep.