Night terrors in children are no joke — and if you've ever experienced them yourself, you know there's a huge difference between a terror and your average nightmare. As a parent, it has to be one of the worst things to watch your child go through, especially since terrors can be so unpredictable and scary.
It's easier to keep your cool when your kid is having a night terror, however, if you know what to look for and how to react when they wake, inconsolable, in the middle of the night.
Bradi Nathan, a New Jersey mom and co-founder of MyWorkButterfly.com, says her son's night terrors began a few years back and now appear at the onset of an illness. Nathan admits there have been many nights that she felt utterly helpless as her son grasped onto her for dear life yelling, "Save me."
"The first terror arrived late at night as my husband and I were in deep REM mode," says Nathan. "It was if Jack was screaming to be saved by a burglar... like a scene out of a sci-fi movie."
"His screams intensified, eyes rolled back, he was thrusting his tongue, yet he was sleeping the whole time," she continues. "We immediately called the pediatrician who told us not to wake him, not to touch him, and to repeatedly say, it's okay, you are safe, mommy is here. The notion is that if a child is woken out of a night terror then they will be afraid to fall back to sleep and often slip right back into in."
Night terrors or nightmares?
According to Dr. Laura Markham, a clinical psychologist specializing in child development and parenting at AhaParenting.com, nightmares are upsetting dreams that happen during REM (dream) sleep. Night terrors occur during Stage 4 Deep Sleep, or during the transition from Stage 4 to REM Sleep. In other words, during a night terror, the person is actually asleep — according to his brain waves — even if his eyes are open. In fact, most of the time the person has no recollection of the terrors.
The cause of night terrors
"Night terrors can occur at any age, but small children seem to suffer from them most frequently. In fact, up to 15 percent of kids reportedly experience at least one night terror," says Dr. Markham. "Scientists think night terrors may be caused by over-arousal of the central nervous system, which regulates brain activity. Most children outgrow them, probably as their brains mature, although some adults do report having night terrors when under stress. This suggests that stress could also trigger night terrors in little ones."
Dr. Markham notes that Stanford researchers have hypothesized that there is a link between childhood sleep apnea and night terrors, so it's always a good idea to have your pediatrician check your child for sleep apnea. Sleep apnea can make it difficult for children to get enough rest, and there are indications that over-tiredness as well as stress can trigger night terrors in people who are prone to them.
Next Up: Best tips for the hard part
Originally published January 2010. Updated May 2017.
13 tips for handling night terrors
Dr. Markham offers these tips for parents:
1. Do try to keep calm yourself. It is likely that your child is not remembering these incidents and is not being traumatized by them. That said, of course you want to offer them whatever comfort you can, and keep them safe. While they will probably seem inconsolable, adults who suffer from night terrors say that they have been comforted by the calm, reassuring voices of those they love. And of course, if they'll let you hug them, then do so.
2. Do try to minimize stress in their life for now. No toilet training or other big developmental challenges if you can help it until they get out of this phase. Be sure they are not exposed to parental loud voices or other emotional stressors. Use "positive discipline" as opposed to spankings, yelling, timeouts or other stressful discipline. Minimize schedule changes and nights away from home.
3. Eliminate TV. The American Academy of Pediatrics recommends that kids younger than 24 months should not watch TV because it negatively impacts brain development, and TV has also been shown to be stressful for little ones who may think the conflicts dramatized on the screen are real.
4. Don't allow your little one to get over-tired, which may make her more susceptible to night terrors. Be sure they have a regular bedtime routine and are getting sufficient sleep. Often little ones need to be asleep by 7 p.m.; when they stay up later they have to summon adrenaline and other arousal hormones to keep it together. Moving to an earlier bedtime not only helps them fall asleep more easily at night but also lessens the possibility of over-arousal.
5. Do adopt a comforting bedtime ritual that includes a bath, snuggling & reading, and follow it each night, making sure that your child has an hour of soothing "wind-down" That means no music, TV, loudness, wildness, or anything particularly arousing, and no food, since digestion seems to be the source of night terrors for some people. Get more tips here on developing a bedtime ritual for kids.
6. Be aware that fevers can trigger night terrors in those who are prone.
7. Do make sure that your child is not being accidentally awakened. There is some evidence that night terrors result from being awakened during Stage 4 sleep (if there is already a predisposition). If traffic or TV or telephone noises intrude on their sleep, they could be awakening them. You might invest in a white noise machine as a precaution.
8. Don't try to force your child to wake up from a night terror. That leaves a person extremely disoriented, sometimes to the point of temporary amnesia.
9. Keep your little one sleeping in a crib until they outgrow their night terrors, if possible. If they have already graduated from a crib, be aware that they could easily leap out of bed during a night terror. Move anything they could trip on out of the way, be sure windows are closed and have a window guard, and use a baby gate to be sure they don't run out of their room and fall down the stairs.
10. Don't let your child get over-heated while they sleep. In particular, avoid footed pajamas. Many parents report that their child is more likely to have night terrors when overheated.
11. If your child has allergies or a cold and their tonsils are inflamed, it can make it harder to breathe, which may trigger night terrors. Ask your doctor about medicine that may help with the allergy symptoms. Some researchers report that removing the tonsils and adenoids can immediately cure night terrors in cases where they were regularly swollen and the child was having a hard time breathing at night.
12. Many parents have reported a complete cure with the radical approach of putting the child's feet into cool (not cold) water during an episode, although some parents report that the night terrors later returned.
13. I hate to wake kids for any reason, but there is evidence that you can help your child reset their arousal cycle by waking them gently 15 minutes before the night terrors usually occur. If you can see a pattern, and the night terrors are frequent, it might be worth it. If you do this for three to five days, it will hopefully interrupt the arousal cycle and prevent the night terrors from recurring.
"My advice to other parents is to try to stay calm and to reassure your child through a soft voice that it's OK, Mommy is here. Do not try to wake your child or to jar him in any way," says Nathan. "This will just exaggerate the episode. And, ride it out. Also, don't recount the happening the next day with your child; very often they will not even be aware of what has occurred. I have been told by my pediatrician that he will grow out of it. He's 9, and I'm still waiting!"