UNDERSTANDING NIGHT TERRORS & NIGHTMARES

We’ve all felt the grips of a really scary dream. Waking with a gasp, face flushed, heart racing, unable to recognize what’s real and what’s not. It’s a completely unnerving feeling and one you may agree you could do without.

It’s unpleasant enough to experience this unconscious terror yourself – it’s a whole other level of helplessness watching your child experience it.

One of the best ways to tackle discomfort is to understand its roots. And so my mission here is to:

detail the nocturnal events that send your child into a fearful tizzy
explain the difference between the most common types of what we call “parasomnias” – night terrors and nightmares
outfit you with some tools that may help ease you and your child through these distressing events

So let’s explore what’s going on here.

What is a night terror? A night terror is a partial arousal from deep, NREM sleep. They are very much like getting “stuck” in between sleep and wakefulness. And while the body may seem alert and active, the brain is not fully conscious to the outside world. Night terrors are most common within the first two to three hours of going to sleep at night, as this is when deep NREM sleep dominates.

What is a confusional arousal? A confusional arousal is somewhat of a toned down version of a night terror. They occur mainly in infants and young toddlers and may involve agitated vocalizations (crying out) and moving or thrashing around. Eyes may be open or remain closed. There is generally no sweating or flushing of the face. The key identifying feature is that your child may appear confused by your presence and be very resistant to consolation. In fact, efforts to help calm them down may only increase the agitation. As with night terrors, sleep should come easily following the event.

If your child is experiencing a night terror, they will probably bolt upright, scream out dramatically and uncontrollably, breath rapidly, and appear extremely fearful. They may speak incoherently about things that they are afraid of, or must do, or must move away from (this may involve physically acting this out). Often no amount of verbal or physical reassurance is enough to jolt your child out of this “in between state”. Following the episode, your child will likely return to a restful state of sleep with ease.

It may be very difficult to tell that your child is having a nightmare while it is happening, since muscle tone and activity are inhibited during REM sleep. They also do not experience sweating or flushing of the face, and only mild increases in heart rate. However, generally a child that has experienced a nightmare will wake up maintaining the fearful feelings of the dream and so may exhibit behaviours related to hiding, burrowing, or other fear responses. They may be able to recount, with some amount of detail, the imagery and events of the dream and will commonly struggle to get back to sleep because of the disruptive content. They will also very likely remember the storyline to some extent in the morning.

These sleep disruptions can begin as early as toddlerhood may persist throughout childhood, but typically phase out on their own with time.

Other factors that contribute to increased frequency of night disruptions include:

illness (this may contribute to difficulties transitioning between sleep cycles)
sleep deprivation (from travel, regular sleep struggles, or intermittent stress)
a sleep-disruptive environment (noisy, bright, or hot)
developmental transitions (which may evoke anxiety or insecurity)
exposure to distressing stimuli (movies and imagery)
another underlying sleep condition (such as restless leg syndrome or obstructive sleep apnea).
There also appears to be a genetic effect with these parasomnias. Children whose parents had night disruptions when they were young may be up to 10 times more likely to exhibit these arousals themselves.

What can a sleep consultant do to help?

First, a piece of reassurance. These sleep disruptions are common and, in most cases, are completely harmless. Meaning, from a healthy sleep standpoint, they do not have to be high on your radar. But that doesn’t make them any less disruptive.

Remember that during these events, your child is, in fact, still sleeping. They will be very difficult to impossible to wake and may resist your efforts to reassure. These events can last anywhere from just a few to 30 minutes (and sometimes longer). As long as your child remains in a safe environment, there is no reason to be concerned about long term effects.

In other words, you are doing everything you can do by just being with your child. Do not try to restrain or prohibit their agitation. Staying with them while they fall back to sleep will provide additional security. Ensuring that your child is getting as much daytime sleep as is needed (based on their age) and an early bedtime can help curtail any sleep further sleep disruptions. A few extra long naps may be in store, particularly during periods of change (i.e., potty training, starting school, introducing a new sibling, travel etc.).

If episodes persist, a sleep consultation can help establish additional techniques such as:

anticipatory waking
body relaxation strategies
rescripting and desensitization
redirecting focus and enhancing attachment and security

The biggest take home from all of this information is that these episodes are common in young children, and though completely distressing to witness, they are NOT usually harmful to your child. Sleep quality is impacted very little, if at all, and in many cases, children simply grow out of these stages. Helping create a highly sleep-promoting environment, calming the body and the mind, and prioritizing healthy, age-appropriate sleep are some of the best tools to minimize these nocturnal disruptions. In the moment, being with your child and comforting them in any way that you know how, but without expectation of a particular response can help to ease your own anxiety surrounding parasomnia episodes.

The content on this website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Monster In My Closet

MIMC understands that sleep is both a biological need AND a learned behaviour. These driving forces must align for your baby to transition happily & confidently into sleep. Founder of MIMC, Denise Gassner, turned her attention to sleep after having her own babies & becoming fascinated & perplexed by how unnatural sleep can feel early on. She’s driven to make sleep less of a mystery for new parents & empower them to make informed decisions on sleep practices that adhere to their unique parenting styles and family values.