My son was 3 years old when he had his first night terror. It was scary. His eyes were wide open, but he didn't seem to register us or the room around him. He seemed to see and react to things we could not see or stop. He was screaming and mumbling. His movements were erratic and unpredictable.
In the last two years, this same late-night scenario has played itself out many times. As with most confusing parenthood moments, I have devised my own methods to help my son through them. When he is fully asleep yet writhing and screaming in bed, I calmly recite a list of his favorite Star Wars characters. As I make my way down that list starting with Luke and always ending with Jabba the Hutt, my son's breathing slows. His flailing eventually ceases. Whatever existential demons he is subconsciously dueling with slowly subside. By the time I make it to the mighty Chewbacca, my son is usually fast asleep and all is good with the Force once again.
Of course, no ad hoc dad fix is effective all the time. Even if it were, I wanted to understand what was happening to my son and how to best support him. So, what is a night terror and what are the best practices for parents to end them or at least make them better?
What Are Night Terrors?
Also known as sleep terrors, night terrors are “episodes of screaming, intense fear and flailing while still asleep,” the Mayo Clinic explains. Night terrors affect up to 7% of kids, according to experts at the Cleveland Clinic, and typically peak between the ages of 4 and 7 years old. Babies can also experience them but it is not typical.
Witnessing these night terrors can be frightening. "When my daughter was around 3, she started having night terrors. She would wake up screaming, shrieking, sweating, crying, with no clear way to calm her. It took several of these episodes for me, a sleep physician, to realize what they were because they were so disturbing," says Matt Davis, M.D., a sleep specialist, neurologist, and associate medical director at Sleep Dynamics in Neptune, New Jersey.
The good news, according to Dr. Davis, is that night terrors aren't typically harmful and rarely indicate any underlying medical issue.
Nightmare vs. Night Terrors
Many parents confuse their child's night terrors for nightmares, but they are not the same. According to Dr. Davis, a nightmare is just a disturbing dream, but a night terror is a type of sleep disorder during which part of your brain is awake and the other part is still asleep. Unlike nightmares, children usually do not recall night terrors even if their frightened parents most certainly do. These nocturnal episodes typically last 10 to 30 minutes but can be longer or shorter.
What Causes Night Terrors?
I was surprised to learn that night terrors are more closely related to other kinds of sleep disorders (parasomnias) such as sleep walking. The most common causes are abnormalities in a child's sleep schedule, not enough sleep, and stress, but night terrors can also be genetic. I experienced night terrors as a young boy and my younger brother was an avid sleepwalker. My mom's favorite story recalls how she and my dad awoke one night to find my fully asleep 3-year-old brother standing over their bed. Holding a paring knife in one hand and an apple in the other, he mumbled "cut it, please." He was asleep, hungry, but also polite.
Night Terror Treatment
Night terrors typically resolve on their own without any intervention. Most kids who experience them tend to grow out of them by adolescence. There are ways, though, in which parents can reduce and possibly prevent their young child's night terrors.
Stick to a sleep schedule
Depending on the child, even a one-hour deviation in the sleep schedule can trigger a night terror. "Keeping a strict sleep schedule is really important," says Dr. Davis. "These behaviors usually will come out more when the child has some irregularities in their schedule. Making sure your child is getting an appropriate amount of sleep for their age is really important too."
Practice waking kids up before a night terror
When a water tight sleep schedule doesn't do the trick, sleep experts suggest trying something called "anticipatory waking" during which parents briefly wake their child up prior to when the night terror usually happens (my son is a sucker for around 10:30 p.m.). Sleep is cyclical and it is well established that night terrors come out of stage three sleep (deep sleep). By interrupting the normal cycling through stage three sleep, these behaviors can sometimes be prevented. While anticipatory wakening also represents a slight disturbance in a child's sleep cycle, sleep experts believe they are beneficial to avoid an even more disruptive night terror. Parents can think of it as a sleep reset.
Don't interrupt a night terror when it happens
If, despite your efforts, your child continues to experience night terrors, most experts suggest that parents don't engage too much with their kids during the episodes. Try to keep your child in bed. Don't attempt to explain or reason with them. Remember that your child is basically still sleeping.
"Do not try to wake your child. That can actually be disruptive and prolong the episode," says Zachary Schwab, M.D., a child and adolescent psychiatrist based in Northern California. "The best action a parent can take is to help keep their child safe and to attempt to soothe them back to sleep."
Seek help if needed
According to Dr. Davis, parents should seek advice from their child's primary care physician or a specialized sleep doctor anytime these sleep behaviors are significantly interfering with the child's quality of life or even a parent's quality of life.
In the rare instances in which night terrors persist in older kids, doctors can sometimes prescribe appropriate medicines, but Dr. Davis does "not consider medication until at least the teenage years."
Try and stay calm
My son still experiences night terrors, but we're getting used to them. I've learned it's important for us parents to try and find ways to stay calm through them. I'm not sure if my soothing recitation of our Star Wars heroes does anything to help him, but I do know that it helps me. Just like my son, I am a big Star Wars fan. Slowly making my way down that colorful list of characters soothes me during stressful parent moments. It is a sci-fi mantra that helps me to be calm and present with my guy when he is having a hard time. All that is required of me is simply to be there and, of course, to never forget to end with Jabba.
