What To Do When Your Kid Suffers From Night Terrors

little girl sleeping
flickr / RichardAlan
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And the award for most apt medical description would definitely goes to –”night terror.” If you’re not familiar, that would be the sleep disorder which often occurs in children, and has a few, subtle symptoms: It happens in the middle of sleep. It’s marked by wild thrashing or running around. And your child screams out like their soul is being murdered.

And while the upside is that kids usually have no clue what happened come morning, the downside is that you do. Dr. Sanjeev Kothare, Director of the Pediatric Sleep Center And Sleep Medicine at the NYU Langone Medical Center, is one of the foremost experts on how to stop these fright nights. Here are his best tips on how everyone can rest easy again.

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Night Terrors Vs. Nightmares

First things first: Night terrors aren’t the same as nightmares. Nightmares are intense, scary dreams that happen during dreamy REM sleep and often stem from something your kid experienced or conjured up in their whacky heads. Frightening nightmares can freak out your kid and send them burrowing into your bed for comfort. A night terror, however, occurs during sleep. It’s an arousal, not an awakening. Sufferers are legitimately scared of something they saw during sleep and will thrash, scream and even sprint through the house as though awake, but they’re more or less still in a state of sleep.

What It Looks Like

Night terrors can be pretty disturbing to witness, mostly because of all the screaming in the wee hours of the morning. “There’s a look of intense terror on their face, they’re sweating, their blood pressure and heart level are elevated,” says Dr. Kothare. “And this could go on for 5, 10, or 15 minutes.” If it lasts longer than that, you might want to call an exorcist.

How Night Terrors Start

The average age that night terrors emerge is age 5, but your kid could show signs of such sleep disturbances as sleepwalking or sleep talking as early as 3 or 4.  They’re all part of the not-awake-but-not-asleep family known as non-REM parasomnias. Night terrors are the most extreme of these conditions, but “it’s a continuum,” explains Dr. Kothare. Your kid might progress from brief “confusion arousal” (waking up out of a state of sleep, looking around, and then falling right back into bed), then move on to sleepwalking, and finally to full-on sleep sprinting-around-the-house-and-yelling. They can also experience this order in reverse as they get older. Although they probably won’t be running backwards.

What To Do In The Middle Of The Night

While kid might not remember booking down the hallway screaming, but they’ll definitely remember falling down the stairs because you couldn’t stop them. Set up a perimeter. “Make sure there are safety latches on the doors and windows, and put up safety gates,” advises Dr. Kothare. Most importantly, Kothare adds that you shouldn’t try to wake kids up or restrain them, because you could just make the terrors worse. Just do your best to steer them back into bed, and they should drift asleep soundly when it’s over. (You, however, might need a glass of scotch and some soothing ocean sounds.)

The other important thing to do is figure out if they’re night terrors, and not nocturnal seizures. “The treatment is completely different,” says Dr. Kothare. If you think your kid is having a seizure, then you should get them to a doctor as quickly as possible. Some signs to look for: their body stiffens up, they stop breathing, they bite their tongue, or there’s jerking of their face or leg. It could last for as little as 30 seconds. And, as with night terrors, your kid won’t have any recollection of it when it’s time for waffles.

The Treatment Options For Night Terrors

One of the first techniquest to try is called “anticipative awakening.” If your kid’s nightly reenactment of Saw is pretty predictable, wake them up about a half hour beforehand to go to the bathroom (or just talk to them about Curious George for a minute). Then, let them go back to bed. This interruption will hopefully shake up their sleep cycle just enough to keep them from hitting that deep state where the screaming starts.

The next step: take them to see a sleep specialist. A doctor will probably start by ordering a sleep study to rule out that your kid’s episodes aren’t being triggered by a disorder such as sleep apnea or leg twitching. “If they sleep more calmly, they won’t wake up and have night terrors,” explains Dr. Kothare. Your doctor might advise giving them a little bit of the sleep hormone melatonin, to regulate their sleep cycle. They might also get nasal spray if it seems as though the episodes are being caused by their snoring. Or an iron supplement, to control twitching.

If there’s no obvious underlying cause, and nothing else is working, your doctor might even prescribe Klonopin. This a similar effect to Xanax or Valium. The goal is to use it for a short period to break the night terror cycle, so your kid won’t necessarily be on it forever. Dr. Kothare still stresses that, as always, you should think of medication as a last resort, no matter how tired (and tired of night terrors) you are.

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