Night Terrors in Children

What are the signs and symptoms of night terrors?

• Your child is agitated and restless but cannot be awakened or comforted.
• Your child may sit up or run around.
• Your child may scream or talk wildly.
• Your child appears to be anxious, but doesn't mention any specific fears.
• Your child doesn't appear to realize that you are there, although your child's eyes are open and staring.
• The episodes begin 1 to 2 hours after going to sleep.
• Your child may mistake objects or persons in the room for dangers.
• The episodes last from 10 to 30 minutes.
• Your child cannot remember the episode in the morning.

What tests are used to diagnose night terrors?

Usually no testing is required to diagnose night terrors. Doctors can make the diagnosis after learning about your child's sleep history. Sometimes, we ask families to keep a sleep log to write down when their child goes to bed, wakes up and when night terrors happen. In rare cases, we may do a sleep study to confirm that these are night terrors and not nightmares or seizures.

How do providers at Children's Hospital Colorado make a diagnosis?

Our sleep specialists can determine whether these events are common night terrors or whether they are a symptom of a more serious sleep disorder like sleep apnea. Doctors at Children's Colorado will combine the information they learn from your child's sleep history, physical exam and other tests, like a sleep study when necessary, to make the diagnosis.

How are night terrors treated?

Treatment of night terrors is focused on calming your child back to sleep and keeping him or her safe during the episode. Parents can also follow some night terror prevention strategies. Doctors rarely use medication to treat night terrors in children.

Steps to help your child through a night terror

• Try to help your child return to normal, calm sleep.
• Don't try to wake your child; it is not possible during a night terror.
• Turn on the lights so that your child is less confused by shadows.
• Make soothing comments such as, "You are all right. You are home in your own bed. You can rest now."
• Speak calmly and repetitively.
• Such comments are usually better than silence and may help your child refocus.
• Some children like to have their hand held during this time, but most will pull away.
• Hold your child only if it seems to help them feel better.
• Understand that there is no way to shorten the episode.
• Shaking or shouting at your child will just cause the child to become more agitated and will prolong the episode.
• Keep your child safe. During a night terror, a child can fall down a stairway, run into a wall or break a window. Gently direct your child back to bed.
• Explain to babysitters and overnight caretakers what a night terror is and what to do if one happens. Understanding this will help them stay calm and control the situation if your child has a night terror.

How to prevent night terrors

Keep your child from becoming overtired. Sleep deprivation is the most common trigger for night terrors.

• For preschoolers, restore the afternoon nap. If your child refuses the nap, encourage a one-hour "quiet time."
• Avoid late bedtimes because they may trigger a night terror.
• If your child needs to be awakened in the morning, that means he needs an earlier bedtime.
• Move lights-out time 15 minutes earlier each night until your child can self-awaken in the morning.
• Hot bedrooms stimulate these events; cool the room and use a fan if necessary.
• Fever, inflammation, teething and illness can stimulate these events, so use an anti-inflammatory such as Motrin for fever or inflammation.
• Some drugs, such as Benadryl, will trigger these events so avoid them when possible.
• Hot baths just before bed may raise the body temperature; try a cool bath or shower earlier in the daytime.
• A full bladder can also trigger night terrors.

If your child has frequent night terrors, you might try the "prompted awakening" technique to readjust your child's sleep patterns at the time the night terrors usually happen. Prompted awakening techniques include:

• For several nights, note how many minutes elapse from the time your child falls asleep to the onset of the night terror.
• Begin awakening your child every night 15 minutes before the expected time of the night terror.
• Remind your child to "wake up fast." Keep your child fully awake and out of bed for 5 minutes.

Why choose Children's Colorado for your child's night terrors?

Night terrors are rarely, but sometimes, a symptom triggered by medical problems, including a disorder of dream sleep, a seizure or a movement disorder. At Children's Colorado, we are experts at diagnosing and treating night terrors, whether they are part of a more complicated sleep disorder or the common condition found in childhood. Often, we can help patients and their families learn to manage common night terrors after a meeting with our sleep psychologist.

At the Children's Colorado Sleep Center, we have providers known internationally for their expertise in sleep research and sleep treatments. The team is made up of sleep specialists trained in different aspects of sleep treatments, including sleep physicians who specialize in children's breathing issues and children's ear, nose and throat problems, a sleep-specialized psychologist, two sleep-specialized nurse practitioners, a sleep-specialized respiratory therapist and a dedicated sleep nurse.

• The National Sleep Foundation provides information on healthy sleep as well as sleep disorders. 
• American Academy of Sleep Medicine (AASM) is the only professional society dedicated exclusively to the medical subspecialty of sleep medicine.
• Healthy Children provides parents with health information on a variety of health issues and is from the American Academy of Pediatrics.