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Nightmares or Night Terrors

Toddler and Teenager Expert Advice from Carleton Kendrick, Ed.M., LCSW

Q: My five and a half-year-old son has been having nightmares or night terrors on and off for about two years. They usually happen about the same time each night. He cries out in terror and runs to my bedroom. When I try to calm him down , I find it's as if he is still sleeping. If I try to take him back to his own bed, he wakes up properly, cries and is really frightened. Sometimes I try to talk to him about what made him frightened, but he is very vague. I've only ever got two answers -- one about a monster coming to catch us and another about a man with very big eyes chasing him.

I've got books on this type of thing from the library to read together, but this has not seemed to help. I am a single mom and usually exhausted at the end of each day. I know that it's not the right thing to do, but I am now just letting him stay in my bed if he does have a bad dream. Do you have any suggestions that could help us get over this problem?

A: Two years is a long time to be having this chronic sleep problem. First, you have to truly distinguish whether he has been suffering from what are called night (or sleep) terrors or from nightmares. Your description seems to straddle the fence between these two very different parasomnias (sleep disturbances).

Let’s see if my describing further what these differences are will lead you to the appropriate identification and responses. Sleep terrors usually occur early at night, often around the same time of the night. They occur during the deepest sleep of the night, and since most deep sleep comes early in the night, most sleep terrors occur during the first deep sleep cycle, within sixty to ninety minutes of falling asleep. Nightmares, by comparison, usually come late in the night.

Sleep terrors begin when the child suddenly sits up in bed, staring wide-eyed with a pained look on his face. The child may scream, thrash about as if fighting off a dreaded danger, and run around the room. In direct contrast, a child having a nightmare is immobilized, with the exception of his eyes, during his frightening dream. A child with night terrors may sweat, shake and experience a rapid heartbeat. A child experiencing a night terror will not respond to your talking to him because he is not really awake and he truly does not know you are present. Don’t ever try to wake anyone having a night terror because he will only become more confused and terrified upon waking in your company. Usually the child returns to sleep shortly and recalls nothing the following morning.

Usually kids (and adults) cannot describe anything about a night terror other than a feeling of heightened anxiety, panic and dread. Those who do recall something usually cite a solitary image that was horrifying and overpowering ( perhaps your two answers of the monster and big-eyed man chasing him fit this equation). Nightmares, by comparison, are usually readily described as a sequence of events. Night terrors are more apt to occur during times of particular stress. Because they occur during deep sleep and kids have more deep sleep than adults, kids are much more likely to have night terrors. Getting overtired can also trigger a night terror since an exhausted child will sleep even more deeply.

You can begin to approach this problem by getting your son to sleep longer. Sleeping longer reduces the amount of deep sleep he will experience and potentially reduces the opportunity he has to have this deep sleep terror. You can also begin to track how much time typically passes between your son’s falling asleep and the beginning of his sleep terrors. Track this pattern for several successive nights. Then gently awaken him fifteen minutes before a sleep terror would typically begin. Repeat this sleep interruption for seven nights. This may break the pattern.

I hope this advice helps clarify this issue. Let me know how your medical team approaches this. This can be successfully treated. Good luck.

More on: Expert Advice

Carleton Kendrick has been in private practice as a family therapist and has worked as a consultant for more than 20 years. He has conducted parenting seminars on topics ranging from how to discipline toddlers to how to stay connected with teenagers. Kendrick has appeared as an expert on national broadcast media such as CBS, Fox Television Network, Cable News Network, CNBC, PBS, and National Public Radio. In addition, he's been quoted in the New York Times, Washington Post, Chicago Tribune, Boston Globe, USA Today, Reader's Digest, BusinessWeek, Good Housekeeping, Woman's Day, and many other publications.

Please note: This "Expert Advice" area of FamilyEducation.com should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.


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