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What to Do About Night Terrors

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: My one-year-old daughter has had four or five episodes that seem like nightmares. She has a very distinctive cry and her eyes are open, but she just keeps jumping and screaming like something is scaring her or like she's in pain. She won't focus on anything or move, she just twitches and screams. The longest episode lasted about 25 minutes, even through changing her diaper and taking a bottle. Then, all of a sudden, she started smiling and acted like nothing was going on. The first one occurred when she was only nine months old. Do you have any insight about this?

A: What you are describing sounds much more like "night terrors" than "nightmares." During a night terror episode, a child may scream, cry, and stare, completely unaware of anyone or anything around her. Her eyes may be wide open, but she really is not awake. Although you may initially think she is having a nightmare, she actually is in a stage of sleep where she does not dream at all. It is because she is not dreaming that she will not have any bad memory (as she would with a nightmare) or even remember the episode in the morning.

Night terrors usually happen within a few hours after a child has fallen asleep and can last anywhere from a few minutes to a half-hour. The child generally falls back to sleep and wakes up the next morning without remembering anything about it. On the other hand, nightmares happen much later into the night when the child is dreaming. A child who is having a nightmare tends to have little interest in going back to sleep and needs comforting. You may even need to stay in the room for a while, but at least she can be consoled.

Night terrors happen to a small percentage of children, while nightmares are upsetting dreams that happen to all kids. As children get older, night terrors happen less often. No special treatment is usually necessary. Don't try to wake her up, but do keep toys and any sharp edges that she might hit while she is thrashing around out of harm's way. Be patient and ask her pediatrician for more information and reassurance.

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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.


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