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Q: My 27-month-old daughter has been having what I believe to be night terrors for about the past four months. (She has them on average at least one time a week and symptoms include waking up shortly after she has fallen asleep, sweaty, and disoriented.) My concern is that there is some underlying problem or disorder that is causing them. Any help that you may be able to provide would be very helpful.
A: Based on your child's age, it sounds like your daughter may be having a mild sleep disturbance. These have been called "confusional arousals," which are similar to, but less intense than night terrors (more common in older children). Although parents often think there is something wrong with their child, you should be reassured that these are common and usually benign. No underlying problem or disorder has been linked as a definite cause of this type of sleep disturbance.
It is true that these partial awakenings do tend to happen within the first few hours after having fallen asleep. They occur from deep, non-dreaming sleep. During the event, your child gets up abruptly and then may stare, look upset, and appear confused. These can be accompanied by sweatiness and fast heartbeat. These confusional arousals usually last only 5 - 20 minutes. They simply run their course as your daughter settles down and goes back to sleep. Fortunately, she is not actually awake and should not have any recollection about these episodes in the light of day.
Try to relax -- only your own sleep is being disrupted a bit. If they are occurring too often, talk with your daughter's doctor. There are possible, much less commonly used alternative treatments such as waking her before the episodes usually occur or very rarely using a medication to help provide temporary relief for the family. Your daughter's doctor can let you know what is best for her.
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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.