My baby has started crying, laughing, babbling and screaming in his sleep- like he is having a vivid dream, nightmare or is in pain. The first time it happened I had never heard him yell so much- not even after his first ever vaccination shots. I bolted, in my pyjamas, through the dark house (tripping over the days debris) to his cot where I expected to find him awake and screaming. Instead I found him lying on his back, arms above his head in his standard sleep pose (also affectionately referred to as the ‘hey, ho- a party over here, a party over there, throw your hands in the air, wave them everywhere’ pose). I picked him up to give him soothing cuddles and immediately had the strangest sensation that he was (or rather, had been) asleep. I could have sworn my picking him up is what woke him- but surely that couldn’t be right… Once in my arms he cried a little in alarm but was easily soothed and went back to sleep very quickly. I left the nursery confused, but thinking I had misjudged him still being asleep. I put my weird thoughts down to baby brain, and Hunter’s wakeful state down to a sudden change in temperature or loud noise.
A few nights later it happened again. The cries coming from him were loud and shocking to me- he was practically shrieking in horror. And yet he was lying so peacefully. Something was not right. I stayed back a while, switched on his night light and observed him- and that’s when I knew I wasn’t a crazy lady. Hunter was asleep and yet screaming...
Those who read my blog regularly know that I love to investigate, research and learn, and so will not be at all surprised to read that I did some online research to find out what was happening to his sleep. And that’s how I learnt about Night Terrors, also known as Parasomnia.
What is a Night Terror?
During a typical night, sleep occurs in several stages. Each is associated with particular brain activity, and it's during the rapid eye movement (REM) stage that most dreaming occurs.
Night terrors happen during deep non-REM sleep. Unlike nightmares (which occur during REM sleep), a night terror is not technically a dream, but more like a sudden reaction of fear that happens during the transition from one sleep phase to another. Night terrors usually occur about 2 or 3 hours after a child falls asleep, when sleep transitions from the deepest stage of non-REM sleep to lighter REM sleep, a stage where dreams occur. Usually this transition is a smooth one. But rarely, a child becomes agitated and frightened — and that fear reaction is a night terror.
During a night terror, a child might suddenly sit upright in bed and shout out or scream in distress. The child's breathing and heartbeat might be faster, he or she might sweat, thrash around, and act upset and scared. After a few minutes, or sometimes longer, a child simply calms down and returns to sleep. Unlike nightmares, which kids often remember, kids won't have any memory of a night terror the next day because they were in deep sleep when it happened — and there are no mental images to recall.
What Causes A Night Terror?
What can be done to stop night terrors?Night terrors are caused by over-arousal of the central nervous system (CNS) during sleep. This may happen because the CNS (which regulates sleep and waking brain activity) is still maturing. Some kids may inherit a tendency for this over-arousal — about 80% who have night terrors have a family member who also experienced them or sleepwalking (a similar type of sleep disturbance).
- overtired or ill, stressed, or fatigued
- taking a new medication
- sleeping in a new environment or away from homeNight terrors are relatively rare — they happen in only 3-6% of kids, while almost every child will have a nightmare occasionally. Night terrors usually occur between the ages of 4 and 12, but have been reported in kids as young as 18 months. They seem to be a little more common among boys. A child might have a single night terror or several before they cease altogether. Most of the time, night terrors simply disappear on their own as the nervous system matures.
Even when the night terrors are a result of an underlying SDB, there are some simple things you can do to address the behaviour. Most importantly, try to relax and get some sleep yourself. You'll need it; after all, your child's had a good night's rest and will be raring to go in the morning! In fact, night terrors are often more difficult on the parents than on the child. While it is upsetting to watch your baby scream and thrash about, touching or picking your child up while he is having a terror will only make it worse. It may feel counterintuitive, but the best thing you can do for your child during one of these episodes is to leave him be.Dr Chris Seton, staff specialist in the Sleep Investigation Unit at The Children’s Hospital at Westmead, says two approaches can be taken to help your child: the hands-off approach and, if this is ineffective, the waking program.
'The worst thing a parent can do is to touch or wake the child. Such action will only make the child sleep deprived, which can make the sleep terrors even worse. The best management tool parents can apply is the hands-off approach. I tell parents, "For the next few weeks, instead of running in, grabbing your child and trying to console them, do the opposite: don’t run, walk. Stand in the room, but in the background. Don’t say anything, because the child can't hear you and, in particular, don’t touch them or pick them up,"' he explains. According to Dr Seton, after about a month, the majority of parents will find the night terrors will stop completely.
If the hands-off approach does not work, and there is regularity to the occurrence of the night terrors (they happen at the same time each night), Dr Seton recommends the waking program where you wake the child 20 minutes before the predicted episode. 'If the night terrors are happening at 10.30 every night, I'll tell parents to wake the child at 10.10pm. Wake the child up fully, give him a sip of water, get him out of bed if necessary. If you do this for 10 consecutive nights, in the right child - the child with regular night terrors - two-thirds of the time the night terrors will stop, not just for the night but subsequently. By disrupting the sleep cycle the electrical trigger that prevents the child from reaching the final stage of sleep is also broken. Both the hands-off approach and waking program are good non-drug treatments.'
When To Seek HelpIn a small number of cases a drug treatment is prescribed, however most often the child will either stop on his own or with the help of one of the management tools described above.
If none of the techniques mentioned above work and your child is still havingthe night terrors, or you are concerned that the nighttime activity is theresult of a sleep disorder, you should speak with your family doctor andconsider visiting a sleep clinic. There are paediatric sleep clinics in eachcapital city.
So to sum up, Night Terrors seem to stem from the painful developmental process of going from an infant to a child, and since a majority of growth occurs during periods of restit is no wonder that bubs can experience a night terror or two.
And so, when Hunter is fully grown, I will regale his girlfriends and cool school buddies with the tale of how, as a baby he had night terrors, and how, as a creepy mum, I watched him while he slept.
Justice Never Sleeps,