Night Terrors and Pediatric Sleepwalking
Night terrors, also called "sleep terrors," and sleepwalking are sleep behaviors that most often occur in young children.
A child having a night terror will often cry out or scream and appear very agitated, frightened and even panicked. Your child may flail around, push you away or behave in other strange ways. Some children who sleepwalk may simply walk to common areas of the house. Other children may head to odd places, such as the basement or outdoors. During night terror and sleepwalking episodes, your child might appear confused or dazed, may mumble or give inappropriate answers to questions and may be clumsy. As disturbing or frightening as these events appear, children having them usually are totally unaware of what they are doing. Although your child might appear to be awake, he or she is actually deeply asleep.
Night terrors and sleepwalking typically last for only a few minutes, occasionally longer. Since they are asleep during the episode, children have no memory of these events. The hardest part for parents is that most children avoid being comforted during these episodes. They may even become more agitated if you talk to them and try to calm them down.
Night terrors and sleepwalking usually occur during the deepest stage of sleep. They are more likely to occur within the first 1-2 hours after falling asleep since that is when deep sleep is most likely to occur. Night terrors and sleepwalking are more common in younger children, because they have much more deep sleep than teenagers or adults. Most children outgrow these sleep behaviors by adolescence. Night terrors and sleepwalking often run in families. Children who have night terrors are also more likely to sleepwalk and vice versa.
Night terrors and sleepwalking are more likely to happen when your child doesn’t get enough sleep. This is because the body gets more deep sleep after not getting enough sleep. The more deep sleep, the more likely a night terror will occur.
The likelihood of night terrors and sleepwalking is increased by anything that interrupts or disrupts sleep. These include:
- An irregular sleep schedule
- Another sleep disorder, such as snoring or sleep apnea
- Fever or illness
- Some medications
- Sleeping with a full bladder
- Sleeping in a different environment
- Sleeping in a noisy environment
How to Respond to Your Child's Night Terrors and Sleepwalking
- Keep your child safe: The most important thing that you can do if your child has night terrors or sleepwalks is to keep him or her safe. Although many children with night terrors do not get out of bed, many also sleepwalk and can injure themselves. Make sure that all outside doors are secure. Ensure that windows do not open wide enough that your child can jump out of them. An alarm, such as a simple bell hung on the door, can signal you when your child is up and about. Make sure to remove things that are in the way. If your child may walk or run around during a night terror, clear away anything that they can step on or trip over.
- Don’t wake your child: Although night terrors and sleepwalking are not harmful to your child, nothing is gained by trying to wake or comfort your child during an episode. If your child is sleepwalking, speak calmly, walking him or her back to bed. If your child becomes upset, let your child be until the event is over.
- Make sure your child is getting enough sleep: If your child seems tired in the morning, they may not be getting enough sleep. Since these events are much more likely to happen when your child does not get enough sleep, you may need to move bedtime earlier.
- Maintain a regular sleep schedule: Night terrors and sleepwalking are more likely to happen on nights when your child goes to sleep at a different time or place than usual.
- Look for signs of other sleep problems: If your child takes a long time to fall asleep, frequently wakes during the night, snores or doesn’t get a good night's sleep, he or she may be more likely to have these events. Addressing these sleep issues often decreases or even eliminates night terrors and sleepwalking.
- Avoid caffeine: Caffeine can disrupt your child’s sleep and increase the likelihood of a night terror or sleepwalking episode.
- Don't discuss night terrors the next day: The morning after a night terror, do not make a point of discussing the episode with your child unless they bring it up. Making a big deal about the event may worry or embarrass your child. If he or she does raise a concern, reassure your child that this is a normal sleep behavior in children, it is not harmful and that you will keep him or her safe.
In most cases, night terrors and sleepwalking require no specific treatment. However, in cases in which a child is at risk for harm or serious disruption to the family, treatment may be necessary. Contact your child's physician if you are concerned.