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When children wake in the night with intense fear or panic, it could be night terrors. Here we explain what they are, how to deal with them, and when to seek help.

What are night terrors?

Night terrors in children are a sleep disorder that can be worrying for both children and parents. They usually occur in the early hours of the night and are characterised by intense fear or panic.

A child may scream, cry, gasp for air, and appear inconsolable, but is usually not fully awake and rarely remembers the event the following day.

Although night terrors can be frightening to witness, they are usually harmless and children usually outgrow them. Understanding what night terrors are and how to deal with them can help families navigate these challenging nights with greater calm and reassurance.

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Night terrors at different ages

Night terrors, or pavor nocturnus, often affect children. About 33 percent of children between the ages of one and two are affected while about 20 percent of those aged three to five have the problem. Only 1-2 percent of older children, teenagers and adults experience them.

Symptoms vary with age, from screaming to disorientation. It is possible for children to have memory fragments of the episode. A stable sleep routine and a safe sleeping environment are important. In cases where night terrors affect daily life, professional help may be needed to address underlying causes.

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What are the symptoms of night terrors?

Symptoms of night terrors can include:

  • Sudden awakening with intense fear or panic
  • Screaming and crying
  • Increased heart rate and rapid breathing
  • Sweating and redness of the face
  • Sitting up or running around
  • Disorientation and confusion on awakening
  • Resistance to comforting attempts
  • The episode comes at the beginning of the sleep cycle and lasts for 30 seconds to 10 minutes.
  • The episode occurs only once per night
  • Unawareness of surroundings and interactions during the episode
  • Zero or limited memory of the episode the next day

Night terrors usually occur during the earlier phases of the sleep cycle, during non-REM sleep. To be considered night terrors, only some of the symptoms need to be met.

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What can parents do if their child has night terrors?

As a parent, dealing with night terrors can be challenging, but here are some strategies that can help:

  1. Remain calm: During an episode of night terrors, try to remain calm and comforting, even if your child seems inconsolable or does not recognise you. Be present around the child.
  2. Ensure the child’s safety: Make sure the child’s sleeping environment is safe to prevent injuries. This may mean removing sharp objects or securing windows and doors.
  3. Avoid waking the child: Do not try to wake your child during an episode, as this can be difficult to do and can increase their confusion and anxiety.
  4. Create a calming routine: Make sure your child has a relaxed routine before bedtime to reduce stress and promote a calm transition to sleep. Take your child to the toilet and let them pee before bedtime.
  5. Maintain a regular sleep schedule: Make sure your child goes to bed and wakes up at the same time every day, even on weekends, to promote regular sleep.
  6. Minimise stress: Try to minimise stress in your child’s life, as it can contribute to night terrors.
  7. Observe patterns: If the night terrors occur at roughly the same time each night, try gently waking your child 15-30 minutes before the expected time to break the pattern.
  8. Talk to a professional: If night terrors are frequent, highly disruptive, or continue to occur as your child gets older, consider consulting a paediatrician or child psychologist for further guidance and support. Some epileptic seizures may look similar so seek professional help if necessary.

Understanding that night terrors are part of a child’s development and usually not a sign of a deeper problem can help you deal with the situation with more patience and empathy. If you feel it is a problem or are unsure, seek professional help.

12 common questions about night terrors in children

What are night terrors?

Night terrors are a sleep disorder that can be worrying for both children and parents. It usually occurs in the early hours of the night and is characterised by intense fear or panic. The child may scream, cry, gasp for air, and appear inconsolable, but is usually not fully awake and rarely remembers the event the next day.

Are night terrors different at different ages?

Night terrors are more common in younger children and tend to diminish as children get older.

Are night terrors dangerous?

Although night terrors can be frightening to witness, they are usually harmless and children usually outgrow them.

What are the symptoms of night terrors?

Symptoms of night terrors include sudden awakening with panic, screaming, increased heart rate, sweating, disorientation, resistance to comfort, and even physical activity such as sitting up or running around. These episodes, lasting a few seconds to 10 minutes, occur once a night during non-REM sleep, and the child rarely remembers the event the next day.

What can parents do if their child has night terrors?

In the case of night terrors, it is important for parents to remain calm, ensure their child’s safety without waking them, and maintain a regular sleep routine. Consultation with a doctor or child psychologist can also be helpful to rule out underlying causes and get further advice.

My child screams hysterically at night, what should I do?

If a child is screaming hysterically at night, start by ensuring the child’s safety and try to calm them down with a quiet voice and safe proximity without waking them up. If the episodes are recurring, it may be advisable to seek advice from a professional to rule out medical causes or get support to manage the situation.

What is a child psychologist?

A child psychologist is a licensed professional with knowledge and experience in promoting the well-being and mental health of children and parents.

What does a child psychologist do?

Child psychologists offer therapy and counselling, but also work with families to support the whole family when necessary. They also work with schools to help create good conditions for the child.

Can I see a child psychologist online?

Lavendla offers online counselling sessions via video conference. Feel free to book an introductory session through our website.

I am worried about my child’s night terrors, what should I do?

If you are experiencing anxiety, and have consulted a professional to rule out medical causes, it may be helpful to undergo self-therapy to manage your anxiety.

Do night terrors go away over time?

Night terrors are common in young children but usually resolve over time. Only 1-2% of adults have night terrors.

Where can I go if I or my child needs help from a child psychologist?

You can turn to different organisations, such as Family Lives which provides to support to families. Lavendla also has experienced child psychologists who are ready to help.

Treatment with a child psychologist

Seeking help from a child psychologist is an important step when a child is experiencing mental health difficulties or if you are having difficulties as a parent. Here is a brief overview of what treatment can look like:

First step: Initial consultation where the psychologist assesses needs through conversations with the child and parents.

Treatment plan: An individualised plan is developed, based on your specific situation and needs.

Types of therapy: Common methods are talk therapy and cognitive behavioural therapy (CBT), which focus on changing negative thought patterns and behaviours. Other methods such as family therapy can also be helpful. Parental counselling, that provides guidance and support is also common.

Monitoring and adjustment: The treatment plan is continuously evaluated and adjusted as needed to ensure the best possible outcome.

It is important to remember that each child is unique so treatment may vary. Working with a child psychologist can give you and your child the tools necesssary for managing emotions and behaviours in a healthy way. At Lavendla, we have experienced child psychologists who can help make the difficult easier.

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Written by dominic

Dominic is a Cape Town-based copywriter and editor with a background in psychology.