Night Terrors Taking the Fear Out of Bedtime Hours

Taking the Fear Out of Bedtime Hours

You're awakened by a blood-curdling scream. You race to your child's room to find her sitting bolt upright in bed, howling, her eyes wide open and filled with terror. You call her name but she stares right through you, as if you aren't there. She may begin thrashing and striking out. She may even try to get out of bed. Then as suddenly as it began, the ''spell'' is over and she's sound asleep.

''Most parents who witness this say the child looks like she's possessed,'' says Barbara Howard, M.D., assistant clinical professor of pediatrics at Duke University Medical Center in Durham, North Carolina. ''But there's a perfectly rational explanation. The child is experiencing a night terror.''

Though night terrors may sound like something that requires professional help, they are actually normal and fairly common in children. Experts say they occur during the deepest part of the sleep cycle, about an hour or two after the child falls asleep.

''Normally, this is the point where the child cycles into a lighter sleep where dreams occur,'' says Ronald Dahl, M.D., director of the Children's Sleep Evaluation Center at Western Psychiatric Institute and Clinic in Pittsburgh and associate professor of psychiatry and pediatrics at the University of Pittsburgh Medical Center. ''But particularly if the child is very tired, a split may occur. Part of the system says it's time to go into light sleep, but another part says, 'No, I'm still tired.' So part of the brain stays deeply asleep while another part goes into a high-arousal state.''

The child who is having a night terror is not awake, yet not quite asleep, notes Dr. Dahl. And the ''terror'' aspect of this phenomenon really only registers on the parents. The child herself is not conscious, nor does she remember playing out this scene from The Exorcist the next day, says Dr. Dahl.

Nightmares, on the other hand, are very frightening for children. ''A nightmare is essentially a dream that is sufficiently scary to wake a child up,'' says Dr. Dahl. ''In fact, the child may wake up quickly, become fully awake and have trouble getting back to sleep. He may be a little confused, but he'll probably be coherent. A nightmare is likely to occur late in the night or early in the morning, in the second half of the sleep period.''

Both night terrors and nightmares tend to run their course and disappear over time. But there are a few techniques you can use to make things easier for your child.

Night Terrors

Stay calm. ''Remind yourself that although a night terror looks scary, it's not a seizure. It's not a terrible thing,'' says Dr. Dahl. ''Night terrors are very common and normal, especially in kids between the ages of three and five.''

Stand by until it's over. Though it may be difficult to watch your child screaming, there's really nothing you can do to stop a night terror, says Dr. Howard. ''But you can make sure the child is safe when it's happening by restraining her if necessary. Children do sometimes hurt themselves thrashing or running around. And it's almost impossible to wake them.''

Don't mention it. ''Don't talk to your child about the episode the next morning,'' says Dr. Howard. ''And don't let siblings talk to her about it either. Kids don't remember night terrors. But if they find out later what they did, they may get upset about being out of control.''

Try a preventive wake-up call. ''If your child is experiencing terrors, you could try waking her up about 30 minutes after she goes to bed, and then letting her go back to sleep,'' says Dr. Howard. ''That breaks up the sleep cycle and tends to interrupt the pattern of the night terrors.''

Make sure your child is getting enough sleep. ''Increase the total amount of sleep your child is getting,'' suggests Dr. Dahl. ''If she's fairly young, it might mean letting her go back to taking daily naps. For an older kid, try letting her sleep longer in the morning or put her to bed a little earlier.''

The reason for this, Dr. Dahl explains, is that the more tired a child is, the more difficult it will be for her to switch from deep sleep to light sleep. ''The classic time for night terrors to occur is when young children first give up their daily naps,'' he says. ''The first time a kid stays up for 12 hours or more, there's more pressure on her sleep system than she's ever had, and it drives her deeply into sleep, deeper than she's ever been. At the end of that first deep sleep cycle is when she's most likely to have a night terror.''

Think happy thoughts. ''If kids are worried, anxious or a little bit more fearful than usual as they fall asleep, they're more likely to have these events,'' says Dr. Dahl. ''Ask your child if anything's worrying her just before she falls asleep. Often a child who is well-behaved, but shy and inhibited by temperament, will get into the habit of lying in bed and worrying. ''Helping the child establish a positive routine at bedtime can reverse that,'' he says. Have her focus on positive thoughts about the good things that have happened to her that day. Help her feel safe and secure. That seems to cut down on night terrors.''

Talk over fears during the day. ''Help your child express her worries and fears during the day rather than letting them surface at night,'' says Dr. Dahl. ''Often a child who gets night terrors has a small, specific but irrational fear that's worrying her. As soon as she expresses her fear and understands that it's not worth worrying over, the night terrors go away.''

Don't make it a habit. ''Be careful to avoid what's called secondary gain, which means the child gets some benefit from having had a night terror,'' says Dr. Howard. ''Even though the night terror was unintentional, if the child wakes up and finds the parent there, concerned about her and giving her a lot of attention, it can seem like a reward. That can reinforce and perpetuate the problem. So it's important not to coddle the child too much--by waking her and giving her something to eat or drink, for instance.''

Nightmares

Turn on the light. If a child wakes up with a nightmare and comes running to your room, be prepared to listen and find out why the child is afraid. ''Most kids want their parents around,'' says Dr. Dahl. ''Some don't need much more than your reassurance that everything is all right.'' But sometimes, you may have to go back to the child's room, turn on the light and show him there's nothing there. ''The child really needs to spend more time with you until he winds down,'' says Dr. Dahl.

Break the rules now and then. Your child may want to spend the rest of the night in your bed, even if it's not usually allowed. ''It's okay to occasionally break the rules if the child is badly frightened,'' says Dr. Dahl, ''though you may have to nip that behavior in the bud before it becomes a bad habit. Most kids will go back to their bed without protest the next night if you remind them of the rule.''

Give the child a nightmare protector. A flashlight or a ''protective'' stuffed animal can be very soothing to a child plagued by nightmares, says Sheila Ribordy, Ph.D., a clinical psychologist specializing in treating children and families and professor of psychology and director of clinical training in the Department of Psychology at De Paul University in Chicago.

''For a child, it's important to feel he has some control over his nightmares,'' she says. ''Children need to have a sense that they are powerful people so things aren't so scary for them.''

Have a bedside chat. ''If a child is having a lot of nightmares, you may need to help him relieve some of the stress that comes up during the day,'' says Dr. Howard. ''Children these days are under enormous stress. Often they're watching violent movies or TV programs. Sometimes they're subjected to a bully at school or at day care. Or they're being asked to toilet train or deal with a new sibling or give up their room.'' Since these stresses can lead to nightmares, it helps if you can talk to your child about what's happened during the day, according to Dr. Howard.

Follow a calming bedtime routine. '' Your child's experience at bedtime should be a calming one,'' says Dr. Howard. She suggests including a story, a song or cuddly animals in the routine.

Children who are having nightmares may develop a fear of falling asleep, and a bedtime routine that includes books or music can help. ''Playing music or story tapes gives them something to focus on other than the fear of nightmares that might be coming,'' says Dr. Ribordy. ''Often these activities are distracting enough to help them fall asleep easily.''