Night Terrors

Night Terrors

"Every night around 10:30 Billy Bolts out of bed and starts screaming uncontrollably. I often find him running around his room looking frantic. I try to hold him, but he just pushes me away. I don't understand what is happening. He looks terrified, and it frightens me" (Mindell 257).

The above quote represents a classic episode of night terrors, or sleep terrors (the terms are interchangeable). Night terrors - called incubus in adults and pavor nocturnus in children (Durand 31) - fall into a larger category of sleep disorders called parasomnias, which are sleep disorders that are classified by abnormal or paranormal brain activity (psychnet). It's also considered a disorder of "partial arousal", where the child is in a mixed state of both sleep and awakenness. The child will be awake enough to act out (sometimes aggressively), but asleep enough not to be aware of what is going on (Mindell 257, 258). Although they may appear to be nightmares, night terrors are significantly different in various ways.

Similarities begin when the episode begins, usually with a piercing scream. The child will look as though he/she is extremely terrified; physical effects might include dilated pupils, rapid breathing and pulse, racing heart and sweating, and an overall look of agitation (Mindell 259). In the throes of a night terror, a child "may bolt out of bed and run around the room or even out of the house" (Mindell 259). During an extreme episode, children might possibly

hurt themselves or those trying to help calm them down. With nightmares, children are easily awakened and usually seek the comfort of a parent. Such is not the case with night terrors. As stated above, the child might try to harm the one trying to comfort them, and they are not easily awakened. Also, nightmares occur during the REM, or dreaming, stages of sleep. Night terrors occur during NREM, or non-dreaming sleep, which is during very deep sleep (stages III or IV) (Durand 31). Usually, the episode will last on average 5 - 30 minutes. As horrific as all of this is for the parents to witness and live through, the child will have no memory of the incident in the morning. If you or someone else are still having problems distinguishing between night terrors and nightmares, there is an easy way to distinguish between the two: if the child is more traumatized in the morning, it was a nightmare; if the parent is more traumatized in the morning, it was definitely a night terror! (Mindell 260).

The NREM stage, or deep sleep stage, is more intense for infants and young children than it is for adults and older children (Cohen 149). Usually, the partial arousals are inconsequential; however, the form they take and what they mean change with the child's age, health and development (Cohen 149). Cohen also mentions that if a child is experiencing these types of parasomnias, or partial arousals, before age six, that most likely the cause is a genetic predisposition; if the child is over age six, stress is most likely a trigger of these nightly occurrences.

Although children in NREM stages of sleep may appear to be battling unseen dangers or trying desperately to escape some terrible evil, they are not experiencing dreams that they will remember. Experts believe that during this deep sleep stage, and also in the body's transition between sleep stages, that the body's sleep and waking states are both active at the same time, and as such, the sleeper is in a state of partial arousal. This is why children may talk, move, or even walk at such times. They may even sit up, look around, and seem terrified, but are unable to communicate effectively - they aren't able to perform any actions that require higher brain functions. In this state, events are not recorded in the memory. This is why nightmares are so different; during REM sleep, the body is virtually paralyzed - the dreamer is unable to sit up, walk or talk - yet the mind is actively involved in the dreaming, and the dreams are recorded in the memory. Some believe that this near-paralysis is "nature's safety device", to keep us from harming ourselves while trying to escape from the terrifying images in our nightmares (Cohen 150).

There were small discrepancies as to the percentage of young children that experience night terrors: Mindell stated that 3% of children experience them, usually between the ages of 5-7, while Durand's percentage fell slightly higher at 5%. These children will be normal, healthy children. Mindell did mention that younger children may experience night terrors as well; sometimes night terrors can occur in toddlers, but if they occur in a child before the age of one, they should bee seen by a pediatrician.

A study was performed in Quebec to examine the prevalence and developmental changes of parasomnias and also to evaluate gender differences, how the parasomnias are related to each other, and how anxiety and family issues relate to the occurrences (Laberge, et al 1). The study involved 664 boys and 689 girls. The study found that night terrors decreased during childhood; basically, as the children got older, the occurrences decreased and virtually disappeared by adolescence. Also, parasomnias are common in children, night terrors being one of the most common, along with sleep walking, enuresis, body rocking, somniloquy (sleep talking) and sleep bruxism (grinding teeth in sleep) (Laberge, et al 1).

During the study, the mothers of the subjects were questioned as to the age of the onset and the age of the disappearance of the parasomnia - in this case, night terrors. Out of 149 children, for 126 of them (84.6%) the onset of the night terrors began between the ages of 3-10 (Laberge, et al 6). Also, out of those same children, for 100 of them (67.1%), the night terrors disappeared during that age range - ages 3-10 years (Laberge, et al 6). There were no gender differences noted for night terrors in this study - they appear to affect boys and girls almost equally (Laberge, et al 7).

Children with night terrors (also children with sleep talking and teeth grinding, among a few others) had a significantly higher anxiety score than did children with some of the other parasomnias (i.e.: enuresis) (Laberge 7). Family issues didn't seem to affect any of the parasomias (Laberge, et al 8).

No one knows exactly what parasomnias are, and unfortunately, no one knows exactly what causes them, either. In one study I read, it was suggested that these occurrences are related to a delayed maturation of the central nervous system (Fleiss 30). This was the only reading that I saw this in. However, it has been discovered that parasomnias have a genetic link - they run in families. For example, if your child