Nightmares and Night Terrors

If your child is having difficulty with nighttime sleep, it often helps to establish sleep routines before bedtime. A four-year-old may respond positively to having a schedule that includes a consistent time for a bath and some quiet time with a bedtime story, and then a time when the lights will be turned off. You might also try getting your child to sleep earlier rather than later; you may find that the nighttime struggles over sleep subside when your child is less tired and cranky. Your child’s need for naps may gradually subside during this time.

Another nighttime issue in this age group is night terrors. Occasionally your preschooler will be in bed, appearing to be awake and upset, perhaps screaming and thrashing, eyes wide open and terrified, but he won’t respond to you. In this case, he’s neither awake nor having a nightmare. Rather, you’re witnessing something called a night terror (or sleep terror)—a mysterious and, to parents, distressing form of sleep behavior common during the preschool and early school years. Typically, the child falls asleep without difficulty, but wakes up a few hours later, wide-eyed and terrified. He may point to imaginary objects, kick, scream, call out (“No, no!” “I can’t!”), and generally be inconsolable. Parents find these experiences particularly disturbing because the child looks and acts so differently from his usual self. (These events are much more unsettling for parents than for the child having them.) The only thing you really can do in this situation is hold the child to protect him from hurting himself. Reassure him: “You’re fine. Mommy and Daddy are here.” Keep the lights dim and speak softly. After ten to thirty minutes of this, he’ll settle down and go back to sleep. The next morning, he’ll remember nothing about the occurrence.

Some children may have just one episode of night terrors, while others experience them several times. It’s not typical, however, for them to recur frequently or for a prolonged period. In cases of very frequent night terrors, sleep medications prescribed by your pediatrician may be helpful, but the best strategy seems to be to wait them out. Since some children have night terrors when they’re overtired, try putting your child to bed about thirty minutes earlier than usual and see if the episodes diminish in frequency. In any case, they’ll disappear naturally as the child grows older.

Sometimes it’s difficult to tell the difference between a nightmare and a night terror. This chart should help.