What Are Night Terrors And What Causes Them in Toddlers?Apr 21, 2023
Have you ever found yourself trying to comfort your child from a nightmare when nothing you do or say seems to have a positive effect on them? It could be that they are actually experiencing a night terror! While it’s common to get the two confused, there are differences between nightmares and night terrors that can help you distinguish one from the other, and how you can best help your child.
It’s likely that most children will experience a nightmare at some point, commonly beginning around 18-24 months (though, of course not every child will!). Nightmares are essentially bad dreams that occur during REM (rapid eye movement) sleep. Children tend to spend more time in REM sleep during the last couple of sleep cycles, which is why nightmares often occur in the wee hours of the morning. Though, they can happen at any point during the night when your child is in a dreaming phase.
When your child has a nightmare, it’s likely that they will be completely awake afterward and want to be comforted by you. Of course, I completely encourage parents to comfort their little ones in any way needed after a fearful nightmare experience, but if your toddler is waking throughout the night consistently needing help getting back to sleep from you, it is a good idea to work on independent sleep skills so that your child can successfully fall back to sleep without help when they wake in the night between sleep cycles!
Contrary to nightmares, night terrors only affect up to 30% of children and are most commonly seen in children ages 3-7 years old . Unlike a nightmare, it can look like your child is awake and fearful but they are actually still asleep!
It’s common for night terrors to look like this:
- Abruptly sitting up
- Screaming out
- Thrashing around
- Appearing fearful
- Difficult to wake
Night terrors are parasomnia, or an abnormal occurrence of physical and verbal behaviors during sleep  (things like sleepwalking, sleep talking, or night terrors, like we are discussing). This may sound scary, but generally, they aren’t dangerous unless your child is in harm’s way while sleepwalking or thrashing. They could also be concerning if there is an underlying medical condition causing the night terrors, so it's always best to talk with your child's doctor to investigate possible underlying medical causes or possible stressors that could be contributing to ongoing episodes.
The good news with night terrors is that your child isn’t actually afraid like they may seem, and they won’t even remember the episode in the morning.
What Triggers Night Terrors and How to Help Your Child During One
So what causes these night terror episodes in toddlers and young children? Night terrors are related to the immaturity of a child’s central nervous system. Contrary to what I discussed above regarding nightmares, night terrors occur during the transition between a child’s deepest non-REM sleep into lighter stages of REM sleep (while your child is in between a state of sleep and wakefulness), which is why night terrors usually occur within the first 2-3 hours of a child falling asleep . During this transition between sleep stages, your child may experience some kind of fear (though they’re not really awake or aware), which causes their nervous system to become overly aroused, resulting in a night terror response.
As I mentioned, they can result from an underlying medical condition, but usually, they’re triggered by more commonly preventable circumstances.
This could be:
- Stress: Stress in a child is often associated with a big or meaningful change to their life or schedule, and could look like adding a new sibling to the family, starting school, moving to a new house, potty training, moving to a big kid bed, etc.
- An inconsistent bedtime: Bedtime should be as close to the same time every night as possible (+/- 30 minutes is ideal). This bedtime should also be early to help your child get as much sleep as possible. I recommend a bedtime between 7-8pm for toddlers.
- Irregular sleep: Not sticking to a consistent bedtime, or your child not sleeping well can lead to exhaustion and overtiredness. When the body is used to a certain pattern, but then gets thrown off suddenly and to a large degree, this irregularity in the sleep pattern can cause a night terror to occur.
- Sleeping in a new environment: sometimes sleeping in an unfamiliar place can trigger a night terror. So, if this occurs while you’re traveling, staying at someone else’s house, or even after your child has switched rooms, know that they will adjust once their routine and sleep space are consistent again.
Another trigger could be your child having a fever. Though this isn’t as preventable as some of the other triggers are, it is an easy one to pinpoint if your child is experiencing night terrors while they are ill.
While one last interesting thing to note is that night terrors tend to be slightly more common in boys than girls and that children who get night terrors are more likely to have someone in their family who suffers from some kind of parasomnia like sleepwalking, sleep talking, sleep apnea, sleep paralysis, etc.
During a night terror, the best thing to do for your child is to stay calm and keep them safe if they are thrashing. Some parents may try to wake their child, and while this may seem like it would help your child through this intense moment, this could actually make the episode worse. It’s best to not attempt to wake them; most children will go back to a sound sleep on their own fairly quickly.
How to Help Prevent Night Terrors
If your child is experiencing night terrors frequently and you feel that it may be because they are not getting enough sleep, or not sleeping well, the easiest way to help prevent any more episodes is by putting your child to bed early and at the same time every night. But remember, changes don’t happen overnight. Be consistent for at least a week to see if there is a positive change. If not, and if you haven’t already, consult your child’s pediatrician.
It’s proven that an early and consistent bedtime (as well as a consistent bedtime routine) is a key component to healthy sleep, and when implemented correctly and consistently can completely transform your little one’s sleep . It's also essential to take into account whether your child is having consistently interrupted sleep or poor sleep hygiene. Toddlers should be getting 10-12 hours of uninterrupted sleep each night. It's important to take measures to ensure your child is getting enough daytime sleep and nighttime sleep if your child is experiencing night terrors as a result of sleep deprivation.
One way to assist in the prevention of night terrors more immediately, since keeping a consistent schedule takes time to adjust to, is to determine if the night terrors are happening around the same time each night, and often. With night terrors, it’s common for them to happen around the same time each night that they occur. If that’s the case for you, you can try to gently wake your child just slightly about 30 minutes before it usually occurs to help prevent it from happening that night. It’s ok to help them back to sleep after waking them if they need it, of course.
While most children will outgrow night terrors by the time they are 10 years old , I know how intense and overwhelming they can be for parents - especially if they are frequent. But there really isn’t much you can do to make them stop other than doing your best to address the causes mentioned above. They will typically stop on their own. Do your best to stay calm for your child and simply be there for them. These intense moments will pass!
If your toddler is suddenly struggling with staying asleep through the night, or perhaps has never slept through the night, don’t miss learning about my Toddler Sleep Training Guide. It offers step-by-step advice for supporting your little one through successfully sleeping through the night (and SO much more!). Or check out my 1-on-1 email support package for personalized troubleshooting guidance of one-off sleep issues or more hand-holding through the sleep training process.
   https://www.ncbi.nlm.nih.gov/books/NBK493222/
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