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: Nightmares and night terrors in children
DEAR DR.PAUL: We have a 29-month-old daughter who has been
having night terrors lately. She often wakes up in the middle
of the night screaming. Needless to say, my wife and I haven't
been getting much sleep and we're going into work exhausted. Please,
can you provide some answers?
PEDIATRICIAN DR.PAUL Answers: One of the most common
concerns of parents is sleep disturbances, including nightmares
and night terrors. Let's discuss nightmares first.
Nightmares occur quite commonly in young children. Typically,
a child with a nightmare wakes up completely, is very anxious,
and usually remembers the content of the dream vividly. Childhood
nightmares require no specific treatment, except for reassuring
the frightened child.
Occasionally, when nightmares become more frequent or occur
on a regular basis, it may be a sign of stress in the child's
life or environment. Also, the content of the bad dream or nightmare
may be a clue to what is stressing the child. Therefore, extreme
situations of persistent nightmares may warrant evaluation of
the child's family/social environment and psychological state.
Night terrors occur less commonly and are different from nightmares.
Typically, children with terrors are out of control, but still
awake. They may be sitting up in bed, appear frightened, staring
with eyes wide open. They may also be sweating, breathing heavily
and complaining of seeing peculiar things or objects that are
not really there. This period of "terror" may last for up to
several minutes and then the child will usually go back to sleep.
What distinguishes night terrors (which occur in less than 5%
of children) from nightmares is that the child does not recall
the dream or event leading to the night terror, and in many
cases, does not recall that anything at all happened during
the night.
Although the exact cause of night terrors, nightmares and other
sleep disturbances, is not understood, they are thought to be
a result of waking up during a certain stage of the normal sleep
cycle. Night terrors occur during the Stage 4 or non-REM sleep
period. Nightmares, on the other hand, occur during another
stage or during REM sleep.
Night terrors are generally infrequent and usually stop on their
own without specific treatment. In rare cases where night terrors
are frequent and/or associated with sleep walking, specific
medications may be required. Again, this occurs very rarely.
To summarize, most children outgrow both nightmares and night
terrors. Knowing this fact is a relief to many parents.
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designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
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