ASK THE EXPERT:Night terrors occur during deep sleep, as opposed to nightmares which occur during REM, writes DAVID COLEMAN
Q Our seven-year-old son has been suffering from night terrors since he was about five. He also has nightmares occasionally and we are fully aware of the difference between the two!
The ‘terrors’ tend to happen most if he is over-tired or has something like a school play on his mind. I have never sought a professional opinion on this as I was hoping he would grow out of them. Am I right to take this approach?
When they first started, he would not remember the episodes the next morning. Lately, while still suffering from the same blind panic, he makes some sense (as opposed to previously when he just muttered un-intelligibly and rushed around the room in a terrible state). He will now ask “please help me mammy” during the ‘terror’ and I can usually calm him down.
He also remembers these episodes the next morning. Is this significant?
He is a bright and sunny child otherwise, with lots of friends and a happy life both at home and at school. He is, however, a little excitable! Is it okay to presume he will grow out of these night terrors or should I consult somebody like a psychologist?
A The core answer to your query is “yes” he will most likely grow out of them and “no” there is no great benefit in bringing him to a psychologist as there is no specific treatment or cure. Additionally, most psychologists and GPs know little about night terrors and, in truth, they are little understood phenomena generally.
What we do know about night terrors we have learned from studies that have been done in sleep laboratories. They are most commonly found in children aged between three and five years old, although younger and older children and even adults can experience night terrors.
You are correct to differentiate between night terrors and nightmares. Normal dreams (and these include nightmares) occur during the period of rapid eye movement (REM) sleep. This is a stage of sleep when your brain becomes active but you remain sleeping. Prior to REM sleep, we are in what is called either stage four sleep or deep sleep.
This deep sleep stage usually has little brain activity going on and is the period of most restful sleep. Unusually, however, this deep sleep period is also when the night terrors occur. As a result, the person will remain very deeply asleep and quite resistant to being woken up. It is also the reason why most sufferers from night terrors never remember their nocturnal fear.
A lot of the anecdotal evidence from sufferers of night terrors suggest that being over-tired, being stressed, being hot or having a very full tummy going to bed will make them more likely to occur. So I am not surprised to hear the apparent triggers you mention for your son.
Usually the experience of a night terror is as you describe; one of blind terror or panic. Often a child (or an adult sufferer) will be screaming and moving around their room. It is okay to try to comfort or soothe them, even if you wake them up. However, the terror can continue for a while after they are awake and so it is important to be very gentle in waking someone experiencing a terror.
If you can’t comfort, soothe or awaken the person then it is just about sitting it out with them until the terror passes. Do speak to them in very calm reassuring tones, letting your child know that you are there and that everything will be okay, even if they remain asleep.
While it can be very distressing to witness your child in such dread, fear and panic, the only real harm they might come to is that of hurting themselves by knocking into something in their room or by stumbling and falling.
Perhaps more effective than trying to deal with the emergence and aftermath of a night terror is to try to avoid them in the first place! As I mentioned, there are no clear treatments for night terrors but there are some things that it might be worth trying with your son.
Central to this is trying to help him feel relaxed and at ease going to bed. If he has had a really busy day or is anticipating a very busy day the next day then he will be quite keyed up. Things like massage, story-time, essential oils like lavender or chamomile, a bath or a foot-rub will help to relax him.
Try to keep his room cool and perhaps get one of those duvets that come as a separate 4.5 and 9 tog that can be buttoned together to make a 13.5 tog for the winter so that he can have a lighter duvet for the summertime (such as it is!).
Night terrors are not guaranteed to pass as he gets older but it may be that as he gets older he will come to recognise and take more responsibility for his tiredness levels and you may then find that they occur with much reduced frequency.
- David Coleman is a clinical psychologist and broadcaster with RTÉ television
- Readers' queries are welcome and will be answered through the column, but David regrets he cannot enter into individual correspondence. Questions should be e-mailed to healthsupplement @irishtimes.com