Night Fears

If you've got a toddler, you should know about two common sleep problems: nightmares and night terrors.

Introduction

It was only 11 p.m. when my son, then 2, woke up screaming. I raced into his room -- and stopped cold. Matt was sitting up, eyes wide open, shrieking. When I touched him, he became even more agitated. I panicked. Was he having a seizure? Yet just as suddenly as the strange episode had started, it ended. Matt stopped screaming, lay down, and closed his eyes. When I bent over him to check, he was sleeping peacefully. The next morning, he remembered nothing.

What my son had experienced, I later learned, is called a night terror. If your child has never had one, you're lucky: This disorder affects thousands of children yearly. Yet even a regular nightmare, which all kids have, can leave parents bewildered. Both night terrors and nightmares, though not unheard of in infants, grow more common at age 2. Knowing how to cope with them will help you and your toddler sleep easier.

Terrors: The Unscary Truth

Night terrors belong to a class of sleep disorders called parasomnias, which occur when someone is partially roused from deep slumber. Though your little one's eyes may be open, he's not awake. "He isn't responding to his environment," says George J. Cohen, M.D., editor of the American Academy of Pediatrics' Guide to Your Child's Sleep (Villard, 1999). "A night terror isn't a dream. It happens during deep sleep, when a child is not dreaming, and he doesn't come fully awake," adds Jodi Mindell, Ph.D., an associate professor of psychology at St. Joseph's University, in Philadelphia, and author of Sleeping Through the Night (HarperCollins, 1997). No one knows for sure whether a child in the midst of a night terror is actually feeling distressed, especially because sufferers can't remember the episode the next day.

Unsolved Mysteries

What causes this odd phenomenon of being caught between slumber and wakefulness? It's not usually possible to figure it out, although in certain uncommon instances it's related to a medical condition called obstructive sleep apnea (see "All About Apnea," right). As for timing, night terrors "usually happen an hour or two into sleep," Dr. Cohen says. Symptoms include screaming, an appearance of fearfulness, and withdrawal when touched. And though a child who's having a nightmare is easily comforted by being awakened and held, a toddler experiencing a night terror is almost impossible to rouse. Because waking him is so difficult, don't even attempt it. Instead, just stand by until the episode is over, keeping your child from falling if she flails about or starts to walk around (sleepwalking can be a related parasomnia).

Unfortunately, there's no foolproof way to prevent night terrors. But you can put safeguards in place in case of recurrence (a wise idea, especially if there's a history of the problem in your family). If your child still sleeps in a crib, you're in luck; there's little chance he can do himself harm by falling out. If your child is already sleeping in a big-kid bed, though, you'll need to take some extra steps to protect him. If his room is on an upper floor, put a gate across the stair landing. Clear the floor, lay down pillows to buffer falls, and raise the bar on your child's bed, if there is one. Consult your pediatrician if terrors start coming nightly or semiweekly. Luckily, the episodes almost always taper off steadily in early childhood, becoming unusual by the time a child is 8 or 9 years old.

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