September is the month of back to school; and we wanted to dedicate the first post after the summer to the youngest members of the household to deal with a very interesting but fortunately uncommon topic, a sleep disorder or parasomnia, which is more popularly known as night terrors. Children who suffer from these sleep disorders; around 3-15% of the child population, are usually between 4 and 12 years old, the most common age being between 5 and 7. They disappear progressively, although they can persist until adolescence and are more common in boys. Their parents experience these episodes with great concern; for this reason we want to go into more depth to detail the symptoms and the differences with nightmares, if any measures or treatment are required and what parents can do. What is night terror Witnessing a night terror can be unsettling for parents, but it is not as traumatic for the child as it may seem. Once the episode is over; the child quickly falls back to sleep and doesn’t remember anything. Night terrors are a transient sleep disorder; one of these episodes can last between 5 and 15 minutes and involve abnormal and unnatural movements, behaviours, emotions, perceptions and dreams that occur while falling asleep, during the first phase of sleep, or during sleep deprivation. Note that night terrors are not dreams or nightmares. Night terrors occur during REM sleep, whereas night terrors are a sudden fear reaction that occurs as you shift from one sleep phase to another. This transition is smooth most of the time, although some children may become frustrated or frightened and suffer a night terror episode. When these episodes occur They usually occur during the first half of the night; within 2 hours of going to sleep (during the slow wave sleep phase), when they have not yet started to dream and appear with significant signs of autonomic activation and loud screaming (increased breathing, tachycardia, sweating, etc.). What are the symptoms Suddenly sitting up in bed. Screaming or crying in distress. Breathing faster. Resisting being touched or held, defensive or hasty flight movements. Increased heart rate. Sweating. Thrashing around. Does not recognise or appear to see parents or respond to attempts to calm him/her. Becoming angry and frightened. Opening eyes, but not waking up. Calm down after a few minutes and fall back to sleep. Not remembering the episode when waking up. Unlike nightmares, children who have a night terror go back to sleep easily (in most cases), they may not even wake up completely and the next day they will not remember anything that happened. Why it happens This sleep disorder is not associated with any type of emotional problem, neurological or psychopathological disorder, but according to child health experts there may be triggering factors: Being too tired or not getting enough sleep. Being ill or stressed. Taking new medication or sleeping in a different place. Having a family history of night terrors or sleepwalking. What to do The first thing to remember is that the best thing to do, according to experts, is NOT to wake them up. Otherwise they will feel disoriented and dazed. The best thing to do is to accompany them until they calm down and fall back to sleep naturally, to prevent them from hurting themselves or falling out of bed (place a railing if they sleep alone in a high bed). What else can we do? Try to reduce stress in your child’s life. Create an easy, relaxing routine at night to help your child sleep better. Make sure your child gets enough sleep. Don’t let your child stay up late. Try putting your child to bed 30 minutes earlier than usual if they are overtired. If they have night terrors at the same time every day, try to wake them up 15 to 30 minutes before they occur. When to see a specialist Some children experience only one night terror, while others experience several. However, these episodes stop occurring as the nervous system matures. It is rare for a child to have frequent night terrors over a very long period of time. Therefore, if you notice that they happen frequently, we recommend that you consult your paediatrician for referral to a sleep specialist if necessary.