What happens during the episode
Sleep consists of alternating stages. The first half of the night is dominated by deep slow-wave sleep, from which it is most difficult to get out of. In children, the mechanisms of transition between stages are still immature, and sometimes the brain gets stuck between sleep and wakefulness: the body reacts as if it is awake, but the mind remains asleep. Hence the scream, fear and vegetative manifestations in the complete absence of contact. Due to immaturity, these episodes most often appear between the ages of 3 and 8 years and belong to the same group as sleepwalking and sleeptalking.
- Occurs in deep slow-wave sleep
- Usually 1–3 hours after falling asleep
- The child has no contact and does not remember the episode
- The same group of sleepwalking disorders
- Often occurs in several family members
- Usually disappears by adolescence
How are they different from nightmares?
A nightmare is a terrible dream that happens in the second half of the night, during the REM sleep phase. After a nightmare, a child wakes up completely, seeks consolation, recognizes his parents and can tell the contents of the dream, and sometimes is afraid to fall asleep again. With night terrors, the opposite is true: the episode occurs in the first half of the night, there is no contact, consolation does not work and even increases excitement, and in the morning the child does not remember anything and is calm. The episode seems much worse to the parents than to the child himself.
- Night terrors - the first half of the night, nightmares - the second
- When fearful, the child does not wake up and does not recognize loved ones
- After a nightmare, the child remembers the dream and seeks support
- Fears end in peaceful sleep
- In the morning the child does not remember fear
- Nightmares can cause fear of falling asleep
What provokes
The most common provocateur is lack of sleep and disrupted routine: the more overtired the child is, the deeper the first sleep and the higher the likelihood of an episode. Fever, illness, jet lag, late going to bed, too many impressions and gadgets before bed, a full bladder, and noise also play a role. Disturbed breathing during sleep deserves special attention: enlarged adenoids and snoring with pauses in breathing often support such episodes, and their treatment often solves the problem.
- Lack of sleep and irregular schedule
- Fever and infectious diseases
- Overwork and excess impressions
- Screens and active games before bed
- Snoring and sleep apnea, enlarged adenoids
- Noise and uncomfortable room temperature
- Stress and anxiety, especially during times of change
What should parents do during an episode?
The main rule is not to wake the child or try to hold him back or convince him: this prolongs the episode and increases excitement. You need to calmly stay nearby, speak quietly and make sure that the child does not hit or fall. Ensure safety in advance: remove sharp objects, close windows, install gates on stairs. After the episode, the child usually lies down and falls asleep. In the morning, you shouldn’t ask him in detail and scare him with a story - he doesn’t remember anything, and a discussion can cause anxiety before going to bed.
- Do not wake up or forcefully restrain
- Speak quietly, stay close
- Remove dangerous objects, close windows
- Do not discuss the episode with your child in the morning
- Record time and duration of episodes
- If you tend to sleepwalk, a safe bedroom
Prevention and when you need a doctor
The best remedy is adequate sleep for your age and a stable routine: the same time of going to bed and getting up, a calm ritual before bed, no screens an hour before bed, a cool dark room. If episodes occur at nearly the same time, some families and their physician discuss an advanced awakening technique—waking the child gently, superficially, 15 to 20 minutes before the usual episode time for several weeks. Medicines are used rarely and only as prescribed by a doctor. You should consult a doctor if the episodes are frequent, unusual, or accompanied by snoring with pauses in breathing or daytime sleepiness.
- Sufficient sleep duration according to age
- Same time for laying down and getting up
- A Calm, Screen-Free Bedtime Ritual
- Cool, dark and quiet room
- Treatment of snoring and adenoids if present
- Advance awakening method - in consultation with the doctor
- Examination by a neurologist for stereotypic seizures