We've all experienced a nightmare or two during our lives. You know the feeling. You fall asleep restfully, and then you're pulled into what feels like an alternate reality, and not a good one. Chances are, you'll wake and remember it in complex detail. Nightmares are scary and awful, but night terrors are something more. They're a violent, full-bodied, interactive hell for the participant, and unfortunately, that participant is usually a child. (Sometimes, a very young child.) If you've noticed erratic sleeping behavior in your little one, you're not alone. But when do toddlers start having night terrors?
Night terrors are the terrifying cousin of the nightmare. Both are considered parasomnias (disordered sleep behavior) but night terrors are decidedly more rare, only affecting two to six percent of children, according to the journal of the Psychiatric Clinics of North America. They can happen in children as young as just over a year old, and come on suddenly. Night terrors, unlike nightmares, happen during NREM sleep, which means the body is not in a paralyzed state, and that's why they're so frequently violent, and can lead to thrashing, screaming, and sleep walking. It's also nearly impossible to rouse someone out of a night terror, because they aren't going to make the connection that allows them to be awoken.
Seeing your child go through that would be difficult for any parent. However, for parents looking for answers, they might be disappointed to discover that their pediatrician doesn't know much more about the disorder or how to treat it any more than they do, noted The American Psychological Association (APA). The APA wrote that "...most healthcare providers receive little if any training in pediatric sleep problems — and most training that does exist tends to emphasize medical rather than behavioral interventions." It's simply not an avenue of study to which much time is devoted in school or practice, which is unfortunate.
According to a presentation by Dr. Cami Matthews, MD, Associate Professor Division of Pediatric Pulmonology and Sleep Medicine at the University of Wisconsin Department of Pediatrics' Wisconsin Sleep Center, sleep terrors or pavor nocturnus usually happen between the ages of 4 and 12, and they're associated with "Pallor, sweating, pupil dilation, piloerection (hairs standing on end), tachycardia (rapid heart rate), and screaming." The children do not respond to attempts to arouse, and often do not remember the event upon waking. (Thank heavens for small favors.)
According to the University of Utah, night terrors are typically caused by being overtired. However, there are other possible underlying conditions that might trigger these events such as medications, fever, or stress, according to Dr. Matthews' presentation.
The remedies aren't simple ones, according to the APA, even though on first glance they appear to be fairly straight forward. They begin with basic sleep hygiene, which sounds easy, but to a parent of a child who is already overtired from a previous night's broken sleep, getting them down can feel like wrestling an alligator in an inky swamp. As per the University of Utah, the aim is to get them out of the pattern of disrupted sleep into a pattern of restful slumber. The website suggested that if your child has recently dropped a nap, encourage them to start it back up. For older children, you can try waking your child after they fall asleep, but before the night terror would usually begin, thus disrupting the pattern. However, the University of Utah noted that you shouldn't even bother trying to wake them during a night terror — it won't work.
As to when toddlers start having night terrors, it's disheartening to realize your baby who isn't even yet stringing together a sentence may be experiencing these episodes. Worse is that there is no silver bullet to treat them. You do the best you can, try to keep good sleep habits, and if you have to, call their pediatrician.
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