Battle bad dreams, night terrors and things that go bump in the dark

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It’s the wee hours of the morning and your child is standing at your bedside, tugging at your arm, wide awake and scared: She’s had a nightmare. While witnessing it can tug at your heartstrings, know that it’s also quite typical for children.Nightmare

“Dreams, even disturbing ones, are a part of normal development,” says Dr. Elizabeth Super, a pediatrician and children’s sleep specialist with the Pediatric Sleep Medicine program here at OHSU Doernbecher Children’s Hospital. “Nighttime fears are very common between ages 3 and 6 and often appear as children develop the ability to imagine.”

Nightmares

It’s not unusual for little ones to have one or two nightmares per week. The reason may be that children spend more time in REM sleep than adults (25 percent of a total night’s sleep versus 10-15 percent), the stage of sleep when nightmares (and all other dreams) occur. REM is an active sleep state during which our brainwaves are somewhat similar to a waking state. These REM periods get longer as the night progresses, which might explain why 2 a.m. seems to be the witching hour.

Have a freaked-out 5-year-old on your hands every few nights? Check out Dr. Super’s sensitive approach:

OfferNightmare 2 brief comfort. With most children who are developing typically, simple reassurance will likely be enough. If your child wakes up in the middle of the night, help her settle back down with a hug, a glass of water and kind words, and then lead her back to bed.

Give the fear a name. Younger children can have a difficult time describing what scared them, so asking your preschooler to explain the nightmare probably won’t help get him settled. Instead, provide reassuring words that describe and help him understand the scary experience: You’re safe; It was a bad dream. It wasn’t real; It was pretend. With time he will be able to use these words to calm himself.

Talk about it in the morning. Some children are able to describe bad dreams in the morning. The light of day is a great time to talk, especially if you suspect that the cause for her nightmare might be something in her waking life: scary movies, TV or books; a big transition, like starting a new school year; or a trauma, such as losing a pet. Ask her about what is bothering her – a simple discussion may help alleviate bad dreams.

Dream and discard. If your child is still rattled by his dream in the morning, invite him to draw it. Did the monster eat his dog? Help your child imagine another ending to the dream (the barking dog scares the monster away!) and draw it together. Discard the drawing and with it, hopefully, the nightmare.

Night terrors

Unlike a nightmare, which wakes a child and leaves her feeling fearful, night terrors happen while children continue to sleep. Children may even scream, cry out or become agitated without waking, and may not remember the incident in the morning.

Night terrors are a type of parasomnia, like sleep walking or talking. Unlike dreams, night terrors occur in deep sleep, during a stage called N3 – it’s the type of sleep where you can transfer your child from car seat to crib and she never stirs. Kids spend more time in N3 sleep than adults do, which may make them more likely to have night terrors. Longer stretches of N3 sleep typically happen in the first half of the night, which makes night terrors more likely at 11:30 p.m.

“If it offers a little comfort, know that night terrors are often scarier for the parents than they are for the child,” says Dr. Super. Here’s how to handle them:

Make sure your child is safe. A sharp cry in the middle of the night will send any parent racing into their child’s room. First things first, check that your sweetie is safely tucked in bed.

Decide if it’s a night terror. He may be breathing quickly, tossing and turning, or have a racing heartbeat. If he only briefly rouses and then quickly goes back to sleep, or never seems to wake up at all, then he could be having a night terror.

Minimal interaction. Because your child is still asleep, the simple reassurance that helps for nightmares can actually do more to agitate her. That said, you may want to wait out the episode by her side to reassure yourself that all is fine.

Review her sleep routine. Night terrors are more common if kids aren’t getting enough sleep, or if they’ve had a shift in their sleep schedule. If you suspect the latter, work on getting your child back to his normal routine, with an emphasis on plenty of quality sleep.

Speak to your doctor. If nighttime fears are starting to affect your child’s ability to fall asleep in the first place (he’s too scared of bad dreams to get into bed), if the terrors are persistent, or if you as a parent don’t feel that you are dealing adequately with the problem, speak to your child’s pediatrician.

Remember that this too will pass! This is a developmental stage that most children will grow through with your support and simple reassurance.

Other posts in the Dr. Super sleep series:
What is your baby’s ‘sleep temperament?’
Six strategies to improve your baby’s sleep skills
Monsters under the bed: Banishing bedtime fears
The real scoop on teething and sleep

 

Dr. Elizabeth SuperElizabeth Super, M.D.
Assistant Professor of Pediatrics
Doernbecher Pediatric Sleep Medicine Program
OHSU Doernbecher Children’s Hospital

 

 

 

 

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Lisa McMahan is a social media coordinator working to discover and share stories at OHSU. Got a story idea? Connect with the team: socialmedia@ohsu.edu.
Doernbecher Best in the Country U.S. News & World Report

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