Night terrors: how to treat them and beat them

Kinderling News & Features

Kids' cries and screams are terrifying for every parent. Especially in the middle of the night.

Not to be confused with nightmares, night terrors are common in kids. One in eight parents will recognise their child as having a night terror once they know what it is.

Dr Chris Seton, a paediatric sleep specialist from the Woolcock Institute, says many children are often misdiagnosed with something else when they actually have night terrors. “Once parents understand that a night terror occurs in a sleeping child, they’re on the path to discovery and understanding,” he says.

What exactly is a night terror?

 “A night terror is what we call a partial arousal, or a partial disturbance of sleep,” Chris defines. “When a child has a night terror, they are actually asleep. The best way to think of a night terror is it’s the equivalent of sleep walking or sleep talking. It’s an awake behaviour in a sleeping brain.”

Listen to Chris on Kinderling Conversation:

In sleep studies, the brain is shown to be asleep, so “they’re one of the few sleep disorders that don’t make kids tired,” Chris notes.

Terrors are very different to nightmares.

“Kids with nightmares have very vivid recall or recollection of their nightmare,” he explains. “In contrast, kids with night terrors cannot remember anything at all about the content, because night terrors occur in non-dream sleep, or non-Rapid Eye Movement (REM) sleep.”

“To parents, night terrors are often interpreted as nightmares because their child is very distressed, screaming, crying and not very responsive to their parents which confuses things.”

This automatic behaviour triggers by the brain is something that a person can’t control, and is very common in the toddler and preschool age group.

What does it look like?

When in the throes of a terror, a child will arch their back, push away from people, scratch, sometimes even spit. This is very distressing to parents if they don’t know what it is.

“Night terrors wake the whole family, so it is an issue,” Chris says. “Paradoxically, the only person with a good sleep during a night terror is the child.”

How do you tell difference between an awake crying child, and an asleep child with a night terror?

Chris shares a useful method for testing if your child has night terror.

“The best way is called visual tracking. If a child’s having a night terror, just move your face to the left and to the right. An awake child will track you with their eyes, they’ll look at you and turn their head,” Chris explains. “A child with a night terror will just look straight through you. They’ll look like they’re in a trance and that’s the best test.”

Also note how your child responds to you when you walk in the room. Chris says that an ‘appropriate response’ as an awake child will mean they reach out for you and respond to any comfort you give.

On the other hand, “a child with a night terror, when a parent comes in the room, very reasonable reassurance will not work. The screaming and crying will continue,” Chris says.

Are kids in pain during a night terror?

The short answer is no.

“The crying and distress in a night terror is not a reflection of true distress or pain,” says Chris. “That’s really important because a lot of… parents think they are in pain, but interestingly the next morning the kids have no recall of this at all. Although they’re expressing crying or pain symptoms, they are not in pain.”

How long do they last?

“It does vary but most kids it’s a couple of minutes at most,” Chris explains.

Occasionally they can be much longer. For a prolonged night terror, Chris recommends that parents who know their child has long night terrors should have a designated time threshold (for example, eight minutes) when they can say, ‘This is too much, I will wake my child up.’

How can we help?

While it’s instinctive for parents to touch and hug their distressed child during night terrors, Chris actually advises the reverse. Ensure they're safe and can't hurt themselves of course, but resist the urge to touch or wake them.  

"Paradoxically, trying to calm a child having a night terror can often blow up in your face,” Chris warns. “[My advice is ] don’t wake your child - stand back, don’t touch because touching will inflame it, and just let it ride its course. There are a few reasons for it. First of all, you’re waking a child who’s asleep, which is not a good thing in itself. The second thing is that kids often become confused."

This approach shortens the night terror and in the long term, the child will have less of them.

According to Chris, there's three things to note that can worsen a night terror:

  1. Touching
  2. Sleep deprivation or irregular sleep patterns. More kids have night terrors in school holidays, so regulate sleep and avoid late nights to minimise night terrors.
  3. Fevers tend to ramp up night terrors. Give them liquid paracetamol or ibuprofen to minimise the effects.

The good news is that most kids grow out of night terrors by the time they start school! And remember that these are medically benign conditions. They’re a nuisance but not harmful.