Toddler Night Terrors

You’re probably familiar with the occasional toddler nightmare. But few things can prepare a parent for the screaming, kicking, crying and even sleepwalking that tend to accompany night terrors in toddlers. Fortunately, these intense nighttime moments aren’t usually a big concern since, like most stages of childhood, kids will outgrow them.

Still, night terrors in children are downright scary for parents and, of course, you’ll want to soothe your tot when she has one. For some help with this, here’s more about the causes of night terrors, how they differ from nightmares and easy ways to try and stop them from happening.

What are night terrors?

A night terror is a generally harmless sleep episode that occurs when your child is partially awake but also in a panic and possibly yelling, kicking, talking gibberish or sleepwalking. Night terrors tend to happen in the deepest part of sleep early in the night, often before you’ve probably gone to bed yourself.  

A night terror may last just 30 seconds, but they can also continue for much longer, even up to 45 minutes, though this is rare. Your child’s eyes may be open during a night terror, but she’s not awake at this moment, nor will she remember anything about it once she does wake up. Other common signs of night terrors include:

• Screaming and shrieking
• Uncontrollably crying
• Bolting upright in bed
• Sweating, shaking or breathing rapidly
• Pushing you away as you try to comfort her
• Kicking, punching or flailing about
• Staring, yet she doesn’t see you
• Looking confused or afraid, but you can’t wake her
• Getting out of bed, trying to run or sleepwalking

What’s the difference between nightmares and night terrors?

You can tell the difference between nightmares and night terrors based on when they take place at night, their intensity and their frequency. Nightmares happen during the second half of the night during the REM (rapid eye movement) stage when dreams occur. During a nightmare, your child will appear as if she’s a little bit restless in the bed while dreaming, perhaps tossing and turning.

It’s only when she’s fully awake that the fear, screaming and crying tend to begin. And when you go to her room to comfort her, she may cling tightly since she’ll likely remember parts of the bad dream and may even tell you about them if she’s verbal enough. Your toddler may also feel afraid and have difficulty settling down and falling back to sleep.

But a night terror happens in the first third or half of the night during lighter sleep — and it’s more dramatic. Your tot may seem to be awake (her eyes are usually open), and she’ll yell and kick. But after it ends, she won’t recall the night terror and will head back to sleep rather quickly since she wasn’t actually awake in the first place.

Nearly every child has a nightmare once in a while during childhood, but night terrors are less common, occurring in about 3 to 6 percent of kids. Night terrors may happen to toddlers as young as 18 months, but they usually take place in kids between the ages of 4 and 12.

What causes night terrors in toddlers?

It’s not exactly clear what causes night terrors, but the over-arousal of the central nervous system during sleep is one physical element. Here are some other causes of night terrors in toddlers:

• Stress. Anxiety due to significant life changes, like a new sibling or starting preschool, may be behind terrors.
• Excess fatigue. Too few Zzzs or an erratic sleep schedule can play a role.
• Sickness. A fever or certain medications are two other potential causes.
• Family history. If you or your spouse had night terrors, your child may be prone to them. In fact, 80 percent of kids who have night terrors also had a family member who did or sleepwalked as well.
• Sleep disorders. Sleep apnea or restless leg syndrome can interfere with your child’s sleep and may up the risk of night terrors too.
• Caffeine. While particular foods aren’t known to cause night terrors, kids who consume too much caffeine may be more likely to experience them.

How to stop night terrors in children

The good news is that once night terrors start, they usually last only a few weeks. In the meantime, here’s what you can do to help:

• Be calm. A night terror is definitely more terrifying for you than it is for your toddler. Still, try to relax when it happens and patiently wait it out at her side.
• Don’t force her to wake. Shouting or shaking your child to wake up may only worsen the situation and confuse your child when she does come out of it. And your reaction may also make it harder for her to head back to sleep.
• Reassure her. If she’s disoriented or worried when she emerges from a night terror, let her know everything’s fine, and then offer some cuddles and quiet talk so she can relax.
• Clear the decks. Since night terrors may be accompanied by attempts to get up, run around or sleepwalk, it’s smart to gently hold her so she can’t get hurt. If she does rise and move about, direct her back to her room and away from stairs or walls. (You may want to add gates to stairwells if your child sleepwalks regularly.)
• Stick to the tuck-in routine. Keep your toddler’s bedtime and routine sacred (bath, story, songs) so she gets enough sleep each night. And nix staying up late on weekends.
• Let the sitter know. If night terrors happen more than once or twice, inform the babysitter, grandparents or other caretakers in case they’re with your tot when they occur.
• Wake her beforehand. Does the night terror happen at about the same time each evening? Many pediatricians recommend waking your child 15 to 30 minutes prior to when night terrors usually occur to help prevent them.
• Reduce her stress. Talk over any shifts in your family’s routine, whether it’s a new job or a move to a different house. And check with your kid’s babysitter or preschool teacher to see if anything’s bothering her. Your goal: reducing your child’s anxiety before bed.
• Avoid caffeine. A light snack before bed is fine or simply a little water, but definitely skip chocolate, soda or anything with this buzzy stimulant. 

When to call a doctor

Start by keeping a diary of your child’s sleep patterns. Make a note of how much sleep she gets (both at night and naps), how long it takes her to fall asleep, how often she wakes and any changes or stressors that have occurred at home. After tracking this information for a week or two, bring it to your pediatrician so you can discuss your child’s sleep issues and learn some strategies for handling them.

Call the doctor if sleep terrors last longer than 30 minutes, or they’re accompanied by a stiffening of the body, jerky movements or drooling. And if your child’s nightmares or night terrors continue despite your efforts or if she’s experiencing daytime dream-related anxiety, talk to your pediatrician. He or she may check for other potential causes (like swollen tonsils) or recommend a sleep specialist.