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Nightmares, night terrors and sleep walking

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There are a range of nocturnal activities which are equally scary for both children and their parents; these include nightmares, night terrors and sleep walking. We provide below an overview of causes, signs and symptoms in children.

Nightmares

Young children have difficulty determining the difference between what is real and what is not, so nightmares are particularly frightening. Most children have nightmares from time to time. Commonly nightmares occur between 4am and 6am – in the REM sleep phase – and almost a quarter of children experience regular nightmares. Age estimates vary but generally experts say they start in children as young as two but are most common at around the age of seven.

When your child wakes from a nightmare he/she will probably come to you for comfort and will probably be afraid to go back to sleep. The child is likely to remember what they dreamed and if old enough will be able to describe what upset them.

Nightmares can be the result of an emotional or stressful experience – dreaming is the way our brain processes events – and the dream may recur until the child gets used to whatever is behind it.

It may help to look at your child’s sleeping arrangements. Sleeping in bunks may not be the best situation if your child is prone to nightmares. A top bunk may be dangerous if the child tries to get out of bed without being fully awake or in a distressed state. A bottom bunk can create a cave-like effect which may add to the child’s fears.

When should I seek help?

If the nightmares are frequent and disturbing the child’s sleep so much that his/her life is being affected even during the day, it’s time to see your doctor.

Night terrors

Night terrors are quite different to nightmares. They usually occur in the deep sleep (non REM) phase (often between 1am and 3am). While a child having a nightmare may scream, in night terrors the child is also likely to be breathing rapidly and sweating with elevated heart rate – in a state of panic. The child’s pupil (the black centre of the eye) may be dilated (large). Although their eyes are open the child is really still asleep. Unlike a nightmare, the child will be unlikely to recall the “ dream ”. The child will be difficult to wake, will appear confused and will be difficult to comfort and may move around. There is usually no memory of the night’s trauma the following day.

Night terrors are most common in children aged between three and five. The terror can last up to 20 minutes. Interestingly night terrors can run in families in a similar way to bedwetting and sleep walking.

What should I do if my child has night terrors?

The child will often go back to “sleep” once the terror passes but you may want to stay close during the terror to make sure they do not hurt themselves. Because the child may get up and move around during a night terror, it is important to make sure your home is safe. Bunks are not a good idea and it would be wise to use stair gates. Because night terrors usually occur not long after the child goes to sleep, some experts suggest waking the child just before the time the terror usually occurs … breaking the cycle. Shouting or trying to “snap” the child out of it will not work and may only make the child more distressed. Hold your child if it seems to help. Try turning on the light and speaking calmly – if the child responds he/she will probably return to bed and sleep well.

Make sure babysitters are aware of the problem and what to do if a terror occurs.

As with nightmares, the child will probably outgrow it.

Consult your doctor if:

  • the terror lasts more than 30 minutes
  • there is jerky movement, stiffening or drooling
  • the child does something dangerous during the terror
  • the child’s day time functioning is affected.

Sleep walking

Like night terrors, sleepwalking usually occurs during deep sleep but may also happen in the lighter sleep stages or non REM. Sleepwalking usually involves more than just walking during sleep. It ranges from simply sitting up in bed and looking around, to walking around the room or house, to leaving the house. It is a common misconception that a sleepwalker should not be awakened. In fact, it can be quite dangerous not to wake a sleepwalker if they are likely to put themselves in physical danger.

Sleepwalking is most common in children between the ages of three and seven. Children who are bedwetters may also be sleepwalkers.

As with night terrors you should make your home safe if you have a sleep-walker, so consider;

  • stair gates
  • no bunks
  • lock windows and doors to the outside

Other symptoms of sleepwalking include:

  • Sleeptalking
  • Inappropriate behaviour such as urinating in cupboards
  • Screaming (when sleepwalking occurs in conjunction with night terrors)
  • Violent attacks on the person trying to awaken the sleepwalker
What can you do if your child is a sleep walker?

Sleepwalking is common in children and they usually outgrow it. If you have additional concerns, consult your doctor.

Tagged:
Paula Skelton

Paula Skelton is a qualified NZ nurse and midwife, a midwifery & childbirth educator and the mum of three lovely girls.

  • A concerned Dad

    My 6 year old daughter regularly yells in her sleep (every night).

    She will often have clear conversations (usually arguments) and they appear to be re-enactments of things that may have occurred during the day, although the re-enactment may be an alternate version of events.
    She will then get out of bed and come up stairs to our bedroom, sometimes not knowing why, sometimes saying she had a bad dream, sometimes appearing to be sleep walking.
    This can happen as often as 4 times a night.
    I used to comfort her and take her back to bed and tuck her in, but as it happens so regularly, and I also need sleep, I now simply tell her to go back to bed.
    I’ve found that taking her to the toilet before bed and after an episode reduces the occurrences, but does not eliminate the problem.
    My latest idea is to play relaxation music or ocean sounds in her room.

    Any help would be greatly appreciated.

    • Maria

      That all is happening to my 6 1/2 year daughter as well, Exactly the same thing I’m wondering as well.
      Any help would be appreciated

  • Emma

    My 3 year son is a notorious sleep talker, he sings and talks sometimes up to 5 hours a night, I initially thought it would pass but he is now starting to be affected during the day from tiredness. I can go in and talk to him when he does it but he doesnt really seem to register anything I say, he just kind of blankly stares at me. I am starting to get really worried about it now. My GP said not to worry but I’m not convinced.

  • Worried Mum

    I’m becoming really concerned for my 3n half year old son… In his life time I have never had any issue’s with bedtime.. being in the dark and going to sleep on his own.. I recently had my fathers ashes bought to my place as my mum was moving away and I felt like I wanted to be closer with my dad.. Ever since the ashes have been in the house.. My son refuses to go to bed..fights being tired.. screams and cries in distraught when he has to go to bed.. He tells me hes scared and that there’s a really scary monster that’s always trying to get him. It makes me really upset to know my son is in fear of sleeping in his own room. I really don’t know what to do about it anymore.. I’m having to let him fall asleep in the lounge n take him 2 bed when hes asleep..but if he wakes up in his rooms he just comes running straight back into my room. I don’t want to believe this could be my dad trying to get through and I don’t want to have 2 remove his ashes out of my house as I have been able to cope with my grieving a lot more having him there.. I’m confused, worried and don’t know what to do and where to even start to get some help… Anyone with any suggestions or advice would be much appreciated :)

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