Night terrors, also known as sleep terrors, are episodes of intense crying, fear, flailing, and potential inconsolability that occur during sleep, typically in the early stages of the night. They are most common in children ages 3-12 and affect boys more often than girls. 

Night terrors are different than nightmares. With nightmares, the child wakes up from REM sleep and can usually remember details about what they were dreaming about that scared them. With night terrors, the child is partially awake but not fully conscious and typically has no memory of the event the next day.

Causes

The exact causes of night terrors are unknown, but they appear to be linked to stages of deep non-REM sleep. Things that can make night terrors more likely include:

  • Sleep deprivation or disruption – This decreases time spent in deep sleep so there is a rebound effect.
  • Stress, anxiety, medications, or fevers – These can increase deep sleep and REM sleep. 
  • Genetics – Night terrors often run in families.
  • Developmental factors – Night terrors often start around age 3-4 when areas of the brain that regulate sleep are still developing. They typically go away by adolescence as the brain matures.

Night Terror Episodes

Night terror episodes usually last from 1-10 minutes but can sometimes go on for up to 30 minutes before the child calms down and returns to deep sleep. They most often occur in the first third of the night during periods of deep slow-wave sleep.

The child may abruptly sit up in bed and shout or scream loudly with a look of intense fear on their face. Their eyes are usually open but have a glassy, distant stare. They do not respond to comforting from parents or carers and may be inconsolable or confused. 

Though night terrors can be disturbing for parents and carers to witness, the child is not awake or aware during the episode. They are usually unable to remember anything about it in the morning. Trying to restrain or wake the child during an active night terror is not recommended, as this can cause more agitation. It is best to make sure the area is safe and wait it out.

Prevention and Treatment

While night terrors cannot be completely prevented, the following can reduce frequency and severity:

  • Maintain a regular sleep schedule with an earlier bedtime – this is especially important for foster children who may have come from disordered homes.
  • Reduce stress.
  • Avoid sleep deprivation.
  • Use a sound machine or white noise to prevent waking at noise. 
  • Comfort them afterwards but do not dwell on the episode in the morning.

Most children eventually outgrow night terrors on their own without treatment. If they persist or are causing significant distress or danger, a doctor may explore underlying causes or rarely prescribe medications to alter sleep stages. Relaxation strategies may also help lower anxiety.

If the child you are fostering with Active Care Solutions has night terrors, mention it to your social worker in case there is an underlying cause you are unaware of. 

In most cases, patience and reassurance is key. Explain to your child that the episodes are not their fault and are not dangerous, even though they may seem scary. Making sure both you and your child get sufficient rest can also minimise frequency so the night terrors eventually fade away.