Q; What do the Boogie Monster, things that go bump in the night and spooky shadows on the wall have in common? A: The power to make you run back and forth between your room and your toddler’s every single night. Once you got that whole sleeping through the night thing mastered, you thought you were home free from bleary-eyed mornings. But deep sleep has nothing on your child’s imagination. We asked Child Psychologist and Anxiety Expert Joanna Robin, Ph.D. how to tell the difference between nightmares and night terrors and how we can help soothe our little ones from both.
Helping Your Child with Nightmares and Sleep Terrors Sleep problems are common among children and adolescents, with up to 25% of youth suffering from them at some point. Two common types of sleep problems are nightmares and sleep terrors. It is important for parents to understand these problems, as they can look similar but are treated differently. Nightmares generally occur in REM sleep during the latter third of the night. When a child has a nightmare, typically she can recall details of the dream when awakened, can be comforted by a parent, and does not speak or move much until awakening. In contrast, when a child has a sleep terror, she awakens suddenly and looks upset and frightened. The child may appear to be awake because she cries out or screams but is actually asleep, has difficulty recalling the event the next day, is difficult to comfort, and may move, sit up, or talk during the incident. Typically sleep terrors occur during the transition to deep sleep, within the first few hours after the child falls asleep. Parents should not to be concerned about their child’s nightmares unless (a) they occur frequently, (b) the child fears going to sleep, or (c) the child regularly loses sleep. However, frequent nightmares can be distressing for both children and parents. To minimize the occurrence of nightmares, parents should create a comforting and consistent nighttime routine. Avoid scary stories and televisions shows before bedtime. If a stressful life event has occurred, talk to your child about his/her stress and change the circumstances if possible. Finally, make sure your child is getting enough sleep to minimize frequency of nightmares. At times, children may avoid going to sleep due to fear of having a nightmare. Below are strategies to minimize this fear: · Comfort your child and let him know you are there to keep him safe. · Allow your child to keep a light on or have a night-light. · Use deep breathing or progressive muscle relaxation with your child · Provide your child with a security object · Try creative techniques, such as having your child “rewrite” the endings to her nightmares, and drawing pictures of her nightmares and throwing them away · For a young child, it can be helpful to use the idea of “magic” (e.g., spray “magic spray” in the room to ward off the monsters, wave a magic wand to protect the child from nightmares) Similar to nightmares, children typically outgrow sleep terrors and medical intervention is not often needed. Sleep terrors are actually more upsetting for the parent than for the child due to the child screaming or flailing during the event.
Shelby Harris, Psy.D, Director of Behavioral Sleep Medicine Program at Montefiore Medical Center suggests that sleep deprivation, failure to maintain a consistent sleep-wake schedule, caffeine intake (soda, chocolate, coffee, tea), fever, and certain medications can increase the likelihood of sleep terrors. Sleep terrors are not caused by mental illness, but they can be made worse with stress. She cautions parents that although it may be tempting to talk to your child during the sleep terror, it is better not to engage the child in conversation or awaken them, as this may actually prolong the event. Parents should make sure that the environment around the child is safe to eliminate any risk of harm. Typically children have little memory of the experience, so it is best not to dwell on it the next day. Although nightmares and sleep terrors can be upsetting, most children grow out of these behaviors and sleep well through the night with minimal disruption. If parents are concerned about their child’s sleep problems, consulting with a sleep specialist may be helpful, as sleep problems are highly treatable. –Joanna Robin, Ph.D, Licensed Clinical Psychologist, Instructor in the Department of Psychiatry at Columbia University Medical Center, Columbia University Clinic for Anxiety and Related Disorders