Some Children Experience Night Terrors

 Vijai P. Sharma, Ph.D

Several years ago a colleague of mine, mother of a three year old child, asked me what could be the reason for her child to panic and scream in the night for no apparent reason. 

She was a, very loving and caring mother, highly sensitive to her child's physical and emotional needs and doing the best she could to comfort and make her child feel secure. In spite of that, the child still screamed and panicked in the nights. 

A mental health professional, she read extensively about children's nightmares and found that it did not fit the pattern. I asked her a few questions about it and observed that those were "night terrors (Pavor Nocturnus)," which are totally different from nightmares and unlike the latter, have a physical basis. 

Very little had been written about night terrors and they still are a relatively unknown condition. So when a reader of this column recently asked me if I would write about the night terrors because her grandchild seemed to have them, I called my colleague in Arizona to find out how her child was doing now. She told me that night terrors disappeared around five years of age. She had a second child who too had night terrors but grew out of them around the same age.

More than 30 percent of preschoolers suffer from sleep disruptions. Nightmares, night terrors, sleep walking, and sleep talking are especially common among children. Most of them outgrow these problems by the time they reach late adolescence. 

Night terrors are especially frequent in children. They occur in the first third of the night when child goes into the first period of deep sleep. They can occur as early as 15 to 30 minutes after the onset of the sleep. 

Night terrors are not a result of a frightening dream. Night terrors occur in deep sleep while nightmares occur in dream sleep. In children, night terrors may be a result of an "immaturity" of sleep pattern in which the brain has still not learned how to make a smooth transition from deep sleep to light sleep. Our sleep shifts from deep sleep to dream sleep, or light sleep. Electrical brain wave pattern changes at different stages of sleep. Perhaps the brain waves pattern shifts too suddenly from "slow waves" of deep sleep to waking alpha waves. As a result, child may sit up in the bed, with a frightened expression, scream loudly, excessively or with a sense of intense terror. 

Sleep walking and night terrors are closely related. The brain waves, heart rate, and breathing rate are similar in the two states. Many children sob or scream, thrash around, run through the house, their eyes are wide open with "glassy look" but do not see anything in the normal sense of the word. 

They can't hear what the parents are saying, so the soothing and comforting words of parents don't have any calming effect. 

In extreme cases, there may be groaning, moaning, cursing, or blood curdling screaming or crying. They may hallucinate and act out in the night terror. In some cases, a person may sleep walk after the night terror episode. Heart rates may reach 160 to 170 beats per minute m just ' 15 to 30 seconds. There is no other situation in which heart rate accelerates so rapidly as it does in a night terror. Breathing rate also increases and there may be tremendous increase in the amplitude of breathing. 

The good news is that the night terror episode lasts only a minute or two, although for parents, it may feel like for ever. The child returns to sleep rapidly. Though the parents may worry about it for days, the child does not remember anything of it the next day. 

We are not aware of any painful or negative after effects of night terrors. They may be viewed as part of "growing pains." 

A word of caution: If the night terrors begin in late adolescence or adulthood, a neurological check-up is advised because in some cases it may be an indication of a temporal lobe epilepsy or some other form of seizure disorder.

Night terrors are more disturbing to the parents than to the children. Children generally go back to sleep rapidly and have no memory or after effects of it. A night terror lasts for a minute or two. So take heart and when it occurs, just wait it out. Stay calm. Wash the child's face with a cool wash cloth. Gently rub the child's back, hold him or her and provide the physical closeness. Words do not have much meaning for the child in that state. The child will gradually lose that glassy stare. 

Keep a regular sleeping schedule. Over stimulation during the day time is to be avoided. Let the child rest sufficiently. A daytime nap, if followed consistently, may be helpful. If the terrors occur very frequently, medication, such as diazepam, may be considered. 

Medication suppresses the deep sleep and as deep sleep disappears, night terrors disappear. Counseling may be helpful for parents.
Reader response

Dear Dr. Sharma:

Ever since we started dealing with night terrors in my daughter, I have taken a great interest in anything written on the subject. I would like to tell you our story.

My daughter started getting night terrors at about 18 months of age, just the time she was eating a regular, adult diet. They were severe, lasting up to 45 minutes, and included thrashing, screaming, and unresponsiveness. I started charting activities, schedule, and diet to see if I could correlate frequency and severity with anything in her waking hours. One item quickly made itself known: whenever she consumed anything which contained monosodium glutamate (MSG), she would have an episode; the severity seemed related to the quantity of MSG. As soon as I realized the connection, I stopped buying any foods with MSG, read package labels carefully, and started coaching her to ask people about MSG before she would accept food from them (at friends' and relatives' homes). With the "clean" diet, the frequency of her attacks dropped from several times a week to once or twice a month. The few that were left could be explained by irregular schedules (missed naps, late nights), irregular meals (high sugar foods, i.e., birthday parties, were particularly bad), and MSG hidden in restaurant foods. She didn't completely outgrow the problem until she was 10 years old, but nights have been peaceful since. Also, I get nasty headaches from MSG and my daughter knows this. Given her history, she still refuses any foods with MSG because she has chosen not to test whether she, too, will get them.

Although I had called a major children's research hospital near our home for advice early on in the problem, I was not able to get any assistance other than the suggestion to put her on barbituates. I was not willing to do that because I was looking for the cause not a treatment for the symptoms.

I hope you will share this information with other parents because too little information is available on the dangers to children of the additives in our food.

Thank you.

Linda Bucklin


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