Spring 2010
Volume 13 Number 1
Things That Go Bump in the Night
People who say they sleep like a baby usually don't have one.-Leo J. Burke
Every parent knows there is nothing like a good night's sleep. And when sleep isn't happening somewhere in the family, it affects everyone. From that newborn crying to nurse every few hours to the teenager who destroys his bed every night while asleep.
There is a set of sleep problems called "parasomnias" which are sleep problems that disrupt sleep. They are much more common that you might think.
Nightmares: Nightmares are frightening dreams that wake children. They are very common in all ages after six months. The content varies by age and often reflects common developmental issues.
Toddlers can have nightmares about separation from their parents, which may cause them to cry and run into their parent's bedroom. School-age children may have nightmares about death or other real dangers. Older children may put themselves back to sleep without even waking their parents.
Nightmares are more likely to happen following some diff cult event in a child's life (such as starting daycare or a parent going away overnight) or after a frightening experience (such as getting lost or being barked at by a big dog).
Avoiding scary stories, television shows or movies can help minimize the likelihood of nightmares.
Parental reassurance and comforting is very helpful, although it may still be diff cult for the child to go back to sleep. It may also be helpful for a parent to talk to the child about the nightmare the next day to see if there is anything bothering the child.
Night Terrors: A night terror is a dream that occurs during deep sleep when it is very diff cult to wake a sleeping child.
Night terrors may happen during the day or at night. They typically begin suddenly, often with a scream and they usually involve crying. They may be associated with extreme terror or agitation and could include shaking, sweating, racing heart or breathing rapidly. They can be distressing to observe.
Approximately two percent of children experience night terrors, primarily during preschool and elementary school years. During these events most children resist being comforted and could become more upset if parents talk to them and try to calm them down. The child often appears to be awake but is really asleep.
Parents should protect children from injury by gently directing them back to bed and to normal sleep. Prepare babysitters for these episodes. Keep your child from becoming overtired, as this could precipitate a night terror.
Sleepwalking: Sleepwalking is the tendency to wander during deep sleep. It is most common in children ages 4- to 15-years old. Almost 40 percent of all children will sleep walk at some time. During sleepwalking the eyes are usually open and the child may appear to be awake but is sleeping. The child may appear confused or dazed and could mumble or answer questions incoherently. The sleepwalking child should be guided back to bed while speaking in a calm voice. Protect your child from accidents and injury. Help your child avoid exhaustion since fatigue or lack of sleep can lead to more frequent episodes.
Confusional Arousals: Confusional arousals consist of mental confusion or confused behavior during or following arousals from sleep, often in the early part of the night. These may also happen upon forced awakening from sleep during the night or in the morning hours.
They are much milder than a night terror. They may begin with crying or thrashing around in the bed. The child will appear awake but in reality is often somewhere between asleep and awake. Confusional arousals are typically short. Comforting your child could make them more agitated.
These sleep behaviors are very common in children and usually do not indicate signif cant psychiatric or psychological problems. Children usually outgrow them. They are often harmless, infrequent and mild. If you have questions regarding your child's sleep problems, make an appointment with your provider.
- Hannah Wilhelm, PA-C