Night terrors in children

What are nightmares in children? The same as in adults: severe, frightening visions in dreams, the realism of which can trigger an autonomic reaction and make you wake up. Nightmare dreams tend to occur in the second half of the night, when the intensity of dreams is higher. Even a very young child can have nightmares, but most often they occur in the dreams of children between 3 and 12 years of age.

What factors can trigger night terrors in children?

According to experts, nightmares in children of different ages are common and most children have them from time to time. But an impressionable child and children with a rich imagination or emotional instability may have such dreams more often.

Nightmare dreams may reflect events or situations that can cause negative emotions and/or anxiety in a child, such as moving to a new place of residence, determination to another kindergarten or school, tense relationships and violence in the family, accidents, etc. Or your child just saw a scary spider or in kindergarten quarreled with a friend....

Possible triggering factors include:

• overwork;
• sleep deprivation (lack of) sleep;
• experiences - a strong emotional reaction to a psychologically traumatic situation;
• depressed state and persistent lowering of mood - hypothymia;
• childhood fears;
• increased nervous excitability, including post-traumatic acute stress disorder in children;
• Social phobias in children and other phobic disorders;
• anxiety disorders in children.

It should also be borne in mind that nightmares in a child can be a side effect of drugs with oxybutynin hydrochloride (Sibutin, Driptan), which are used in the treatment of nocturnal enuresis.

What symptoms accompany night terrors in children?

Nightmares are dreams that evoke a strong but unpleasant emotional response. Any dreams are the result of activity in a system of interconnected brain regions such as the thalamus, the medial prefrontal cortex of the frontal lobes of the cerebral cortex, and the posterior cingulate cortex.

Nightmares usually occur during the REM (paradoxical) phase of sleep with rapid eye movement. During this phase, which becomes longer towards morning, BP and brain activity increase. Before awakening, memories are combined and consolidated, and the images presented in the dream are remembered when leaving the REM phase. For more information, see. - Sleep Physiology

Nightmares are accompanied by symptoms such as increased heart rate and restlessness in sleep, and when the child is fully awake, there may be panic, crying and screaming. Older children remember the dream in more detail and can talk about it.

Every child's nightmares manifest themselves differently, but all of them contain frightening elements (in the form of scary monsters, aggressive animals that pose a threat to people); in nightmares the child may be scolded, hurt, intimidated, harassed, etc.

Also read: Sleep problems in a baby

What are the possible complications of night terrors in children?

These complications include: sleep deprivation (i.e., a decrease in the length of nighttime sleep required by the body), general lethargy, and excessive daytime sleepiness, which can lead to concentration problems and difficulty in school.

There is also the possibility of developing a cycle of insomnia and fear of sleep - hypnophobia.

See additionally. - What are the dangers of schoolchildren not getting enough sleep?

How are night terrors diagnosed in children?

Parents - by the child's reaction - realize themselves that the child is having nightmares. In more severe cases (anxiety and phobic disorders), psychiatrists conduct neuropsychiatric examinations.

More details in the publication - Sleep Disorder - Diagnosis

A differential diagnosis may be required because nocturnal frontal (frontal) or temporal (temporal) epilepsy may be manifested by paroxysmal awakenings during sleep and nocturnal seizures.

How to treat night terrors in children?

Addressing underlying medical problems or stress is part of the treatment. In the presence of childhood phobic or post-traumatic stress disorder, cognitive-behavioral therapy aimed at changing patterns of thinking and behavior using role-playing, body relaxation techniques, emotional stabilization techniques, etc. Is necessary. And here you need the help of a child psychologist or psychotherapist.

In the case of nightmares, the so-called imaginary rehearsal therapy is most often used. Its essence: while awake, the child is asked to invent an alternative ending to the remembered scary dream (funny or happy) so that it is no longer threatening.

And if the child is worried about a recurring nightmare, psychologists advise to visualize the dream in a drawing, supplementing it with funny details, laugh with the child, and then let the child tear up the drawing and throw it in the trash.

Also, children need to be explained: what frightened them in the dream did not really happen, and they are safe in their bed and room.

Although medications are not used, in severe cases, your doctor may recommend selective serotonin neurotransmitter hormone reuptake inhibitors (SSRIs).

What should I do if my child has night terrors?

Hug your child, pat him/her on the back and reassure him/her that everything is okay. And you need to be close to the child and talk calmly to him/her until he/she calms down.

If the child is particularly frightened, use anything to soothe him with a favorite (sing a lullaby, read a book, tell a story with a happy ending).

What are some methods for preventing night terrors in children?

The question that all parents are interested in answering is: what recommendations will help me improve my child's sleep and prevent nightmares?

To prevent nightmares, experts recommend:

• adhere to a healthy sleep schedule, i.e. The child should go to bed at approximately the same time. Parents should know that children who go to bed too late are more likely to have nightmares;
• exclude everything that can excite the child: do not watch before bedtime cartoons with fantastic monsters, horror movies and action movies with scenes of violence, do not play computer games (in the genre of action, "shooters" or "wanderers"), do not read books with dangerous adventures of characters;
• giving your child his or her favorite soft toy at bedtime (many babies find this helps them feel safer);
• Leave a night light on and the door ajar in the child's room before putting him to bed.

It is recommended to eat dinner 2-2.5 hours before bedtime (because food can speed up metabolism, activating brain functions), and exclude proteins and fats of animal origin and sweets from the dinner menu. A cup of warm milk at night will help your child sleep better: whole milk is a source of the essential amino acid tryptophan, which is a precursor to the "joy hormone" serotonin and the "sleep hormone" melatonin.

In addition, foreign researchers have found that in the process of digestion of milk protein casein (cleavage by digestive enzyme trypsin) several peptides are formed, which, binding to the GABA receptor, have a calming effect and improve sleep.

What is the life prognosis for night terrors in children?

Nightmare dreams are considered a very common way of processing emotions and information, and in the vast majority of children, nightmares pass with age without affecting adulthood.

Nightmares are considered a disorder only when they occur very often and before going to sleep, the child is afraid that the scary dream will occur again.