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SLEEP PROBLEMS

By Dr Evelyn Lewin

Sleeping issues include difficulty falling asleep, frequent night waking, night terrors, sleep talking, nightmares. A night terror is when a sleeping child suddenly displays agitated or distressed behaviour, usually in the form of screaming. A nightmare is a scary dream that happens during sleep. Nightmares often wake children from sleep. Once woken, children can recall what happened during the ‘bad’ dream.

symptoms

Night Terrors -  According to the Royal Children’s Hospital in Melbourne, night terrors occur in approximately five out of every 100 children. Though distressing to witness, night terrors are not a sign of emotional or psychological problems. Night terrors do not cause any long-term harm to your child, and most children grow out of them. Within the first few hours of sleep, when the child is transitioning between sleep cycles, she will startle and may scream, cry or become agitated. While she may look awake, the child is still asleep. For this reason, she is very unlikely to recall the episode after it happens.  She may start running around, or thrash around in her bed. She may look awake, with her eyes open, but she will not recognise you or react to you trying to console her. This is because she is still asleep. During a night terror the child will look scared. She may have a glassy-eyed appearance, where she looks through you, rather than at you. These episodes usually last around ten minutes.

Nightmares - tend to occur around 4-6am, when your child is most likely to be dreaming. It is common for children to have nightmares. According to Better Health Channel, approximately one quarter of children have them at least once a week. There is no known cause for nightmares. However, they may occur more commonly following a traumatic event or when your child is stressed. According to Better Health Channel, nightmares usually start around age two and peak between ages three to six. Children who wake from nightmares often scream and/or cry, are distressed and call out for comfort. Following a nightmare, children may become unwilling to sleep alone and have difficult falling asleep. If your child has recurrent nightmares she may be tired during the day due to sleep interruption. She may therefore have poor concentration and be more irritable.  See Sleep Disorders in Toddlers. 

treatment

There is no treatment for night terrors. However, it is important to keep your child’s room safe and free of danger, so if she does become active with a night terror she cannot hurt herself. To reduce the chance of your child having another night terror, try not to let her become overtired. Going to bed a little earlier may help. A relaxing bedtime routine may also help. Include wind-down time in the bath, followed by reading soothing books before bed. Avoid violent or aggressive TV shows. While it is tempting to offer comfort, it will not help her and may worsen the episode. Only intervene if you worry she may hurt herself. If you are concerned about your child’s night terrors, speak to your GP for further advice. Paying attention sleep hygiene is essential for a good night’s sleep. That means following a set routine each night, around the same time. This sends the message to the brain that it is now time for sleep. Use the bedroom for sleeping only – no TV’s or communication devices.

When your child has a nightmare, it is important to comfort her. She needs to feel reassured before attempting to go back to sleep. Listen to her concerns but remind her she is safe and the nightmare wasn’t real. To help reduce the likelihood of nightmares, implement a soothing bedtime routine. This may include a warm bath and reading gentle stories together. Do not allow your child to watch violent TV, play inappropriate video games or read scary stories during the day. Encourage your child to continue sleeping in her own bed. Otherwise, she may begin to think of your bed as ‘safe,’ and her bed as being the place where nightmares occur. It may help to put a child-safe night-light in her room. She may also like to sleep with a soft toy for comfort. If your child experiences recurrent nightmares, talk to her during the day to see if anything is stressing her. Discussing her nightmares during the day can also make them seem less scary at night. If your child has repeated nightmares or you are concerned, see your doctor.

Reviewed by Dr Evelyn Lewin 30 March 2015 references
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    Evelyn Lewin
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    23.05.2015

This document has been developed and peer reviewed by a KIDS HEALTH Advisory Board Representative and is based on expert opinion and the available published literature at the time of review. Information contained in this document is not intended to replace medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner.

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