Dear Therapist:

My very bright, mature, lovable, happy 5-year-old son has begun to experience what I have been told is called "night terror". He is a very happy child during the day, definitely with a more intense personality, but very healthy and well-adjusted and extremely bright. At night, he will wake up in terror, screaming, cowering in the corner, looking at me or my husband with terror, eyes opened wide, with real fear...and then a few minutes later will calm down and have no recollection of feeling afraid. This behavior scares me and almost seems psychotic as if something is possessing/terrorizing my child. We have a healthy, normal, safe home...and the same goes for school. My son feels comfortable (to the best of my knowledge) discussing his worries or if someone/something is bothering him and I do not see a real terrifying trigger. Does the panel view this nighttime behavior as a sign of emotional/psychological issues? And how would you suggest dealing with the situation?

 

Response:

Night terrors can be quite scary for parents. However, they don’t generally appear to affect the child who experiences them—at least on a conscious level. Although their physical reaction to what may be a startle response to the transition from one sleep stage to another may seem indicative of conscious fear, your son’s emotions are likely experienced only on an unconscious level.

There are many factors that can contribute to the occurrence of night terrors. Seemingly, the most common factors are stress and not enough sleep. When anyone is overly stressed—generally or at a specific time—they are more likely to have an overt stress reaction. Reactions can vary. Some people become jumpy, others act grumpy, and yet others can become belligerent.

I have seen a couple of studies that point to an apparent link between childhood night terrors and later psychotic episodes, but I personally haven’t read any studies that clearly show that night terrors cause later problems. It’s quite possible that other co-occurring factors—alone or taken together—contribute to later issues. Some of the factors that have been shown to cause night terrors are some medications, restlessness, sleep deprivation, too much noise, stress, too much caffeine, a full bladder, an overly warm room, and overly warm body temperature (i.e., due to fever or going to bed shortly after a hot bath). Some of these possible causes of night terrors—and others—may also contribute to later issues. In addition, despite indications of linkage, the percentages are still rather low.

Aside from reducing the occurrence of known causes, you can try to isolate the causes specific to your son’s night terror experiences. Identifying patterns relating to the night terrors can help you to avoid them. Pay attention to things like your son’s bedtime, the levels of noise and distractions in the house, the amount of time between eating and sleeping and between bathing and sleeping, and his stress levels in the hours prior to bedtime. You may begin to see a pattern in which one or more factors are often different than the norm prior to the incidence of night terrors.

Hopefully you’ll be able to identify some type of pattern, allowing you to adjust your son’s routine to decrease the frequency of his night terrors. Doing so would likely also decrease the likelihood of any later associated problems. Also, after about age five, night terrors generally tend to decrease. There’s a good chance that your son’s night terrors will cease fairly soon, and that there will be no lasting effect.          

Yehuda Lieberman, LCSW

 psychotherapist in private practice

 Brooklyn, NY   |   Far Rockaway, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317