II. Epidemiology
-
Prevalence
- Child: 1 to 6.5% (typically age 1-8 years, resolving by age 12 years old)
- Adult: 2.2%
- Male predominance
- More common during stress or Fatigue
- Hereditary
III. Findings: Signs and symptoms
- Timing
- Occurs 90 minutes into sleep (Sleep Stage III-IV)
- Episodes last 10-30 minutes
- Sudden Agitation or intense fear
- May sit up in bed, scream or cry and run about
- May see objects in room as dangerous
- May act out in dangerous ways
- Frightened, but difficult to awaken or comfort
- Eyes open, blank stare
- Will not remember episode in morning
- Associated signs
IV. Differential Diagnosis
- Seizure Disorder
-
Nightmares
- Event occurs in REM Sleep in any age patient
- Patient is arousable and remembers event
V. Associated Conditions: Other Parasomnias
VI. Management: General
- Reassure parents (episodes resolve without intervention)
- Treat as with other Parasomnias
- See Sleep Walking
- Ensure adequate sleep and consistent sleep schedule
- Ensure safe home
VII. Management: Children
- Calm your child
- Turn on lights so that child less confused
- Eliminates shadows
- Say soothing comments "You're alright. You're home"
- Speak softly and repetitively
- Shaking and shouting child only prolongs attack
- Does not awaken child sooner
- Hold child if it seems to comfort him
- Turn on lights so that child less confused
- Protect your child
- Child can fall down stairs, run into wall
- Attempt to direct back to bed gently
- Prepare baby sitters
- Describe Night Terror and what to do if one happens
- Help child discuss fears
- What frightens him during daytime?
- Consider Prompted Sleep Awakening Technique
VIII. Management: Infants
- Stay with your child if he is fearful
- Stay at crib until infant is calm
- Do not lift child out of crib
- Sit quietly in a chair in the room
- Consider listening to music via headphone
- Avoid talking after initial comforting remarks
- Stay at crib until infant is calm
- Leave briefly every 15 minutes
- Return after 1-2 minutes
- Helps habituate against Separation Anxiety
- Leave the door open and the night light on
- During the day, show love, attention, affection
- Hug, cuddle and comfort generously
- Carry about in a backpack or front sling
- Play separation games during the day
- Peekaboo
- Hide-and-Seek
- Chase me
- Reference