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Night Terror
Aka: Night Terror, Sleep Terror, Pavor Nocturnus, Fearful Night Crier
- See Also
- Night Awakening in Children
- Sleep Problems in Children
- 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
- 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
- Tachycardia
- Tachypnea
- Differential Diagnosis
- Seizure Disorder
- Nightmares
- Event occurs in REM Sleep in any age patient
- Patient is arousable and remembers event
- Associated Conditions: Other Parasomnias
- Sleep Walking
- Confusional Arousal
- 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
- 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
- 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
- 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
- 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
- Schmitt (1991), Your Child's Health [PubMed]
- References
- Carter (2014) Am Fam Physician 89(5): 368-77 [PubMed]
- Pagel (2000) Am Fam Physician 61(7):2037-44 [PubMed]
- Thiedke (2001) Am Fam Physician 63(2):277-84 [PubMed]