Sleep disorders and difficulties falling asleep are very common problems in childhood. “Parasomnias” are those disorders characterized by abnormal events or behaviors associated with sleep, its specific phases or the transition periods between sleep and wakefulness.
Parasomnias include disorders such as sleepwalking, bruxism, nocturnal enuresis, nightmares and night terrors. Although these last two alterations are often confused, the truth is that the Nightmares and night terrors have as many differences as similarities.
A nightmare is a dream with terrifying content that causes strong feelings of fear or anguish. When the child wakes up after a nightmare, he remains in touch with reality and responds appropriately to the environment. When you wake up, it is common to remember the content of the dream.
The nightmares occur during the REM phases of sleep which occur to a greater extent during the second half of the night. REM sleep is characterized by high brain activity, lack of muscle tone, high respiratory rate, rapid eye movements, and a rapid, irregular pulse. It is precisely in this phase of sleep that most dreams, including nightmares, usually occur.
It is one of the most common disorders in childhood and adolescence. According to studies, between 10 and 50% of children between 3 and 6 years old suffer from them. Although nightmares do not usually pose a risk to the child’s health, they can cause a certain fear of going to bed, especially if they are frequent. In these cases, the sleep pattern may be altered and excessive drowsiness, irritability, anxiety, etc. may appear secondarily.
What are night terrors?
During night terror episodes, it is common for the child to sit up abruptly in bed and begin to scream, moan, stammer, or cry with a terrified facial expression. He keeps his eyes open without being really awake and shows signs of anxiety with great autonomic activation (tachycardia, hyperventilation, sweating, etc.). Furthermore, night terrors occur in the deep phase of sleep, when there is no muscle tone.
The appearance of this sleep disorder in adults is not ruled out, but it is in childhood when they are most common. Its onset usually takes place between 4 and 12 years and it is estimated that between 1% and 6% of children suffer episodes of night terrors.
Why do they occur?
Factors such as emotional tension, traumatic events, anxiety, fatigue, irregular schedules of sleep, fever or taking some medications seem to increase the appearance of these sleep disorders.
Night terrors are usually attributed to the stress suffered by the child during the day; Going to sleep agitated increases the likelihood of an episode occurring. Unpleasant dreams are more common when the child is distressed or worried about something and are often based on these worries.
Unlike what happens in nightmares, hereditary factors seem to play a causal role in the presentation of night terrors. Around 80% of children who suffer from them have family members who have also had these sleep disorders. This genetic basis is shared with sleepwalking.
Differences between nightmares and night terrors
Fundamentally, The differences between nightmares and night terrors are as follows:
1. The possibilities of awakening
Unlike what happens in nightmares, in night terrors the child usually does not wake up easily despite the parents’ efforts. If he wakes up, he appears confused and disoriented, does not respond adequately to his surroundings, and is overcome with a certain feeling of fear. The episode usually lasts 10 to 20 minutes and then you can go back to sleep. They often do not remember the episode when they wake up the next day, and if they do remember anything it is usually in isolated, blurry fragments.
2. The sleep phase
Night terrors, like sleepwalking and unlike nightmares, arise in deep sleep and not during REM phases. They usually emerge during the first third of the night. During deep sleep, muscle tone is weak and heart and respiratory rates decrease.
If our child suffers from nightmares or night terrors, it is best to act calmly, trying to normalize the situation. If children see their parents alarmed or worried, their anxiety will be greater.
You should also avoid intense light as this could lead the child to develop a phobia of the dark, associating it with fear. It is not a good idea to talk in detail with the child about what has happened because she may become more active and this will make it difficult for her to fall asleep again.
It is recommended stay with the child until he or she has calmed down enough and you can fall asleep again, but you must stay in your room and sleep in your own bed. If parents convey to their child that every time she has an episode she can sleep with them, they will be reinforcing the sleep disorder and promoting inappropriate habits.
Treatment of night terrors
Night terrors cause real panic in parents, more than in the child himself, who, as we have seen, normally will not remember the episode. In mild cases, parents should remain calm and do not try to wake your child during the horror episode.
It is advisable to ensure that the child does not fall out of bed or suffer any physical harm during the episode, since he is deeply asleep and is not aware of what is happening around him.
Normally these sleep disorders disappear over time and They do not usually require psychological treatment except in those cases that, due to their frequency or intensity, constitute a problem for the child and it is necessary to consult with a health professional.
Pharmacological treatment is not recommended for minors, since drugs such as benzodiazepines can produce significant side effects and when they stop taking their benefits disappear, so in no case do they solve the problem.
An effective psychological technique in parasomnias such as night terrors and sleepwalking is scheduled awakening technique which consists of waking up the child before the time at which the disorder usually manifests itself. This is done to shorten the sleep cycle and thereby prevent the onset of the episode.
Treatment of nightmares
Parents should try to reassure children after nightmares and try to get them to go back to sleep, trying not to appear excessively worried or anxious. For older children, ages 7 or 8 and up, you can talk the next morning about the nightmare, trying to find out if there is anything worrying that could be responsible for these terrifying dreams.
If applicable, it is important promote proper sleep hygiene that is, regular sleep patterns that help the child know that sleep time is approaching.
It may also be advisable to avoid heavy dinners and violent or horror programs or movies that stimulate the child’s imagination, as well as modify any inappropriate habits or stimuli that may disturb their rest.
In some severe and frequent cases of nightmares, when they have existed for a long time or occur very often, are very intense and cause significant discomfort, it may be advisable to see a psychologist.
There are effective techniques that teach the child to successfully cope with dreams that cause anxiety, such as Rehearsal therapy in imagination, consisting of rewriting and reimagine the dream so that its content stops generating fear.
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This article has been reviewed by our editorial team at PsychologyFor to ensure accuracy, clarity, and adherence to evidence-based research. The content is for educational purposes only and is not a substitute for professional mental health advice.
