Night Terror

1. See Also
   1. Night Awakening in Children
   2. Sleep Problems in Children
2. Epidemiology
   1. Affects 2% of children ages 1 to 8 years old
   2. Disappears by age 12 years old
   3. Male predominance
   4. More common during stress or Fatigue
   5. Hereditary
3. Signs and symptoms
   1. Timing
      1. Occurs 90 minutes into sleep (Sleep Stage III-IV)
      2. Episodes last 10-30 minutes
   2. Sudden Agitation
      1. May sit up in bed, scream, and run about
      2. May see objects in room as dangerous
   3. Frightened, but difficult to awaken or comfort
      1. Eyes open, blank stare
      2. Will not remember episode in morning
   4. Associated signs
      1. Tachycardia
      2. Tachypnea
4. Differential Diagnosis
   1. Seizure Disorder
   2. Nightmares
      1. Event occurs in REM Sleep in any age patient
      2. Patient is arousable and remembers event
5. Management
   1. Calm your child
      1. Turn on lights so that child less confused
         1. Eliminates shadows
      2. Say soothing comments "You're alright. You're home"
      3. Speak softly and repetitively
      4. Shaking and shouting child only prolongs attack
         1. Does not awaken child sooner
      5. Hold child if it seems to comfort him
   2. Protect your child
      1. Child can fall down stairs, run into wall
      2. Attempt to direct back to bed gently
   3. Prepare baby sitters
      1. Describe Night Terror and what to do if one happens
   4. Help child discuss fears
      1. What frightens him during daytime?
   5. Consider Prompted Sleep Awakening technique
6. References
   1. Pagel (2000) Am Fam Physician 61(7):2037-44
   2. Thiedke (2001) Am Fam Physician 63(2):277-84