Sunday Sleep Dilemma

Q: How do I soothe my child's sleep terrors?
A: Remember from my post the other day, sleep terrors are different than nightmares. Taking that into consideration, if you have identified that your 18 month old+ is having night terrors, you may ask, what you can do to soothe them. Recall, your child is not awake during night terrors, so soothing is some what more for you than your child. If your child is out of their bed- gently guide them back to their bed (REMEMBER they are asleep and act accordingly). It is normal for them to last as long as five to fifteen minutes.

According to Dr. Marc Weissbluth in Happy Sleep Habits Happy Child "Night terrors appear more often when a child has a fever or when sleep patterns are disrupted naturally, such as on long trips, during school vacations, during holidays, or when relatives come to visit. Recurrent night terrors are also often associated with chronically abnormal sleep schedules. Enabling them to get more sleep is the way of treating over-tired children who have frequent night terrors. I have observed that night terrors disappear when the parents moved the bedtime earlier by only thirty minutes."

So friends:
-Don't freak out- as a out of control sleeping, screaming child can be concerning.
-Make sure they aren't sick.
-Take them calmly and gently back to their bed- you don't need to wake them up.
-Evaluate their sleep schedule- are they getting enough sleep. Make adjustments as needed.

Sunday Sleep Dilemma

Q: What are some ways I can deal with my child when he wakes up crying and screaming because he has had a nightmare?

A: Getting woken up in the middle of the night in and of itself can be a frustrating experience, so stay calm- be patient... If your child has come to your room, I suggest walking him back to his room. If he is in his own room screaming go to his room. In your sleepy haze identify if this is a nightmare or night terror (see the post from May 21).

Now, that you have identified it as a nightmare try and calm him down- usually you being there and holding him will do just that. If needed, you may have to take him potty or get him a drink of water (possibly place one on his night stand before bed). Once he has calmed down, you can ask him to tell you why he is so upset. Then you can talk to him about it and how funny things can happen in our heads- try to understand his fears and make sure not to make fun of them. At this point you may want to help him think about telling the bad guys to "go away". If you are a praying family you can pray for him and pray for the room. You can look around the room and talk about how safe it is and how safe the house is and how close mommy and daddy are to his room. "Communicate the idea of safety over and over again (NSF)." "Teach your child coping skills and alternative ways to respond." Keep in mind that he needs to go back to sleep and get needed rest (as do you- which I'm sure is ringing in your head). Make sure he is calm when you prepare to leave him. He may start to freak out when you actually leave- at that point you can say that you will leave the door open a crack for tonight if you want. Nightmares can be difficult to deal with, below is a list of possible strategies to try.

Nightmare prevention strategies (of course these are not fool proof):

-Consider everything that your child puts into his mind- TV, movies, video games- and remember each child and the way they process things is different
-Consider any undue stresses you or your husband inadvertently put on your child- arguing, talking about stressful situations...
-Consider any other negative situations that could be provoking the nightmares (kids at school...)
-Spend some time in the dark at other times- play flashlight tag or read a story in the dark with a flashlight. Even clean or play under bed, in their closet, or wherever seems scary- "Make friends with the dark."
-Be wary to bring your child into your bed- if you do it may quickly become your child's way of coping with nightmares- habits are formed quickly.
-Be wary of introducing a light on, nightlight, door open, or other such thing that may end up hindering sleep- be deliberate about the choices you make. Some suggest that the nightlight may suggest that darkness is something to fear.
-Give your child some resources to use during the nightmare: tell the child that he/she can tell the 'bad guy or bad thing' to "go away" or tell the child to choose to not go to the scary place in the dream.
-Add something to your bedtime routine: prayer for the situation and protection during dreaming, a snack (complex carbohydrate and protein combo), take some extra time to calm down before bedtime (soothing music, mellow story time- think about the books you are reading).
-After the nightmare: have the child tell you the "story" of it and have each family member (or whomever) change the ending to a happy ending where the "child surmounts of obstacle".
-Leave a cup of water on their night stand- don't bring them water in the night.
-Monitor your child's nightmares- if they become extreme or too often you may want to consult a doctor.

Resources used:
-Laurie Walker, "How to Stop Nightmares in Children"
-Sleep Foundation, "Children and Bedtime Fears and Nightmares"
-Marc Weisbluth, Healthy Sleep Habits, Happy Child

Other Resources You May Want to Check Out:
- Alan Siegel, "Nightmare Remedies"
-American Academy of Sleep Medicine, "Sleeping Scared: Nightmares in Children"
-Center for Effective Parenting, "Nightmares"

Article Review Day 10: Sleep Terrors vs. Nightmares

My oldest daughter has nightmares every once and awhile. She wakes up upset and tells me about the nightmare or "bad dream" as we call them. They are usually about something that she has heard about or seen the day before. I am already very cautious about what my children watch on television, but I am extra cautious about what my daughter watches since she is very sensitive. I am also cautious about the conversations my husband and I have around her and the other kids- I don't want my children to be burdened with undue stress that they don't understand.

Nightmares occur in 25% to 50% of children ages 3 to 6. Both boys and girls struggle with these. "Occasional nightmares are not worrisome, but recurrent nightmares or those with disturbing content may indicate excessive daytime stress. You should gently question children regarding their daytime experiences such as tv shows or encounters with other children to try to determine possible frightening content or situations." After you figure out why your child is having these nightmares you should do whatever you can to "eliminate or reduce the child's exposure" to whatever is causing the nightmares.

I know parents that also struggle with sleep terrors. You may wonder what the difference is? Both are just being scared during sleep, right?

Well, sleep terrors usually begin after 18 months old, where nightmares usually begin between 36 and 72 months old. Sleep terrors usually occur during the first third of the night, where nightmares occur during the last half of the night. Sleep terrors occur during NREM (non-rapid eye movement, stages 1 to 4) and nightmares occur during REM sleep (stage 5). With sleep terrors the child appears extremely agitated- screaming, increased heart rate, and dialated pupils could occur. With nightmares the child is sometimes agitated but to a much lesser extent. The child does not wake up during sleep terrors even though they may seem awake and they don't usually remember in the morning; the child does wake up with a nightmare and can remember details and often still remembers in the morning. The child does return to sleep easily with sleep terrors and it is suggested that you gently guide them back to their bed. The child does not return to sleep easily with nightmares.

"Children with more violent, prolonged, or unusual episodes should be evaluated at a pediatric sleep disorders center. Although sleep terrors are often very disturbing to parents, they can be reassured that sleep terrors are a developmentatl phenomenon and are not a sign of underlying issues."

Please share your experiences with sleep terrors and nightmares.

And another resource from a recent article from the National Sleep Foundation: nightmares