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10/10/13blog post

nightmares, night terrors, and sleep walking, oh my!

By: Stacy Meyer, MD

Sprout has always been a bit of an “interesting” sleeper but recently things have gotten to be even more entertaining at our house in terms of sleep!

Let’s start at the beginning…When Sprout was around 12 months of age, he began having night terrors. Now those of you with children who have night terrors know exactly what I am referring to here, but for those of you who have never seen it, allow me to explain. Approximately 1-3 hours after Sprout falls asleep (usually on nights when he is over tired or sick) he awakens screaming in terror, eyes “glazed over” and completely inconsolable. After up to 30 minutes of screaming, he will suddenly either awaken and appear normal, or lay down and go back to sleep.

The first time one of these episodes occurred, daddy and I ran into the room and immediately tried to awaken him. Having already completed my pediatric training at this time, I knew that this was a night terror after a few seconds of observing him but had a hard time following my own typical advise of not interfering and allowing the terror to run its course. (It is amazingly hard to watch your child scream as if in pain or fear and not attempt to awaken or soothe them!) Of course, I learned quickly why I had always given that advice and am not exempt from following it….

Night terrors are classified by the American academy of sleep as a parasomnia. They are by definition not truly a “dream state” but a fear reaction that occurs as we transition in sleep stages. The typical person will transition through 6 stages of sleep during the night with one of those stages being REM sleep (rapid eye movement sleep). Typical dreaming and nightmares occur in REM sleep, however, night terrors occur in non-REM sleep and approximately 3 percent of children will be affected by them. These episodes occur shortly after falling asleep (30 min- 4 hours) with the child awakening screaming as if in fear, pupils dilated/eyes glazed, and sweating. Children will not typically respond to their environment during these episodes and, in the case of Sprout, can actually show worsening fear with attempts to awaken or soothe them.

So after a few nights of screaming accompanied by Sprout attempting to escape or fight us when we comforted him, daddy and I learned to keep our distance and wait it out. So, although, still disturbing for mommy (Sprout never remembers any of the episode in the morning) who watches from the doorway now to ensure Sprout doesn’t hurt himself, we seem to have control of our sleep “situation”.

That is until recently, when Sprout started his night time “wanderings”. At approximately 3 and a half, Sprout had his first episode in which I found him outside of his bedroom clearly asleep. Think horror film here… I must have heard something to awaken me and went to check Sprout’s bed…no Sprout. I called for him a few times with no response (panic ensues) and proceeded to run down the stairs. There in the middle of the kitchen, in complete darkness, stood Sprout. After a few deep breathes, I called his name a few times. He slowly turned to look at me, and I asked him what he was doing in the kitchen…no response. Sensing that he may be still sleeping, I told him it was night time and we needed to go back to bed. To which he said “ok” and allowed me to guide him back to bed. Now although that was the scariest episode for us, it has certainly not been the last. There have been nights in which I have found him standing at the edge of my bed asleep, in front of the refrigerator or in the middle of the bathroom.

Sleepwalking, like night terrors, is another parasomnia. These have a higher incident with up to 40 percent of children having at least one episode and 3-4 percent having frequent episodes. Just like with Night terrors, children are not truly awake during these episodes and will often not respond appropriately to their environment. They may answer questions slowly or not respond at all when questioned. And just like with night terrors its best to let it run its course with gentle guidance back to bed and away from danger.

By: Dr. Stacy Meyer – “Dr. Mom Squad”

So as the season for scary movies approaches, I urge you to choose wisely… some of those scenes could literally come back to haunt you!

Happy Slumber!

Dr. Meyer is a pediatric endocrinologist at Dayton Children’s Hospital. She is the mother of two boys who she lovingly refers to as “Busy Bee” and “Sprout!” As part of the “Dr. Mom Squad,” Dr. Meyer blogs about her experiences as both as doctor and a mom and hopes to share insight to other parents on issues related to both parenting and kids health. Learn more about Dr. Meyer!

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