Sleep Terrors in Children
Sleep terrors in children, also referred to as pavor nocturnus in the Encyclopedia of Mental Disorders, cause significant terror during the child's sleep. There is a physical and emotional display of terror that can result in impairment in functioning.
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Symptoms
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Sleep terrors are characterized by episodes of extreme fear that the child cannot be woken from. The child will appear awake and frightened by an unseen object but she is actually still asleep. She may experience rapid heart rate, confusion, crying, hyperventilation and sweating. The child typically has no memory of the event but he may recall brief episodes of terror. Sleep terrors can occur during nighttime or during daytime naps. The child may sit up suddenly or even attempt to get out of bed. Sleep terror episodes typically last one to two minutes, but it can take up to 30 minutes to console the child. Daytime symptoms are fatigue, impaired functioning at school and distress.
Causes
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The cause of sleep terrors is not exactly known. It is possible that stressors during the day can manifest into a sleep terror. Other possible causes of sleep terrors are sleep deprivation, genetics, medications that affect the central nervous system (CNS), fever and an immature CNS.
Diagnosis
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The first step in diagnosis is a complete medical physical. A physical can rule out any other medical conditions. A diagnosis is typically made from the child and parent's reports of the episodes. Mental health professionals use The Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) to determine if the description matches criteria for a diagnosis. There are currently no lab tests for sleep terror diagnosis.
Treatment
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Treatment may not be needed if the episodes are infrequent and do not cause impairment. Start by consoling the child if he is frightened. Attempts to wake the child may result in injury. Set up the child's room so that she cannot injure herself during a sleep terror episode. Rearrange furniture, put away sharp or dangerous objects, and lock the windows. Among the successful medications for treatment of sleep terrors are Imipramine, Benzodiazepine and Benadryl. These medications can help sedate the child and reduce the number of episodes of sleep terrors.
Statistics
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Sleep terrors occur more often in boys than girls. According to eMedicine, anywhere from 1 percent to 6 percent of children will experience sleep terrors during their lifetime. The age groups most commonly affected are ages three through 12. The average age of onset is 3.5, according to eMedicine.
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