Q. My daughter and I are exhausted. She and her 5-year-old son live with me and his night terrors have worn us out.
My grandson went to sleep easily and in his own bed until he was 2, then he started getting up two to three hours later and climbing into bed with his mother or me. Although he is clearly asleep when he does that, his eyes are wide open and he doesn’t know where he is or who we are. He also mutters unintelligible things to himself and sometimes he has night terrors, too, just as my older daughter did when she was a child. We bring him back to his own bed afterwards, which is difficult to do without waking him up, but he often has another episode later in the night and we have to go through the same routine.
I don’t get it. His bedroom, which is quiet and dark, has a soft white noise machine and a blue light on his humidifier and no TV so I thought it would be a perfect place for him to sleep, but obviously I was wrong. Any advice?
A. Almost all children have dreams and some of them have nightmares too, but only 1-6 percent of children have this problem, so there hasn’t been much research on that subject. Doctors do know, however, that children who have night terrors come from all races and sexes; that 80 percent of them have relatives who are sleepwalkers; and that the problem usually begins when a child is 3½, tapers off around age 5 and stops without any help from anybody when they’re about 12, with the exception of a small number of adults who have night terrors, too.
No one really knows whether children develop the problem because they have an immature central nervous system; a chemical trigger that is misfiring in the brain or they are super-stressed or super-tired; their blood sugar is too low or their medicine too strong or they ate a dinner that was too big or too late. Take your pick.
Although night terrors are often confused with nightmares, these two problems have different symptoms, different causes and they even happen at different times in the night.
The experts tell us that dreams keep the brain active; sort our worries and our plans and let us remember those vivid, movie-like stories we whipped up the night before. But sleep studies show us that dreams take place during the last, deep stretch of active REM sleep — the acronym for rapid eye movement — and it comes much closer to morning.
The start time of night terrors varies from one report to the next but in the early part of the evening. One says that they begin 15-60 minutes after the child falls asleep, another says 90 minutes and you (and the American Academy of Pediatrics) say two to three hours, but the studies show that they occur during the transition from the third to the fourth (and last) stage of the quiet non-REM sleep that precedes the REM cycle and which children almost never remember when they wake up.
Whether your dear grandson takes one minute or 30 minutes to get through his night terrors, it must be so painful to watch him scream in fear; act confused and disoriented and look at the people he loves without even knowing who they are, for night terrors make even a quiet child become intense, dramatic and almost demoniacal. They make his heart race, his breathing go into overdrive and his body get drenched with sweat. Think Godzilla on speed.
As tempting as it is, this is no time to wake up your grandson. It’s much better to turn the lights low and tell him, softly and gently, that everything is really alright and keep saying that until he calms down and you can take him back to his own bed.
Although he’ll fall asleep after this episode, it may leave you and your daughter quaking with worry. This is truly unnecessary, however, because night terrors are seldom a medical or psychological problem. If you’re afraid your grandson might be having a seizure, however, you can always take him to the pediatrician for a quick check-up, but you would do better if you and your daughter took turns in the care of your grandson. If your daughter takes care of him one night, you will have more to give him the next night when it’s your turn.
To learn more about sleep, dreams, nightmares and night terrors, read “Sleep,” edited by Rachel Y. Moon, M.D. ($17), a fine book published by AAP, and go to medlineplus at nlm.nih.gov to read about the latest sleep studies.
Questions? Send them to advice@margueritekelly.com.