What to Do About Infant Night Terrors

Although they typically occur in children between the ages of 4 and 12, there have been reports of babies and younger toddlers experiencing night terrors. Most of the time, night terrors are outgrown during adolescence, but when they do occur, they can be pretty scary, especially if you don't know what's happening.

Most often, it’s nothing to worry about, but sometimes they can be a symptom of an underlying issue. It’s always a good idea to let your child’s doctor know what’s going on sleep-wise so they can get a comprehensive picture of your child’s health.

what causes night terrors in infants
Illustration by Brianna Gilmartin, Verywell

What Are Night Terrors?

Night terrors, also called sleep terrors, are sort of like a nightmare but can be more intense. They are what is called a parasomnia, which is abnormal behavior of the nervous system during sleep. During a night terror, a child might:

  • Suddenly sit up
  • Stare with eyes wide open
  • Scream or make noises of distress
  • Sweat excessively or breathe heavily
  • Thrash around
  • Be upset or act scared
  • Be inconsolable

A night terror typically resolves after several minutes, although sometimes it can last longer. Night terrors, unlike nightmares, leave no memory because even though the infant might look awake, they’re asleep throughout the incident.

What Causes Night Terrors?

Night terrors occur during non-rapid eye movement (REM) sleep, which is when someone isn’t dreaming. This differs from nightmares, which occur during REM sleep. Non-REM sleep usually occurs about two or three hours after children fall asleep. It’s not known what exactly causes night terrors, but there are some factors that come into consideration. These can include:

  • Being overtired or sleep-deprived
  • Stress
  • Disruptions to routines or schedules, like during travel or a change in daily routine
  • Illness or fever
  • Sleep-related breathing issues like apnea

Night terrors might also occur in children who start taking a new medication, are sleeping in a new environment, or if they’ve ingested too much caffeine. There may also be a hereditary component—infants and toddlers with family members who've had night terrors may be more likely to have this sleep disturbance than someone who has no family history.

How Do I Treat Night Terrors?

During a night terror, it’s best not to try and wake the infant. It’s usually incredibly difficult to wake someone out of a night terror to begin with, and forcing them awake might make it even worse by making it harder for them to fall back asleep. The most important thing is to make sure they’re safe during the event. During a night terror, reassure your child in a soothing voice that they are safe, and if it seems to calm your child down, hold them until it's over. Sometimes the infant can bang their face against the crib, or a toddler might sleepwalk down the steps.

There’s no “treatment” of night terrors per se, but you can reduce the risk of occurrence by taking some steps:

  • Follow a bedtime routine for your infant
  • Have a regular bedtime and don’t let them stay up too late
  • Try not to let them become overtired
  • Help reduce any stress your infant or child might be experiencing
  • When traveling, try to stick to the regular bedtime routine as best as possible

If the night terrors become frequent or intrusive enough that they interfere with your infant’s rest, last more than 30 minutes at a time, or significantly impact their life, talk with their pediatrician about it. It might be helpful to keep a sleep diary to note any patterns in behavior or nighttime awakenings to give your doctor more information about what’s been going on with your infant or toddler. This will also give them information that you might have forgotten, as well as give them a bigger clinical picture of the issue.

The doctor will usually do an examination of your child to rule out any physical cause of the night terrors or any underlying medical condition. Sometimes, a sleep study might be recommended, or your doctor might refer your child to a sleep specialist if they’re especially concerned or think a second opinion might be helpful.

Most times, no treatment is needed. Night terrors are generally outgrown in adolescence, but if the night terrors get worse, it's important to let your pediatrician know. Though it may be stressful to you and upsetting to watch in the meantime, this issue is transient​ and will pass.

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