Night terror leads to sleep disorder!

It is a natural result that night terror leads to sleep disorder. And sleep disorder because of night terror can typically occurs between children in the age of 3 – 12 years.

Sleep generally is divided into two categories:
1.    rapid eye movement (REM).
2.    Non-rapid eye movement (non-REM).

Non-REM sleep is further divided into four stages,
1.    progressing from stages 1-4.
2.    Night terrors occur during the transition from stage 3
3.    Non-REM sleep to stage 4
4.    Non-REM sleep, beginning approximately 90 minutes after the child falls asleep.

There is a big different between night terror and nightmares, which occur during REM sleep. Night terrors are characterized by frequent recurrent episodes of intense crying and fear during sleep, with difficulty arousing the child. Night terrors are frightening episodes that can disrupt family life.
 
About 1% - 6% of children experience night terrors. Boys and girls are equally affected. Children of all races also seem to be affected equally. The disorder usually resolves during adolescence.

Causes of night Terrors.
Night terrors may be caused by the following:
•    Stressful life events.
•    Fever.
•    Sleep deprivation.
•    Medications that affect the central nervous system.
•    Recent anesthesia given for surgery.

Symptoms of Night Terrors:
In addition to frequent recurrent episodes of intense crying and fear during sleep, with difficulty arousing the child, children with night terrors may also experience the following:
•    Tachycardia (increased heart rate).
•    Tachypnea (increased breathing rate).
•    Sweating during episodes.

Unlike nightmares, most children do not recall a dream after a night terror episode, and they usually do not remember the episode the next morning.

The typical night terror episode usually begins approximately 90 minutes after falling asleep. The child sits up in bed and screams, appearing awake but is confused, disoriented, and unresponsive to stimuli. Although the child seems to be awake, the child does not seem to be aware of the parents’ presence and usually does not talk. The child may thrash around in bed and does not respond to comforting by the parents.

Most episodes last 1-2 minutes, but they may last up to 30 minutes before the child relaxes and returns to normal sleep.

If the child does awake during a night terror, only small pieces of the episode may be recalled. Usually, the child does not remember the episode upon waking in the morning.

When should we seek medical care?
Sleep disruption is parents’ most frequent concern during the first years of a child’s life. Half of all children develop a disrupted sleep pattern serious enough to warrant physician assistance.

•    In children younger than 3½ years, peak frequency of night terrors is at least one episode per week.
•    Among older children, peak frequency of night terrors is one to two episodes per month.

If your child seems to be experiencing night terrors, an evaluation by the child’s pediatrician may be useful. During this evaluation, the pediatrician may also be able to exclude other possible disorders that might cause night terrors.

Tests for Night Terrors!
Usually, a complete history and a physical exam are sufficient to diagnose night terrors. If other disorders are suspected, additional tests may be useful to exclude them:

•    An electroencephalogram (EEG), which is a test to measure brain activity, may be performed if a seizure disorder is suspected.
•    Polysomnography (a combination of tests used to check for adequate breathing while asleep) may be done if a breathing disorder is suspected.
•    CT scans and MRIs are usually not necessary.

Home Remedies for Night Terrors
Parents might take the following precautions at home:
•    Make the child’s room safe to try to prevent the child from being injured during an episode.
•    Eliminate all sources of sleep disturbance.
•    Maintain a consistent bedtime routine and wake-up time.

Medical Treatment for Night Terrors
Unfortunately, no adequate treatment exists for night terrors. Management primarily consists of educating the family about the disorder and reassuring them that the episodes are not harmful.
In severe cases in which daily activities (for example, school performance or peer or family relations) are affected, tricyclic antidepressants (such as imipramine) may be used as a temporary treatment.

Medications for Night Terrors
Although tricyclic antidepressants (such as imipramine) are rarely indicated for night terrors because they do not provide long-term help for the child, they may be used as a temporary treatment. Tricyclic antidepressants are usually only prescribed for severe symptoms in which the child’s waking behavior (for example, school performance or peer or family relations) is affected.

Next Steps & Follow-Up
Frequent follow-up care with your doctor to provide support and reassurance helps alleviate their anxieties.

Night Terror Prevention
If your child has night terrors, you can try to interrupt her sleep in order to prevent one.
•    Note how many minutes the night terror occurs from your child’s bedtime.
•    Then, awaken your child 15 minutes before the expected night terror, and keep her awake and out of bed for five minutes. You may want to take your child to the bathroom to see if she will urinate.
•    Continue this routine for a week.

Outlook for Night Terrors
Night terror episodes are short-lived and usually occur over several weeks. Nearly all children outgrow night terrors by adolescence.

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