Q&A: night terrors

Bernalgirl writes:

"Last night our 16-mos old daughter woke up screaming just 1.5 hours after she went to sleep. She was inconsolable for 20 minutes. No thrashing, and it wasn't entirely clear she was awake, but she's pretty verbal, and was able to tell us that nothing hurt. As she calmed down she just said "Hug, hug, hug" over and over again. She didn't want to go back to her crib (where she normally prefers to sleep) so for the first time in a while we had a family bed. It was scary, and then heartbreaking.

She had a HUGE day yesterday, I had her in one more activity than was prudent (and realized it part-way through the day) and last night she walked on her own more than she ever has in her life (possibly cumulatively).

Does this sound like night terrors? And what should I do about it? Sears says nothing at all on this in his Baby Book; What to Expect said to leave them alone to self-soothe (no way, not when she's muttering Hug, Hug, Hug); and Brazelton described the lead-up perfectly, although by his account she's a little young yet. Then he scared me to death by stating that night terrors show up as small seizures when measured on an electroencephalogram.

Other than simplifying her schedule and holding her as long as she needs to, I'm at a bit of a loss on diagnosis and response. Is this a totally normal developmental phase or can I do something more to prevent this from recurring?"

I don't know if it's "night terrors" specifically, but it's definitely terror in the night. Poor thing. She reminds me of the monkey in the Jez Alborough book Hug.

I don't have much experience with this, myself. There have been a couple of nights when my older son woke up screaming in the middle of the night. We did what you did--went and comforted him, tried to figure out if there was anything physically wrong with him, and then brought him in with us to sleep the rest of the night. For us it seemed like isolated incidents that were, just like they were for you, a result of overstimulation the day before.

I hate to have to say "I've got nothing" to people who write in to me, so I went looking to the "experts" for the thoroughly-researched theory behind and treatment for night terrors. I didn't find anything helpful. Basically, the party line (that crosses sleep-theory party lines) is "Sometimes kids have night terrors. It'll pass." Gee, thanks. All of you people and your collective pontification couldn't come up with anything better than that?

So all of what I'm going to say is just a shot in the dark, but at least you didn't spend $14.95 for it on Amazon.

It seems to me that night terrors (aka "waking up in the middle of the night screaming") could be caused by any or all of the following things (or, of course, something we don't know about or understand):

* Too much activity or intensity the day before, or a few days before. Kids can seem fine with all the stuff that's happening around and to them, but then it'll come out in their subconsciouses while they're sleeping.

* Movement, or new skills in general. The brain gets ahead of the body or the body gets ahead of the brain, and something's got to give, so it vents off in the middle of the night.

* Food they've eaten that gives them bad dreams. I always thought the food-dreams connection was kind of bogus, but my husband swears that when he eats certain foods too close to bedtime he'll have nightmares. If it happens to adults, why couldn't it happen to kids?

* Scary sounds or images. Little kids are sponges for things they hear and see, even when they don't understand them. If they overhear scary (or even just intense) things on TV or movies or catch glimpses of images they don't understand, those things can ricochet around in their little brains and turn into something really frightening in the middle of the night. At our house it's a constant battle to mute the TV or change the channel when a scary trailer or commercial comes on because the baby sleeps on the other side of the wall the TV's against.

* Things that go bump in the night. There could be noises she's hearing as she sleeps that wake her up, but she's incorporating them into dreams that scare her. You know what I'm talking about--your alarm's going off but your mind makes it the sound of a fire alarm ringing in the dream you're in the middle of. If there are noises in your child's room at night, they could be morphing into whatever dreams she's having and making the dreams more intense.

* Fake panic attacks. She could be having blips in her nervous system. (Stay with me here.) During both of my pregnancies, I've gone through phases in which my hormones were raging so much that they stimulated my nervous system to produce all the symptoms of panic attacks. (Despite what I say about him otherwise, I will always be thankful to Dr. Sears for mentioning this as a possibility in The Pregnancy Book. I haven't read about it anywhere else, and I thought I was actually having real panic attacks for awhile.) It really feels exactly like a panic attack--racing pulse, confusion, sweating, closed-in feeling, desire to scream, fear--except that the only thing causing it is hormones, not feelings. It makes complete sense to me that a growing child (hormones!) could experience the same thing in the middle of the night. How could you not wake up screaming from that feeling?

I guess the upshot is that if you try to calm down her activity level, bland down her before-bedtime foods, and keep the noise pollution out of her hearing, there's not much else you can do to prevent night terrors. And they obviously do pass eventually. You're absolutely handling them the right way by comforting her. If she's fine going back to sleep where she usually sleeps, that's great, but if she needs to come in with you, a few nights in with you for the rest of the night isn't going to have much long-term effect on your sleeping arrangements. But knowing that her parents will come help her when she needs it will stay with her forever.

The "good news" is that once they're older and potty-trained, overstimulation results in wetting the bed instead of night terrors. That may not be good news for everyone, but I'd much rather have sheets to wash than have my sweetheart screaming in fear in the middle of the night.