Sleep is a luxury for new parents. Just when you’ve fallen asleep, your 1-year-old starts crying uncontrollably and you haven’t a clue why. Struggling to stay awake, your mind starts ticking through all the possibilities for his discomfort while you try to calm him. There’s no fever. His diaper’s dry. He was fed just before putting him down. Is it teething, or could it be his first nightmare?
Nightmares vs Terrors
Do babies actually have nightmares? Or could it be a night terror?
“It’s not known for sure when nightmares begin, but by age 1 – 2, children can have them,” says Phaythoune Chothmounethinh (Dr. Phay), M.D., at Saint Thomas Medical Partners in Franklin. Dr. Phay says night terrors can begin as early as 2 years old, but are more common in children between the ages of 4 and 12. One thing’s clear: there’s a definite difference between a nightmare and a night terror.
“Nightmares generally occur in the early morning hours, while night terrors tend to occur within one to two hours of falling asleep,” says Dr. Phay. If your child wakes from sleep and goes right into screaming, appears agitated and doesn’t respond to you, he’s experiencing a night terror. Dr. Phay also says the child won’t remember the episode later.
Ruling Things Out
Of course, while nightmares or night terrors may first pop into your head as the cause of nightly wakings, be sure to check for other things, too.
“Virtually any illness or condition can lead to crying — hunger, skin irritation from diaper rash, teething, infections such as ear infections, fever, acid reflux,” says Dr. Phay. “If he has a fever or is having trouble feeding, your pediatrician can help rule out other possibilities such as infection or GERD (gastroesophageal reflux disease). If your child is lethargic or has difficulty breathing, seek medical attention immediately.
If you’ve ruled out health issues and are convinced your child’s experiencing nightmares, avoid giving him a sleep aid such as melatonin.
“The brain naturally produces melatonin, a neurotransmitter that helps signal sleep,” says Dr. Phay. “It has a good safety record for short-term use in adolescents and adults, but we don’t know the effects of extra melatonin on early childhood development.”
Melatonin supplements are not recommended for babies and should rarely be used for children and only under a doctor’s supervision. Children who have seizures may experience more of them if given melatonin. It can also trigger hyperactivity, behavioral changes, worsening sleep patterns, nightmares and constipation. The safest course of action is to try and pinpoint the underlying cause of sleep trouble in your child rather than to rely on sleep medication for any child younger than the age of 12.
Helping your child to have a good night’s sleep begins in babyhood when you establish a soothing bedtime routine and make it consistent. Dr. Phay suggests starting with a warm bath, a gentle song, a bedtime story, etc.
There’s an entirely different method to approaching a child experiencing a night terror, which generally occurs in the first one-third of your child’s sleeping hours.
“For night terrors in older children, ‘scheduled awakening’ is a behavioral technique where you wake up your child 15 – 20 minutes before the usual time when the sleep terrors occur,” says Dr. Phay.
“During the scheduled waking, comfort him and behave as you would when awakened by him.” Doing this on a routine disrupts his sleeping pattern and can help him sleep through the night again within one month’s time.