Stories about: Center for Pediatric Sleep Disorders

Soothing Night Terrors

Dennis Rosen, MD is the associate medical director of The Center for Pediatric Sleep Disorders at Boston Children’s Hospital and author of Successful Sleep Strategies for Kids. If you have a sleep-related question to ask, please email it to Thrive@childrens.harvard.edu.

Dennis Rosen, MD

Q: Over the last several weeks, my 6-year-old has been waking up about two hours after falling asleep. She screams and cries inconsolably for about 20 minutes, goes back to sleep and then doesn’t remember anything when we ask her about it the next morning. This has been happening three or four times per week for a few months. Any suggestions on how we can help her?

-Frazzled in Philly

A: Dear Frazzled,

What you are describing sounds like night terrors, which are quite common in young children. Unlike nightmares, which usually occur in the second half of the night, night terrors tend to happen in the first few hours after sleep onset. Another difference between the two is that while a child will likely remember some aspects of a nightmare after she awakens, with night terrors there is no recollection of them the next morning.

All sleep is not the same. Over the course of the night, we repeatedly cycle between deep, light and REM (rapid eye movement) sleep, sometimes awaking as we shift between the different sleep stages. When the transition between deep sleep and wake isn’t complete, parts of the brain wake up while others remain fast asleep.

This can lead to behaviors that reflect aspects of both the waking and sleeping state and can result in what are called “confusional arousals.” They include night terrors, sleep walking and sleep talking.

In general, anxiety, an irregular sleep schedule, insufficient sleep, illness and other physical discomfort increase the chance of night terrors and other confusional arousals.

How can you reduce the chances that your child will have a night terror? Start by keeping her on a regular sleep schedule. Put her to bed each evening—and wake her up in the morning—at a regular time, which allows for an age-appropriate amount of sleep.

You also may find it helpful to sit with her in the last few minutes of the evening as she is getting ready for sleep, and go over the events of the day to try and identify any sources of anxiety. If you do, try talking her through the problems or refocusing her attention on more pleasant and soothing topics through soft conversation or by reading a story together.

When confusional arousals do occur, it isn’t necessary to try and wake her up or to forcibly “pull her out” of them, even though it can be difficult to watch her cry or scream as she sleeps. The most important thing you can do is keep her safe by guiding her back to bed and waiting for the episode to resolve on its own.

If your child has a sleep-related issue that requires medical attention, please call our Center for Pediatric Sleep Disorders at 781-216-2570, or visit the center’s website and click the “request an appointment” button.

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How closely related are a good night’s sleep and good behavior?

A study recently published in the journal Pediatrics found that 7-year-old children with regular bedtimes are less likely to display behavioral problems during their waking hours than those children without fixed bedtimes.

Interesting, but not exactly earth-shattering, news.

“I don’t think that anyone with a 7-year–old child at home will be surprised to learn that well-rested children are typically better behaved,” says Dennis Rosen, MD, associate medical director of The Center for Pediatric Sleep Disorders at Boston Children’s Hospital. “While it’s nice to have the scientific data, these findings will probably only reinforce what most parents already know.”

While the study may not hold any breakthrough revelations, it did reveal that behavioral issues in children without set bedtimes could be reduced or eliminated once bedtimes are introduced. In other words, even if your child doesn’t have a bedtime right now, it’s not too late to start enforcing one, and doing so could correct or lessen behavior problems your child may be having.

So, if behavior is becoming a concern in your house and your child doesn’t currently adhere to a regular bedtime, now might be a good time to start.

According to Rosen, consistency is key in setting up bedtimes and helping kids stick to them. To do so, he suggests the following:

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Behavioral issues in children could be linked to snoring

If you’ve ever lived with a person who snores, you know the noise can be enough to keep you up at night. It’s an annoyance for sure, but new research shows that when young children snore it could lead to more serious behavioral and emotional problems.

A new study, published in the journal Pediatrics, shows that young children who have sleep-disordered breathing (snoring or other breathing issues during sleep) could be more likely to develop conditions like attention-deficit/hyperactivity disorder or anxiety by the time they’re seven years old. The study followed 13,000 children, from infancy to the age of 7, and found that those who snored or had some form of breathing problem while asleep were far more likely to develop behavioral or emotion problems than children who had no breathing issues while asleep.

So how are the two related? The answer is going to be different for each child, but it often comes down to how a child’s nighttime breathing affects his rest.

“When you have sleep-disordered breathing, you wake up momentarily when your breathing drops,” says Sanjeev Kothare, MD, interim medical director of the Center for Pediatric Sleep Disorders at Children’s Hospital Boston. “So if a child is waking up 50 times a night he’s not getting the proper amount of rest, and that could manifest itself in hyperactivity or other behavioral problems.”

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Why have kids’ sleep recommendations changed over the years?

There’s a general consensus among the medical community that many young people aren’t getting enough sleep these days. And with high tech distractions like TV, video games and the Internet competing for their late night attention, it’s no wonder that today’s children aren’t getting as much rest as they should.

But is there really such a thing as the perfect amount of sleep for young people? And is this current lack of sleep really a new problem, the byproduct of our kids’ fascination with Xbox, Facebook and the like? According to a new study in the journal Pediatrics, the answer is no on all accounts.

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