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Sleep and Sleep Disorders in Children (cont.)

Nightmares vs Night Terrors and Confusional Arousals in Children

Nightmares occur during REM sleep and thus are more common later in the night. The child acts scared and will often be able to remember his or her dream. Simple parental reassurance and comforting are effective.

In contrast, night terrors occur in non-REM sleep and thus, generally, within the first four hours of sleep. The child may become very violent with thrashing of the arms and legs while crying out in a confused manner. Routine comforting of the child is not helpful and the child will be confused and bewildered when awakened. Generally, the child will rapidly return to a "normal" sleep with no memory of the events in the morning.

Confusional arousals are a variant of night terrors. It is believed that the child is so deeply asleep that the normal waking pattern at the end of the sleep cycle is suppressed. The major distinguishing point between confusional arousals and night terrors is that the former gradually builds from moaning to crying out and may culminate in the child standing and yelling out apparent random words or phrases. Night terrors tend to have an acute onset with the very rapid development of thrashing and yelling (commonly for parents). Both conditions share several points that parents should consider when they encounter either situation.

  • Don't try to awaken the child. They are asleep and if awakened, they will have a difficult time falling back to sleep.
  • Anything that upsets the normal sleep rhythms -- such as illness, being away from home, and disrupted naps -- may trigger either pattern.
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