Nightmares and Other Sleep Problems in Children

Topic Overview

Why is sleep important to your child?

A good night's sleep helps your child to grow, to form memories, and to learn. Sleep helps your child stay alert and focused at school and play.

Children who don't get enough sleep over time can have behavior problems and trouble learning. They may become moody, sad, or angry.

What kinds of sleep problems can children have?

Most sleep problems occur when the child is only partly asleep. Problems may include:

• Sleep talking: Your child may talk loudly or shout for a few seconds and then fall back asleep. You may not be able to understand what your child says. Sleep talking is more common than sleepwalking, although some children do both.
• Nightmares: These are very common in preschool and school-age children. Your child may cry out for your comfort or go to your room after a nightmare. The child usually can be reassured and calmed.
• Confusional arousals: Your child may wake up crying, confused, and groggy. He or she may not recognize you or be comforted. As with sleep talking, your child may say mixed-up words that make no sense.
• Night terrors: Night terrors are more intense than confusional arousals or nightmares. They are not very common, but they can be very upsetting for parents. Your child may suddenly scream or yell in a terrified way. He or she may thrash around in bed. A night terror can go on for many minutes. Your child may not recognize you and won't be comforted.
• Sleepwalking: Your child may walk around his or her room or the house. Your child's eyes may be open, but he or she is still asleep. Children who sleepwalk often can do very simple tasks, such as walking around furniture. But they can't do more involved things, such as eating a snack. Children may be in danger if they try to walk out of the house or climb out a window while sleepwalking.

Children spend more time than teens and adults in a deep stage of sleep that happens early in the night. Sleep problems such as night terrors often happen during the change from this phase of sleep into lighter sleep. Nightmares tend to occur later in sleep, in the early morning hours when children are dreaming.

It may take some time for your child to go back to sleep. Children usually remember a nightmare, but they don't tend to remember night terrors, confusional arousals, or sleepwalking.

What can you do to help your child?

Sleep talking

• Sleep talking usually lasts for only a few seconds. Then the child quickly goes back to sleep.
• If your child also sleepwalks, take the steps listed below under "Sleepwalking" to help keep him or her safe.

Nightmares

• Comfort your child with a hug and calming words. Remind your child that the nightmare isn't real.
• Your child may remember the nightmare and want to talk about it. Ask your child to talk about anything he or she is worried about. Worries and stress may make nightmares or other sleep problems more likely.
• Help your child stay away from scary books or movies before bed. Scary stories might lead to nightmares for some children.

Night terrors and confusional arousals

• Most children who have night terrors and confusional arousals don't want comfort from parents. They usually will fall back asleep when it's over, and they won't remember the event the next morning. But a night terror can be very upsetting to watch.
• Don't try to wake up your child. He or she may become more confused and scared.
• Because night terrors usually happen at the same time at night, your doctor may recommend that you wake your child 15 to 30 minutes before the problem usually occurs. Then let your child fall back asleep. This breaks the cycle of the sleep problem. This also may prevent sleepwalking.

Sleepwalking

• Don't try to wake up your child while he or she is sleepwalking. He or she may become confused and upset and have more trouble getting back to sleep.
• Gently and quietly lead your child back to bed.
• Make sure all doors and windows are locked so your child can't leave the house. Put a gate at the top of stairs.
• Put a ringing alarm on your child's door that will alert you when he or she leaves the bedroom.
• As with night terrors, you may be able to prevent sleepwalking by waking your child 15 to 30 minutes before sleepwalking usually occurs. Then encourage your child to go back to sleep.

When should your child see a doctor for sleep problems?

Children outgrow most sleep problems. But you may want to take your child to the doctor if:

• Your child often has trouble getting up in the morning.
• Your child often seems sleepy and irritable during the day.
• Your child has problems with schoolwork or behavior.
• You aren't getting enough good sleep.
• Your child sleepwalks and you're worried about keeping him or her safe.

The doctor may look for health problems that could cause sleep problems. For example, children who are under stress because of problems at home or at school may be more likely to have nightmares.

Your doctor may suggest counseling if your child has a lot of stress and often has nightmares.

Most children don't need medicine. In rare cases, a child may take medicine to help control the phase of sleep in which sleepwalking occurs.