
Night terrors are a common occurrence in children, with 13% of 5-year-olds experiencing them. They are characterised by screaming, shouting, or wailing while in a deep sleep state, often appearing awake but remaining inconsolable and confused. While night terrors can be distressing for parents, they are usually benign and children will outgrow them without any clinical intervention. They are triggered by various factors, including sleep deprivation, emotional stress, and a noisy sleeping environment. If night terrors become disruptive, certain strategies such as maintaining a consistent sleep routine and addressing underlying triggers can help prevent them.
| Characteristics | Values |
|---|---|
| Condition | Night terrors |
| Occurrence | Common in children aged 2-4 years, but can happen up to 12 years |
| Symptoms | Screaming, shouting, wailing, staring blankly, crying, breathing rapidly, sweating, thrashing around, sitting up, running around, talking |
| Cause | Sleep deprivation, full bladder, emotional stress, anxiety, bullying, noisy sleeping environment, alcohol or caffeine consumption, febrile illness, ADHD, autism, epilepsy, sleep apnea, PTSD, etc. |
| Treatment | Consistent sleep routine, limiting stress, waking them prior to an episode, co-sleeping, addressing triggers, maintaining a comfortable sleeping environment |
| Medical Attention | Consult a doctor if night terrors are severe, last longer than 30 minutes, happen more than once a week, disrupt daytime functioning, or are accompanied by breathing problems |
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What You'll Learn

Night terrors
Symptoms and Causes
During a night terror, a child might sit up and scream in terror, with a racing heart, rapid breathing, sweating, and thrashing movements. They may even get out of bed and run around. While they might appear awake, they are actually in a hybrid sleep-wake state, and it is difficult to wake them fully. Night terrors occur during deep sleep, usually in the first few hours after falling asleep, when the brain enters non-REM sleep and the "fight-or-flight" response becomes overexcited.
The exact causes of night terrors are not fully understood, but they can be influenced by various factors, including sleep deprivation, a full bladder, emotional stress, anxiety, bullying, a noisy sleeping environment, and certain substances like caffeine. Additionally, underlying conditions such as ADHD, autism, epilepsy, sleep apnea, and PTSD may also contribute to night terrors.
Management Strategies
While night terrors can be alarming, there are ways to manage them:
- Do not wake them: Waking a child during a night terror is not recommended. They will likely be confused and disoriented, and it may take longer for them to settle down and return to sleep.
- Ensure safety: Keep your child safe by preventing them from hurting themselves during the episode. Remove any sharp objects or obstacles, and stay close to guide them away from potential hazards.
- Maintain a safe sleep environment: Take measures to create a safe sleep environment by covering sharp corners, removing freestanding lamps, and securing windows.
- Follow a bedtime routine: Establish a consistent and relaxing bedtime routine to promote better sleep hygiene. A simple routine like a bath, story, and bed can help.
- Address underlying factors: Identify and address any underlying factors that may trigger night terrors, such as stress, anxiety, or sleep deprivation. Consult a doctor if you suspect any underlying medical conditions.
- Wake before the episode: If night terrors occur regularly at the same time, try waking your child about 15-30 minutes before the expected episode. This can help interrupt the deep sleep cycle associated with night terrors.
- Consult a doctor: If night terrors are severe, frequent (more than once a week), or affecting your child's overall sleep and daytime functioning, consult a doctor. They may recommend further evaluation or treatment options.
Remember, night terrors are typically outgrown by the teenage years, and most children will not remember the episodes. It is important to remain calm and follow the above strategies to help your child manage and eventually overcome night terrors.
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Nightmares
Night terrors, on the other hand, are more dramatic and intense experiences. During a night terror, a child may scream, shout, or wail, and their eyes may be open, but they are still asleep. They may also experience increased heart rate, rapid breathing, sweating, and agitation. Night terrors occur during deep sleep, usually in the first few hours after falling asleep. While they can be alarming, night terrors are typically harmless and most children outgrow them by puberty.
If your 5-year-old is experiencing frequent night terrors, there are some strategies you can try. Maintaining a consistent sleep schedule and a relaxing bedtime routine can help prevent night terrors. Ensuring your child gets enough sleep is crucial, as sleep deprivation can trigger night terrors. Creating a comfortable sleep environment, such as keeping the lighting low and using white noise to block out disturbing sounds, can also be beneficial.
In some cases, night terrors may be related to underlying conditions such as sleep apnea, reflux, or emotional factors like stress, anxiety, or bullying. If you suspect any of these factors are contributing, it is important to consult a healthcare professional for guidance. They can provide advice and, if necessary, refer you to a sleep specialist or other specialist for further evaluation and treatment.
It is important to note that while night terrors can be distressing for parents, it is generally advised not to wake your child during an episode. Instead, sit quietly nearby to ensure their safety and let the night terror run its course. Most children will eventually calm down and return to sleep within a few minutes without any recollection of the event in the morning.
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Separation anxiety
Night terrors are a common occurrence in children, with a longitudinal study finding that 13% of 5-year-olds experience them. During night terrors, children are in the deepest stages of sleep but may be screaming, breathing rapidly, sweating, and thrashing around. While night terrors can be distressing and disruptive to a child's sleep, they are generally harmless and not considered dangerous. They usually go away on their own before adolescence, and children rarely remember them the next day. It is best not to wake a child during a night terror, as this can cause confusion and upset. Instead, parents should sit quietly nearby to ensure the child's safety and let the night terror run its course. Maintaining a consistent bedtime routine and good sleep hygiene can help prevent night terrors.
In summary, if a 5-year-old is screaming in their sleep, it could be due to night terrors or separation anxiety. While night terrors are generally harmless and require a calm, patient approach from parents, separation anxiety can be addressed through consistent routines and strategies that promote comfort and security.
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Illness
If your 5-year-old is screaming in their sleep, it could be due to an illness. Illnesses such as fevers, vomiting, ear infections, body aches, and congestion can cause discomfort and pain, leading to your child screaming or crying in their sleep. In some cases, it could be due to an unexplained fever, also known as febrile illness.
It is important to monitor your child for any additional symptoms that may indicate a more severe illness. These symptoms can include persistent high fever, lethargy, vomiting, diarrhea, or symptoms of an ear infection. If your child exhibits any of these symptoms, it is recommended to consult a pediatrician or seek immediate medical care if you suspect dehydration, breathing difficulties, or extreme lethargy.
Additionally, illnesses can disrupt your child's sleep patterns and cause them to become overtired. This overtired state can further contribute to sleep disturbances and make it more challenging for your child to settle down and fall asleep. Ensuring that your child gets enough sleep and maintaining a consistent sleep routine can help prevent and manage sleep disruptions caused by illness.
While illnesses are a common cause of sleep disturbances in children, it is important to consider other potential factors as well, such as night terrors or nightmares. Night terrors are episodes of intense screaming, crying, or fear during sleep and usually occur during non-rapid eye movement (non-REM) sleep. They can be distressing for both children and parents, but they are typically benign and not considered dangerous. Most children outgrow night terrors before their teenage years.
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Teething
If you suspect that your child is screaming in their sleep due to teething, look for other common teething symptoms during the day. For example, if your child has been chewing on everything during the day, they are likely teething. Other symptoms of teething include drooling, gum soreness and irritation, mild fever, diarrhoea, and a rash.
There are several ways to provide relief from teething pain and help your child sleep better:
- Gum massage: Try offering your child a cooling gum massage with a clean finger or a durable teething ring.
- Teething toys: Solid plastic teething toys can be chilled in the fridge or freezer to provide additional relief. Be sure to inspect the teething toy after each use to ensure there are no broken pieces that could pose a choking hazard.
- Over-the-counter pain medication: Baby acetaminophen (Tylenol) or age-appropriate ibuprofen can help block mouth pain and improve sleep. Always check with your child's doctor first to confirm the proper dosage.
- Distraction: Sometimes, a bit of distraction can help redirect your child's attention away from the discomfort. White noise machines can also help some babies fall asleep despite the pain.
It is important to maintain a consistent sleep routine and keep your child as comfortable as possible during teething. While teething can be challenging, it is a temporary situation, and most children will eventually grow out of it.
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Frequently asked questions
It could be that they are experiencing night terrors. Night terrors are when children enter a state of panic during deep sleep, often looking awake but remaining unaware of their surroundings. They are usually harmless and children will outgrow them.
It is recommended that you do not try to wake your child during a night terror. Instead, sit quietly by their side and ensure they do not hurt themselves by thrashing or running around. Night terrors usually pass in a few minutes, after which your child will go back to sleep.
Night terrors can be prevented by addressing common triggers such as sleep deprivation, a noisy sleeping environment, emotional stress, and anxiety. Establishing a consistent sleep routine can also help. If your child has regular night terrors, try waking them up 15-30 minutes before they usually occur.
Night terrors are usually benign and do not warrant clinical attention unless they are severe enough to disrupt daytime functioning. However, if you are concerned, consult a doctor and consider keeping a sleep diary to track your child's sleep patterns.























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