Could my four-month-old son be having night terrors?

Dr. Pat

By Patrick J. McGrath OC, PhD, FRSC

Question:

My four-month-old son has been waking up screaming about an hour after going to sleep at night. This has been happening the last few nights. He falls asleep easily after following our normal routine, but starts screaming about an hour later. He often takes around five to 10 minutes to settle from a very upset state. Could he be having night terrors at 4 months, and can I do anything to help prevent this? What should I do?

Dr. Pat responds:

Your son’s pattern is typical for night terrors, but night terrors usually occur in older infants and young children. Night terrors sometimes are called confusional arousals and occur as a child is changing sleep levels. Children with night terrors tend to have more dramatic shifts in EEG patterns during the night.

The symptoms of night terror include very high levels of arousal (such as a high heart rate and often screaming) often early in the night. The child is not dreaming and usually has no clear memory of the event. When they come out of the terror, children may be quite confused or may just fall into a sleep. Children with night terrors seem to be in a great deal of distress, but they do not have any awareness of the arousal. They are not suffering.

There are two strategies that you can use when he has a terror:

• You can comfort and soothe him so that he falls back into a deeper sleep.
• Or you can try to arouse him, say by gently jostling him in your arms.

Of course at 4 months of age, your son cannot tell you anything. Atlhough it is likely that he is having night terrors, I would recommend you have his doctor examine him and check out any other possibilities.

Try to figure out if there has been anything different happening to him on the days he has night terrors. Is he over-tired? Is he having breathing difficulties because of a cold? This may give you a clue to events that trigger a night terror and how to help him.

Sometimes waking the child for a few minutes about 10 or 15 minutes before the terror is going to begin helps by disrupting the sleep cycle.

In almost all cases, children with night terrors grow up without any more problems than children without night terrors.

Patrick J. McGrath OC, PhD, FRSC is a clinical psychologist and a researcher. He is Professor of Psychology, Pediatrics, and Psychiatry at Dalhousie University and Vice President - Research at IWK Health Centre in Halifax. Read more "Ask Dr. Pat" columns Ask Dr. Pat a question