Patient's question:
My daughter is 1.5 years old. She often wakes up at night, screaming, and is quite alert, waking up at the slightest noise. What could be the reason for this, and what should I do?Doctor's answer:
Hello: About 3% of children experience night terrors, with slightly more males than females. They can occur at any age but are most common between 5 and 7 years old and become less frequent after puberty. Night terrors typically occur within the first half hour after falling asleep and no later than 2 hours.The clinical presentation of night terrors includes: The child suddenly awakens from sleep, sitting up with wide eyes, appearing agitated and terrified, though still in a dazed state. Their face may turn pale, breathing becomes rapid, pupils dilate, sweating occurs, and the pulse may accelerate to 180 beats per minute. If called during an episode, the child is often difficult to wake. They may ignore the call, continue to panic, cry, or shout, and tightly grasp anyone nearby, as if enduring intense suffering. They may ignore attempts by parents to comfort, hug, or reassure them. This state usually lasts for a short period before the child falls back asleep on their own. Some children may also experience sleepwalking during an episode, where they get up and perform simple, repetitive movements like opening a drawer, but have no memory of it afterward. The frequency of episodes varies, with some children having multiple episodes in one night or fewer episodes over days or weeks. Additionally, night terrors can sometimes be an early symptom of epilepsy, and an electroencephalogram (EEG) may be used to differentiate between the two. Night terrors often resolve on their own, whereas epilepsy does not.
The main causes of night terrors are anxiety and fright, such as severe illness or death within the family, the first time a child is separated from parents and enters an unfamiliar environment, or traumatic and frightening events that cause anxiety and distress. Furthermore, listening to scary or tense stories before bed or watching frightening or suspenseful media can also trigger them.