Sleep disorders in children: nightmares, night terrors and main alarm signals in sleep disorders in childhood

What are nightmares and night terrors and how to differentiate?

Nightmares and night terrors are parasomnias. They are childhood behavioral changes that occur during sleep, characterized by motor and vegetative behaviors that occur in times of sleep and wakefulness part.

The distinction between nightmares and night terrors is as follows:

Nightmares occur in the second half of the night and REM sleep. In these cases children are easily aroused and remember what happened, often the dream itself. They recognize their parents and ask, for fear that comfort them, which also prevents them initially reconcile sleep.

Instead, night terrors occur during the first half of the night, children do not recognize their parents and may even reject. many alarming physical manifestations also appear to be common for the child sits in bed and cry, sweat, cry with a facial expression of terror and signs of intense anxiety (may be dilated pupils and tachycardia appear). As it regards recovery sleep, sleep easily become. But they do not usually wake up even if they have their eyes open and with efforts to do so, which is inadvisable. However if you wake up, the child is disoriented for a few minutes and with a feeling of fear, there is total amnesia of what happened. Although episodes of night terrors can be alarming for parents as they tend to think that the child comes up with something serious or is suffering, most children outgrow them to grow, being helpful guidance from a specialist to provide customized educational guidelines.

Why do they occur?

Children are very susceptible to all that happens around them. A given situation may provoke an elevation of anxiety and manifest in their dreams. If nightmares are sporadic, and children receive understanding and support, it will be only a temporary, simple concern, but if it is not resolved can lead to anxious demonstrations and that nightmares are frequent daily.

Normally, nightmares last few weeks and are related to some external stimulus that has alarmed the child. As decreases anxiety, nightmares are also disappearing in frequency and intensity.

Night terrors can be caused by different factors. Sleep is an evolutionary process, which until five or six years does not reach maturity. Experts say these changes tend to improve with age by brain maturation.

What age usually appear?

They can start between 6 and 7 months, being more frequent between 2 and 6 years.

How you can reassure the child?

In nightmares

• Try to avoid situations that may scare the child (movies ...).
• Reduce daytime stress generated from the child's environment.
• Find a quiet environment before bedtime.
• Explain how they have fared the day, they also help comment and express their emotions. Or if they are very small through drawing or playing with puppets.

After the nightmare:

• Go to your room to reassure them, get importance to what happened and stay a while with them until they begin to sleep

In night terrors

• Prevention is the best, try that children go to sleep more rested and calm. Roundly avoid any screen (TV, computer, tablet or mobile) one hour before bedtime.
• Given the time of night terror must have a conservative attitude of parents, making sure that the child does not fall out of bed or knock.
• Be at his side in a discreet way because if we try to catch him may not want.
• Do not try to wake him.
• The episode will yield after 4 or 5 minutes, can persist up to 15 minutes.

Both in nightmares and night terrors is necessary to help the children feel relaxed and calm when approaching bedtime. It is also very useful to create a pleasant routine for the child and tell a story or hear a soothing melody, which will help the child is calm at the time of going to sleep. Then is best left in your room and say goodnight. In the case of young children, it is important to talk about their fears to help them overcome. What is counterproductive laugh at your fears or minimize. However, we must not feed back their fears, but explain to them that have the strength to face them and overcome them.

When to see a specialist when infant sleep disorders?

It would be desirable to see a specialist in Child and Adolescent Psychiatry when we observe the following warning signs: Sleep disorders by educational cause, Fear of sleep, insomnia, hypersomnia or obstructive apnea. Also when the child has night terrors, sleepwalking and bruxism. And finally when there somniloquy, offense capitis and narcolepsy.

Dr. Jordi Andreu Sasot Llevadot and Jenifer