Dennis Rosen M.D.

Sleeping Angels

Soothing Night Terrors

How to prevent night terrors and other confusional arousals

Posted Nov 02, 2013

Last week, a reader wrote:

Dear Dr. Rosen,

Over the last several weeks, my six-year-old has been waking up about 2 hours after falling asleep. She screams and cries inconsolably for about twenty minutes, goes back to sleep, and doesn’t remember anything when we ask him about it the next morning. This has been happening 3-4 a week since September. Any suggestions?

Frazzled in Philly

Dear Frazzled:

What you are describing sounds like night terrors, a common sleep disorder in young children.

All sleep is not the same. During the night, we repeatedly cycle between deep, light, and REM (rapid eye movement) sleep, occasionally awakening as we shift between the different sleep stages. Sometimes these transitions aren’t complete, resulting in parts of the brain becoming fully wake while others continue to be fast asleep. This can lead to behaviors that reflect aspects of both states, such as night terrors, sleep walking, and sleep talking.

In general, things which push a person in either direction (wake, deep sleep) will increase the likelihood of night terrors and other confusional arousals. These include anxiety, an irregular sleep schedule, insufficient sleep, and illness or other physical discomfort.

So how can you reduce the incidence of night terrors in your child? Aside from getting your child to bed (and up in the morning) at regular times that allow for an age-appropriate amount of sleep, it may be helpful to sit with your child in the last few minutes of the evening as she is getting ready for sleep and to go over the events of the day, trying to identify any sources of underlying anxiety which may be present and defusing them. Afterwards, you can try to refocus the child’s attention on more pleasant and soothing topics, either through conversation or by means of a story you read together.

When confusional arousals do occur, it isn’t necessary to awaken the child fully, as disturbing as it may be to you to see your child in this state. The most important thing is to keep her safe, and to prevent her from inadvertently injuring herself. Return her back to bed, and wait for it to pass on its own.


Dennis Rosen, M.D.

Help your child get a great night's sleep with: 

Successful Sleep Strategies for Kids (a Harvard Medical School Guide)