Night Terrors In Children

Terror Night (also called night terror) is a typical disorder of childhood, and is characterized by a partial arousal from deep sleep accompanied by screams, intense agitation, pallor, sweating, rapid heartbeat, rapid breathing. The child appears inconsolable, unresponsive to environmental stimuli and, if you woke up, confused, disoriented and does not recognize the people around you. Sometimes you can get out of bed, walking, and / or screaming for home terrified. Immediately after he is woken up in the morning or after the child does not remember the event. It is a sleep disorder which fall in parasomnias (changes in the normal sleep structure), it looks more like an anxiety crisis.

SYMPTOMS
During an episode of night terror, a person may:
- Sit on the bed
- Cry, cry
- Have muscle stiffness
- Sweat, breathe heavily or have tachycardia
- Not being able to wake up
- Be inconsolable
- Get out of bed and run around the house
- Engage in violent behavior (more common in adults)
- Be with eyes wide open
- Do not remember anything in the morning.

DURATION OF EPISODES
The episodes usually occur in the first third of the night, and the duration of the episode may last from a few seconds to 10 minutes, but in some cases can be up to half an hour. The disorder shows a gradual and spontaneous remission in time.

WHEN YOU COMPARE THE DISORDER
Night terrors are relatively rare, affecting only a small proportion of children, often between the ages of 3 and 12 years. Although the night terrors are most common in children, they can also affect adults aged between 20 and 30 years. However, usually the night terror is not cause for concern being a benign and transient phenomenon.

RELATIONSHIP BETWEEN Terrors NIGHT AND OTHER PSYCHOLOGICAL DISORDERS
Children with night terrors do not have a higher incidence of mental disorders or psychopathology than the general population.
On the contrary, in adulthood, it is higher than the incidence of problems related psychopathology, such as Posttraumatic Stress Disorder and especially Anxiety Disorders. The Personality Disorders that are associated with night terrors are the Employee Disorder, Schizoid, and Borderline.

DIAGNOSIS

For the diagnosis it can be made an examination to identify any physical or psychological conditions that may contribute. The sleep study (polysomnogram) in a sleep lab overnight is appropriate if that requires a differential diagnosis with episodes of seizure in sleep or is suspected of breathing problems in contemporary sleep. For the rest, the diagnosis on the basis of the clinical history may be sufficient.
The differential diagnosis must be made with the nightmares, typical of REM sleep, which differ in the phase of sleep concerned (first part of sleep in the case of night terrors, middle stage / last part in the case of the nightmares), but also for the fact that generally the dreamer of a nightmare wakes up from the dream and remember the details, but a person who has an episode of terror remains asleep and has a total amnesia of the episode in the morning.
Night terrors, also, must be distinguished also by episodes of nocturnal panic attacks which consist of an awakening associated with tachycardia, sweating and feeling of suffocation.
Often, the events of the night terror overlap with those of sleepwalking from which the night terror is different for the activation of the autonomic nervous system (palpitations, sweating, trembling, redness) and the expression of terror.

CAUSES
Various factors can trigger an episode of night terror:
- Sleep deprivation
- Fatigue
- Stress
- Anxiety
- Fever (in children)
- Sleep in an unfamiliar environment
- Lights and sounds
- Breathing problems
- Familiar: there is a 10 times greater risk of developing night terrors if at least one of the close relatives have experienced this or other parasomnias (eg. Sleepwalking) in their lives.

 COMPLICATIONS

The terrors are not necessarily a problem. However, they can cause excessive daytime sleepiness, which can lead to difficulties in school (or at work, in the case of adults), or problems with daily activities. Incidents of terror during sleep can cause discomfort in social and affective. The person, in fact, can begin to avoid situations where others might be aware of the disorder, like go camping, sleeping from friends or classmates (or sleep with a partner, in the case of adults).
Harming themselves or others is another possible complication rare. Occasional night terrors are not usually a cause for concern.
It 'important to consult a specialist if:
- Become more frequent
- Disturb sleep
- Cause the child to fear going to sleep
- Lead to dangerous behaviors or harmful
- Seem to follow the same pattern each time.

TREATMENTS
If the night terrors have a frequency of less than one episode per week and do not put at risk of accidents the child treatment is not necessary.
If the night terror is associated with an underlying medical condition or psychological treatment it is aimed at the underlying problem. If stress or anxiety appear to contribute, it is crucial the meeting with a psychotherapist.
Drug treatment is used only in extreme cases (frequent episodes or risky for the safety of the child), as it may cause side effects.

ACTION TO TAKE HOME?
Usually when parents see their child fussing and crying during the night in terror, they feel helpless and stir in turn trying to stop the crisis in any way of the little terror.


It 'important to adopt certain behaviors in order to calm the child without harm it:
1) When your child has a fit of terror, it is important to remain calm. Do not ever shake nor shouting in the presence of an episode of night terror, this would worsen things. Much better to wait and calm the baby with tranquility. Sometimes the feeling of impotence in the face of the child is strong but it is important not to scare more.
2) During the terror attack the child is awake. When he rushes to him, you must be careful not to wake him taking him in her arms, as this may worsen and prolong even further the current crisis. Rather, you can pet it gently, making him still feel your presence beside him. Although he will scream and cry for a while, it is important to try to talk to him in a low voice.
3) Probably, if the child has had a seizure, the cause is to be found in some event that happened during the day, which somehow generated stress and tension in him. Therefore it is important to try to limit the stimuli throughout the day and treat sleep hygiene (keep a regular sleep-wake rhythm, avoid caffeine and cola, etc ...).
4) Finally, it is counterproductive to report to the child, the next day, what happened during the night as it may cause anxiety disorders.