Bad Dreams and Nightmares
Though parasomnias (night terrors) are more easily identifiable by their symptoms to the parents of babies too young to talk about what has frightened them, bad dreams and nightmares are harder to pinpoint. At what age are babies capable of having such bad experiences in their sleep? It's hard to say. We know that by the age of two, toddlers are capable of having scary dreams.
But how much earlier can these incidents occur? Though no one can answer that with certainty, if your baby wakes up crying for no apparent reason, if he seems frightened, and if he clings to you, there's a good chance he's had a bad dream or a nightmare.
What causes a bad dream or nightmare in a baby?
It is difficult to know for certain. Parents should avoid exposing their babies to scary television shows or movies, scary music, or even mildly scary games in the period shortly before bedtime, as these could contribute to scary dreams.
Certain medications and some foods can increase metabolism, which in turn can bring about nightmares. If your child appears to be having nightmares and this occurs more often than once in a while, talk to your pediatrician and see if he or she feels that anything in your baby's diet might be inducing these incidents.
Time for TLC
If your child seems to have had a nightmare, comfort her, hold her, and reassure her. For very young kids, reassuring them that it was “only a dream” is useless. Even if your child is a toddler old enough to have a very limited vocabulary, she cannot understand the concept. Rather, cuddle her, stroke her, and show her that there's nothing to be afraid of. Leave a night-light lit, turn on a lamp on a low setting, or leave a hallway light on that will illuminate the room partly. Don't make it so bright that she'll have trouble falling asleep or get confused as to whether it's night or day, but do let her see that there's nothing lurking in the darkness waiting to get her.
If your child has experienced a nightmare and doesn't want to go back to sleep, it's okay for you to stay with her in her room for a little while. Hold her, rock her, then put her down in her crib and keep talking (or singing) to her, keep your hand in contact with her body, and encourage her with your soothing voice to go to sleep. If she has a “lovey” (such as a teddy bear) or if she uses a pacifier, offer it to her.
Parasomnias/Sleep Terrors/Night Terrors
Parasomnia is an umbrella term that encompasses a number of behaviors occurring when a baby or toddler partially wakes from sleep in a state of terror and/or confusion. Though frightening, these incidents are more common among babies and toddlers than you may realize and occur to most children at least once. Children old enough to walk may sleepwalk.
The difference between night terrors and nightmares is that nightmares are dreams, which occur during REM sleep (active sleep), whereas night terrors occur as a child is coming up from non-REM sleep (quiet sleep), when he is not dreaming. How can you tell if your child is having nightmares or night terrors? In children old enough to talk, it's easier to distinguish. If, on the morning after the event, the child has no memory of it, it was almost certainly a night terror; nightmares often are remembered. An even better barometer is that babies (or older children) experiencing a night terror frequently don't recognize their parents and are generally confused, which is not true of nightmares. Another means of determining, which will work even with babies, is that night terrors usually occur within an hour or two of falling asleep; nightmares occur in the latter part of the night.
These incidents seem to occur when the child has been in a deep and dreamless sleep and he only partially awakens from it. It is difficult to get him fully awake if you try, even though he may be sitting up in his crib and/or thrashing around. If you try to comfort him or hold him, he may flail against you or resist you. He may return to sleep quickly on his own, or he may remain semi-awake for as much as half an hour before returning to sleep, most commonly to a deep sleep.
Many parents worry that their children who have parasomnias are exhibiting symptoms of a psychological problem or disturbance. This simply isn't so. Though the child appears to be terrified — and the parents, witnessing the event, most surely are terrified — parasomnias are not in any way indications of anxiety, depression, hallucinations, or any other psychological problem.
Indications of Sleep Terror
Your first indication that your child is experiencing a sleep terror is likely to be a scream or shriek that sounds different from his usual cry. His facial expression may cause him to look horribly frightened. Other physical indications that may be present include dilated pupils and rapid breathing. In addition, your baby may appear sweaty, and if you put your hand on his chest, you may find his heart racing.
Certain factors can predispose a child to experience sleep terrors:
Sleep deprivation and, indirectly, stress. Sleep terrors are more likely to occur the night after a bad or incomplete night's sleep. Though psychological problems do not cause parasomnias, stress can be an indirect cause in that stress causes sleep loss and sleep loss in turn can bring on night terrors.
Sleeping in a strange place. Even a “happy” strange place — a hotel room or cottage on a vacation or a night spent at Grandma's — can predispose a child to an incident of parasomnia.
Illnesses, especially those accompanied by high fever. Even a child who has never before experienced night terrors may have such an event under these circumstances.
Certain medications. If your child has recently begun taking a new prescription and begins experiencing night terrors, check with your pediatrician to see if something more than mere coincidence is at work here.
Sleep apnea. Because your baby who has sleep apnea is transitioning from deep sleep to wakefulness suddenly and more often, she is more subject to parasomnias than the average baby.
Parasomnias, though scary to the parents, are not dangerous to the baby. In older children who may sleepwalk, there is a danger of them falling down stairs or even out a window, even though sleepwalking children can see where they are going; but babies confined in cribs, even if they are old enough to walk, are fairly immune to such dangers.
Parasomnias tend to run in families. If your first child experiences night terrors or any other form of parasomnias, there's a better-than-average chance that your next child(ren) will, too, and also a good chance that one or both parents experienced them, whether or not you or your spouse are aware that you did.
If your baby experiences an occurrence of parasomnia, don't try to wake him during it. Though the old adage that waking him will harm him is simply not true, what it will do is make the event last longer. Don't try to comfort him, either, as it will only agitate him. In fact, there is not much you can or should do that is proactive during the course of the event, but you can try to settle the child back down and comfort him and then settle him back to sleep once the event is over. Your best proactive move is preventive: Try to ensure that he sleeps long enough and on a regular schedule so as to preclude avoidable recurrences. You may not be able to avoid all occurrences of parasomnia, but knowing that certain factors, including sleep deprivation, make an occurrence more likely means you're better able to prevent them.