This child has experienced a night terror. Night terrors are sleep disturbances that occur only during non-REM sleep.
Night terrors occur primarily in children between age three and eight. They will often occur approximately 90 minutes into sleep, during stage 3 or 4 non-REM sleep. Children are often tachycardic, tachypneic, and diaphoretic during the episodes. Night terrors, as well as somnambulism and enuresis, all categorized as parasomnias, are thought to be related to central nervous system immaturity.
Thiedke discusses pediatric sleeping disorders. She notes that reassurance is the primary treatment for parents and children as night terrors are generally self-limiting. In those children for whom night terrors are not self-limiting or are especially disruptive, diazepam has been used with some success.
Davey et al. discuss the use of sleep diaries, home video, and a published questionnaire to assist in the diagnosis of night terrors. BEAR's questionnaire asks about bed time problems, excessive day time sleepiness, awakenings during the night, regularity and duration of sleep, and snoring. This helps to distinguish between night terrors and other pediatric sleep disorders such as nightmares, confusional arousal, sleep walking, and obstructive sleep apnea.
Video V is an example of a child having a night terror. Note the lack of responsiveness and the self-limited episode.
Answer 1: Night terrors generally resolve by age 8.
Answer 3: Night terrors only occur during non-REM sleep.
Answer 4: Night terrors are not specifically associated with child abuse. However, they can be a sign of a child experiencing stress, and so a discussion of potential stressors should be undertaken.
Answer 5: Night terrors are not associated with later development of mood disorders.
Thiedke CC. Sleep disorders and sleep problems in childhood. Am Fam Physician. 2001 Jan 15;63(2):277-84. PubMed PMID: 11201693.
PMID:11201693 (Link to Abstract)
Davey M. Kids that go bump in the night. Aust Fam Physician. 2009 May;38(5):290-4. PubMed PMID: 19458797.
PMID:19458797 (Link to Abstract)