Confusional Arousals and Night Terrors

About a year ago, something terrifying happened while I was babysitting.

The boy had been asleep for a couple of hours when I heard the most blood-curling scream coming from his bedroom. I ran straight upstairs and saw him thrashing about in bed and gasping, like he’d been possessed. I instinctively grabbed him and brought him into another room (he shared a room with his brother who I didn’t want to wakeup) and did my best to comfort him. He kept then alternating between more screaming and then looking at me but more like he was staring right through me. He eventually came round but was so clearly so confused about where he was and what had happened.

At the time, I didn’t know what it was so presumed it was just a bad nightmare. However, now I have trained as a sleep consultant, I know it was a ‘confusional arousal’.

This is something that many parents have witnessed and most likely will never forget. So, I just wanted to explain a bit more about confusional arousals and night terrors- what happens and how to deal with them.

To begin with, let me explain the difference between the two:

Confusional Arousals-

These happen in the first 2-4 hours of sleep and your child may thrash about and seem distressed. If you approach them to try to comfort them, they might not recognise you. Like I saw with the boy I was babysitting, they might seem to be looking right through you, almost like a zombie. This is because they’re neither properly awake or asleep, almost like they’re stuck in a limbo state of in-between. Throughout a confusional arousal, they will stay in their bed.

Night terrors-

Night terrors happen in the first half of the night when your child wakes up abruptly from a deep sleep. They’ll appear distressed, thrash about and will often be inconsolable. They’ll be unlikely to recognise you if you try to comfort them. Throughout a night terror, they’re more likely to jump out of bed or move around.

Both confusional arousals and night terrors are distressing for a parent to watch but your child won’t remember the episode in the morning.

So how should you deal with them?

The best thing to do is to observe them from a distance while ensuring your child is safe. It feels counter-intuitive, try not to intervene and comfort your child as you may become a part of the terror itself and agitate your child even more.

What causes them?

Confusional arousals-

These are caused by overtiredness so the key is addressing where this is coming into your child’s day and night sleep;

· Are they getting enough daytime sleep?

· Are the naps spaced correctly with the right wakeful windows to make sure they are not getting overtired in-between?

· Are some late bedtimes creeping in?

· Are they starting the day to early?

Night Terrors-

These are also caused by overtiredness. But they can also be caused by other things like medication that induces deep sleep, or if your child is woken up suddenly by something like anxiety, a full bladder or a loud noise. If your child regularly has night terrors, it may help to have a chat with them to find out if anything is worrying them and then triggering the night terror episodes.

Night terrors are also more common in children with family history of them or of sleep walking behaviour.

There are also occasionally medical reasons that could be waking your child from a deep sleep and inducing a night terror such as enlarged tonsils (which can cause breathing problems). If you are concerned, then please speak to your GP.

Although these episodes are scary for adults to see, your child will be none-the-wiser and won’t remember a thing in the morning, so don’t worry. They’ll eventually grow out of them. In the meantime, by identifying the cause, you’ll be able to put in practical steps to resolve them.

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