Ask the expert: Turn a nightmare into a knight’s tale

Q My six-year-old daughter often has nightmares in the middle of the night, sometimes twice a week. She can get very upset and then comes into our bed for comfort. What is the best way to help her? Is there anything causing them, and should we continue to let her come into the bed with us or try to help her cope alone?

A Frightening dreams and nightmares are very common in young children from about three to eight years of age, and many children have weekly nightmares. While nightmares can happen more frequently when a child is stressed about something, or after a worrying event, in most cases there is no specific cause.

Generally, nightmares are thought to be the result of the everyday worries and stresses associated with the trials and tribulations of growing up.

If your daughter wakes up during a nightmare, your important role as a parent is to be reassuring and supportive. Listen to what happened in the dream if she needs to tell you, before reassuring her that it was only a dream and that everything is okay.

Stay with her until she is relaxed enough to return to sleep and you might find it helpful to repeat gently a relaxing mantra: “Everything is fine, go back to sleep now.”

Whether or not you let her come into your bed is your personal judgment. It is perfectly okay to reassure her as you tuck her into her own bed and help her settle back to sleep, and this may help her learn to cope by herself in the long term.

You can also help her cope with recurring bad dreams by talking about them in the morning. Ask your daughter to tell you what exactly happens in the dream. You can also help her to imagine strategies she might use if it recurs.

For example, if she is being chased by a monster, maybe she can gain a special power to fly away or invent a special wand to turn the monster into a frog.

Help your daughter think of other, happier endings for the dreams. Expressing what happens in the dreams during the cold light of day with some humour and creative imagination can remove a lot of the fear.

Finally, protect your daughter from unnecessary triggers for the dreams during the day. Take time to ensure there is nothing particularly worrying or stressing her at home or in school.

Make sure she is not reading scary books or watching frightening television shows. Remember, young children can worry about upsetting news stories and may need to be protected from over- exposure to them.

Q We found our four-year-old son sitting up the other night screaming and shouting. He looked really upset and agitated, yet seemed to be still asleep. It was very upsetting to see and we didn't know what to do. In a few minutes he settled down and went back to sleep soundly. My sister says it was probably a night terror. Is that the case, and is there anything we need to worry about?

A What you describe does indeed sound like a night terror. Though very upsetting to witness, night terrors are a common disturbance in young children’s sleep.

During a night terror, the child might sit bolt upright screaming and shouting, breathing very fast and appearing very upset, almost in a fearful or panicked state. They may thrash around with their eyes open, yet, strangely, still asleep. Usually after a few minutes the child calms down and settles back to a relaxed sleep.

A night terror differs from a nightmare in a number of ways. Whereas children usually awake from a nightmare and can remember the details, children tend not to remember a night terror as they are usually in a deep sleep at the time and aren’t dreaming.

In addition, whereas most children have an occasional nightmare, night terrors are relatively rare (some studies say 3-6 per cent of children experience them).

While night terrors can happen at any age, they tend to be most common between the ages of four and 10 years old. A child might have a single night terror, or several, before they grow out of them as they mature.

While there are no specific causes to night terrors, they can be more common when children are overtired, or whose routine has been changed.

No harmful effects
The good news is that night terrors are generally considered benign and, although they are distressing to witness as a parent, they have no harmful effects and children tend to grow out of them over time.

The best way to handle a night terror is to wait it out patiently and make sure your child doesn’t get hurt by thrashing around.

Sometimes it can be helpful to hold your child gently and to say comforting, relaxing things. Children usually will settle down and return to a relaxed sleeping state on their own within a few minutes.

Generally, it is not recommended that you wake a child who is having a night terror. It usually doesn’t work, and if you do succeed in waking your child, he is likely to be disoriented and confused, and may take longer to settle down and go back to sleep.

You can also help to prevent night terrors by ensuring your child does not get overtired or stressed, and by creating a relaxing routine before bedtime.

For the relatively few children who get frequent night terrors, it might help to wake your child up before the time that he usually has a night terror.

This is thought to interrupt or alter the sleep cycle and prevent night terrors from occurring.

If this continues to be a concern for you, consult your GP about whether a referral to a paediatrician or sleep specialist is necessary.

Dr John Sharry is a social worker and founder of the Parents Plus charity. See solutiontalk.ie for details of his books and courses.