What are Night Terrors?

What are “night terrors” and why do children get them?
Grace Montenegro – Fremont, California

Dr. Greene’s Answer:

Within fifteen minutes of your daughter’s falling asleep, she will probably enter her deepest sleep of the night. This period of slow wave sleep, or deep non-REM sleep, will typically last from forty-five to seventy-five minutes. At this time, most children will transition to a lighter sleep stage or will wake briefly before returning to sleep. Some children, however, get stuck — unable to completely emerge from slow wave sleep. Caught between stages, these children experience a period of partial arousal.

Partial arousal states are classified in three categories: 1) sleep walking, 2) confusional arousal, and 3) true sleep terrors. These are closely related phenomena that are all part of the same spectrum of behavior.

When most people (including the popular press and popular parenting literature) speak of sleep terrors, they are generally referring to what are called confusional arousals by most pediatric sleep experts (Principles and Practice of Sleep Medicine in the Child, by Ferber and Kryger). Confusional arousals are quite common, taking place in as many as 15% of toddler and pre-school children. They typically occur in the first third of the night on nights when the child is over-tired, or when the sleep-wake schedule has been irregular for several days.

A confusional arousal begins with the child moaning and moving about. It progresses quickly to the child crying out and thrashing wildly. The eyes may be open or closed, and perspiration is common. The child will look confused, upset, or even “possessed” (a description volunteered by many parents). Even if the child does call out her parents’ names, she will not recognize them. She will appear to look right through them, unable to see them. Parental attempts to comfort the child by holding or cuddling tend to prolong the situation. Typically a confusional arousal will last for about ten minutes, although it may be as short as one minute, and it is not unusual for the episode to last for a seemingly eternal forty minutes.

During these frightening episodes, the child is not dreaming and typically will have no memory of the event afterwards (unlike a nightmare). If any memory persists, it will be a vague feeling of being chased, or of being trapped. The event itself seems to be a storm of neural emissions in which the child experiences an intense flight or fight sensation. A child usually settles back to quiet sleep without difficulty.

These are very different from nightmares. Nightmares are quite common, occurring in about 60% of children in the preschool years (Pediatrics in Review, March 1996). You won’t become aware of your child’s nightmares until after she awakens and tells you about them. They are scary dreams that usually occur during the second half of the night, when dreaming is most concentrated. A child may be fearful following a nightmare, but will recognize you and be reassured by your presence. She may have trouble falling back asleep, though, because of her vivid memory of the scary dream.

True sleep terrors are a more intense form of partial arousal. They are considerably less common than confusional arousals, and are seldom described in popular parenting literature. True sleep terrors are primarily a phenomenon of adolescence. They occur in less than 1% of the population. These bizarre episodes begin with the child suddenly sitting bolt upright with the eyes bulging wide-open, and emitting a blood-curdling scream. The child is drenched in sweat with a look of abject terror on his or her face. The child will leap out of bed, heart pounding, and run blindly from an unseen threat, breaking windows and furniture that block the way. Thus true sleep terrors can be quite dangerous, in that injury during these episodes is not unusual. Thankfully they are much shorter in duration than the more common confusional arousals of the pre-school period.

The tendency toward sleepwalking, confusional arousals, and true sleep terrors often runs in families. The events are often triggered by sleep deprivation or by the sleep schedule’s shifting irregularly over the preceding few days. A coincidentally timed external stimulus, such as moving a blanket or making a loud noise, can also trigger a partial arousal (which again shows that the event is a sudden neural storm rather than a result of a complicated dream).

Interestingly, a recent study published in the journal Pediatrics in January 2003, showed that children who have recurrent partial arousal states may also have other sleep disorders (including sleep disordered breathing and restless leg syndrome) that may benefit from a physician’s care.

Treatment usually involves trying to avoid letting the child get over-tired, and trying to keep the wake/sleep schedule as regular as possible. When an event does occur, do not try to wake the child — not because it is dangerous, but because it will tend to prolong the event. It is generally best not to hold or restrain the child, since her subjective experience is one of being held or restrained; she would likely arch her back and struggle all the more. Instead, try to relax and to verbally comfort the child if possible. Speak slowly, soothingly, and repetitively. Turning on the lights may also be calming. Protect your child from injury by moving furniture and standing between him or her and windows. In most cases the event will be over in a matter of minutes. True night terrors, or bothersome confusional arousals, can also be treated with medications, hypnotherapy, or with other types of relaxation training.

Recently, my youngest son was having a confusional arousal, and his mother observed that these events are most common at the same ages that children are becoming aware of the bladder feeling full during sleep. Perhaps some of these kids just need to go to the bathroom? We stood him in front of the toilet, and he urinated, still not awake. The episode faded abruptly, and he returned to sleep. The calm was dramatic.

Was this a coincidence? Or might this be a revolutionary new help for parents whose kids have these frightening episodes? A number of readers have tried this approach. Most said it worked wonders; a few said it had no effect. If you try it, let me know the results, either way. Together we can learn more about the wonder and mystery of sleep in children. I have sat with my children through confusional arousals, and know how powerfully these episodes tug at a parent’s heart. Just understanding what they are (normal childhood sleep phenomena that children outgrow — not a sign of maladjustment or the result of bad parenting) helps tremendously.

Dr. Alan Greene

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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  1. Felix

    I have a 2 year old daughter cries when I’m watching tv, or I’m in bed or I go outside to the front yard. She does the same with the mother of my child. She cries during the nights. And wants to be constantly in arms. I’m just worried because she started with this two weeks ago. Any advice? Please. Should I take her to the doctor?

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    • Felix,

      It is not unusual for children at this age to have separation anxiety. Dr. Greene has written extensively about separation anxiety. The good news is kids do grow out of this stage. You can find more here.

      I hope that helps.
      Best, @MsGreene
      Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

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  2. Gioia

    My 6.5 year old has been waking up about 1 hour and 30 minutes after bedtime (she wakes at 9pm) with these night terrors for 4 months. I went in her room at 8:50 every night for a week and she stopped having the terrors. A month later and it started again. I had also heard the recommendation to take her to the bathroom. Afterwards she goes straight to sleep. I’d love to hear any tips from others.

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  3. Kellie Spaulding

    It’s heart wrenching to watch and not to mention we tussle half the night and we are ALLL tired, as I refuse to leave her alone. I “coddle” her. It’s the only thing that makes sense at the time. Looks like they will outgrow. 🤞🏼 Seems She has no recollection. (Besides heavy breathing) love and prayer. No one wants their baby going through anything traumatic 😞💕🙏🏼

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  4. Lucy Janusch

    My 4 1/2 year old son has had a number of these. He will wake up screaming, but not be fully aware of his surroundings. He will become very distressed. The first few times he then wet himself. I was concerned it may be seizure activity as our daughter suffers with epilepsy but have noticed that he needs a wee 100% of the time. As soon as he has emptied his bladder he goes back to sleep. Definitely think that is the cause of them!

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  5. Jessica Bianco

    For the past 2 years, I believe my 5yr old son has been having night terrors on an almost regular basis.

    Regardless if its during night time ir nap time, and with no recognizable trigger, he will wake up hysterical crying, and even get out of bed, and pace around a lot. He kind of acknowledges me during this time by coming to me on his own fir brief comfort before continuing his pacing and crying.

    I do believe that it is partially due to his bladder being full, since after a while he will pull down his pants and try to pee, even when not in a bathroom. He never seems to recognize where he is while all this happens. I usually end up either grabbing his hand and taking him to the potty, or picking him up and carrying him. Sometimes I even have to direct him to where the potty is in the bathroom, or he will pee on anything.

    Shortly after peeing though, he calms down and either goes back to sleep or just snuggles with me as if just waking up. He also never remembers what happens during these times.

    I just wish I knew of a way to help him better too…

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    • Jessica

      Have you found any help with this my 5 year old is going thru this same thing he peed all over his room floor but wasn’t aware of what was going on around him he flipped his room light on and I got up and he was already peeing

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  6. Davinia Bonner

    Hello, presently my son is having night terrors and sleep walking. I do as you suggest, passing next to him and repeating a soothing Mommy is here and it’s ok. He seems to fade to sleep slowly, it takes him roughly fourty-five minutes to fall asleep. I’ve yet to try having him go to the bathroom, I will try this and let you know the outcome. Thank you for your assistance.

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  7. Jo

    My son is 2 and a half and has had these episodes 3 times since he was born, the last one was tonight.
    He gets restless and calls for me ( this time. Before he was too small to actually talk) and when I go to him he will not let me touch him. He cries, kicks his legs, tries to get as far away from everyone as he possibly can and if I try to pick him up he fights me and tells me he wants to go to bed.
    In the end I just sat near him and repeatedly told him I was there and it’s ok. After about half an hour he went back to sleep.
    He’s not potty trained so not sure how that could be related.
    Any suggestions?
    Thanks

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  8. Rose

    Hi, I’m 20 years old , and I have a 3 month old baby. The other night I was asleep and I woke up rolling around the bed screaming , my boyfriend had to calm me down, I’ve never experienced anything like this before , I woke up panicked and shaking, my heart was beating so fast, I would just like to know the cause for this and if I should see someone about it

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  9. Advice Needed - sleep walking

    My 3rd grade daughter walked while asleep out of our home and to the street in the middle of the night (2am). She awoke on her own while outside and couldn’t get back in. Eventually a neighbor heard her screaming. We (her parents) were sound asleep inside. She was terrified; we were in shock. Ever since she’s asked me to sleep by her side to feel safe. It’s been 6 months and we need to break this and get back to normalcy. Advice? She hasn’t been sleep walking since and the one event was after a big overseas trip and she was very overtired.

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    • Dear Advice Needed,

      Here’s my suggestion — Try installing “child-safety locks” on all your doors at a level above your daughter’s reach. Show her the locks and let her watch you lock them each night before bed. Tell her she couldn’t unlock these locks in her sleep, so she’s safe. Also, install alarms on all your exterior doors that alert you when they are opened. This can be annoying during the day, but they will serve as a safeguard. Even if she was able to move a chair to the door, figure out how to unlock the child-safety locks, and escape — all while staying asleep — you would know.

      Once she feels safe, you can begin slowly moving away from her. The first night, sleep in the same room, but a few feet between you. The next night, you can move to outside her door. Then down the hallway and finally into your own room.

      I hope that helps.

      Best, @MsGreene
      Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

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  10. Stephanie

    My 5yo daughter has had night terrors since starting school, always when she’s too tired and seems when she’s has to pee at night. We take her to the bathroom and it 98% of the time stops the terror and calms her. However the last two weeks during the day she has been crying randomly saying “I want mommy” just the same as during the terrors. I ask her why she’s crying and she says “I don’t know” I reassure her, but it almost seems like PTSD of the night terror? I don’t know…thoughts anyone??

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  11. Want to be unknown

    I have had night terrors since I was a young kid. I am 38 years old. I still have them. I used to get them like once to twice a week. I get them every night now. I have injured myself during the terrors. Recently I jumped out of bed I’m not sure what was going on I felt scared anyway I jumped real fast right out of bed and somehow I fall and hit my head on the wall and broken my toe. My husband said I was screaming. Help and stop hurting me. Just 2 nights ago I’m not sure what was going on but I fall and hurt my self again during my sleep. Last night I woke up 3 times screaming and my husband was calling my name because I had dug my nails and into his back. I have hit, scratched , cried during my terrors. My doctor just put me in a new medication today for it. I have a hard time going to sleep. I’m praying this will help me.

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    • Dear WTBU,

      How hard this must be. I am so sorry.

      This does not sound like the night terrors children experience.

      Have you seen an adult sleep doctor?

      Best, @MsGreene
      Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

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  12. Lianne

    I am now 47 but have a strong memory of incidents such as these in my own childhood. At around the age of 3, I used to get up and run round and round the lounge in circles crying. I remember the feeling of being incredibly scared and trying to run away. I even felt scared of my parents. I also remember feeling trapped. My parents tell me that they didn’t understand it but learned that they couldn’t comfort me and that I wasn’t properly awake and they just had to ride it out until it passed. It is good to hear that I was not abnormal and that this was probably caused by big changes in my life at the time, perhaps toilet training. Many children start nursery/ play school around this age too. Perhaps this could be a trigger for some children?

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  13. Thompson Candice

    My 6 year old daughter has just had her second confusional arousal episode last night (screems, violent words, seemed to be aware and said she wanted to kill me, her mum, and kill the whole family… like possessed). she is an otherwise adorable loving little girl (4th child). It was definitely triggered by the fact I lifted her to the potty (like most nights around 11pm) to prevent her wetting her bed. I have a question though: for the last 6 months, she has been saying that she is a fairy and that fairies do not poop. We have told her number of times that of course, everyone needs to poop, even fairies, but she is totally stuck on that one. I was wondering if it could be the same with poop retention. Have night frights been correlated to that one?

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    • Great observation and I don’t know the answer to that one. I bet it could be, though.

      What are you doing to help this little fairy stay regular? Is there a timing link between when she’s last pooped and the confusional arousal?

      I’d love to hear how this turns out!

      Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

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  14. Helen m

    I had them as a child I also would sleepwalk
    I could feel them coming on, I felt my teeth feeling weird I felt terribly scared and frightened for no apparent reason
    I had no control of these feeling and would try to talk myself out of them as they slowly started
    I would scream and cry hysterically my mind wasn’t in control or understanding and that was what scares you the most
    They went away and now 45 I had recently been experiencing them again

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    • Stephan Rogers

      Hi I am 63 now and when I was a real young child I had them on a regular basis. My mother would always try to comfort me. After a while it would dissipate. It was like having a panic attack in my sleep. I called it the black hole. I still have those feelings every now and then but I’m not asleep. Still looking for answers.

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  15. Terri

    Our 4 1/2 year old little girl experiences these episodes. At first they happened more frequently, and I don’t even remember what made us make the connection when she was having these night terrors but we realized it was because she had to urinate. At first it was happening 3-4 times a week, she would “wake up” crying, bawling, inconsolable, not talking, not responding to us at all. Once we made the connection about urinating we would sit her on the potty, she would go (still completely unaware). Once she is done she settles down and goes right back to sleep. She has no memory of any of it the next morning.
    These episodes happen less frequently, maybe 1-2 times per week now, and now that we know how to fix it life and sleep has gotten much easier for everyone!

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  16. Stef

    My 3 year old wakes screaming, kicking, completely inconsolable. She will lash out if you talk to her or touch her. Eyes closed, hysterically crying, and screaming. My husband or I will pick her up, carry her to the bathroom, put her on the toilet, tell her to go. She does every. single. time. When she is finished we carry her back to bed, she is now calm, and hugs us, sometimes opens her eyes and will answer a question.
    When this started we were terrified something was really wrong. Then after what seemed like forever we figured out the connection. Had no idea this was a thing and others experience this as well!

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  17. Swati

    I was very glad to read this article and the comments from readers linking night terrors to urination. It started when my daughter was 3 year old and after 3 years now I am now sure its linked to bladder 90% of the time and stressed day 10% of the time. Whenever my daughter is going through them I try to persuade her to urinate and that ends the episode. I am so relieved to read the same observation from other parents too.

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  18. Jacque Applegate

    Dr Greene, You should know that children have night terror’s also when their mother marries a very violent man who is also a drunk. He beats her mother up on a daily basis. And verbally abuses the children. I had horrible dreams , nightmare’s ect. But you failed to mention bad parents. When we were used to a wonderful peaceful life. Until this devil married mom. It was horrible. She put him 1st. He never worked. Yes as the oldest child, I was his supply and his scape goat. She married this man in the 5o’s. He fooled all of us. But he stayed until he was in his late 80’s. He died. But this is another reason for a Childs night terror’s.

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    • Jacque,

      I am so sorry for what you’ve experienced. This truly sounds terrifying.

      @MsGreene
      Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

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  19. Stephanie P

    My son is 4 years old and the event he just experienced is identical to the description I read of confusional arousal. I read this after he was back asleep but about 5-10 minutes into it he told me he had to pee, and did. And very shortly after he was very sleepy and back to bed. This was terrifying for me but reading this really did help.

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  20. Maegan

    My son is 4 years old, he just had his second night terror ever and indeed its terrifying for the parents. I’ve read about them through and through and know it’s normal but it doesn’t make it any easier. The first one lasted about 30 minutes, months later this one lasted 20 minutes. For the first 15 minutes I could not of course get through to him at all. While he laid there screaming and thrashing he screamed he had to pee, then jumped out of bed squirming like he was about to pee his pants. I asked him all the quesrions, can I take you to the bathroom, yes. Can I turn on the light, yes. He peed, and abruptly he calmed right down. I asked him if I could pick him up and laid him down and right back to sleep he went. I read your article and wanted to say this time the urinating and turning on of light helped quickly end the situation. Thank you for the read!!

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    • Anafel

      Hi!
      I just started to notice this from my 2 yr old last night. She had 3 episodes of these confusional state last night. I read from the comments that it is mostly related to children needing to go pee. Can you please tell me how to deal w/ this when my 2 yr old is not potty trained yet. Thank you.

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  21. Cdm

    My daughter is 6. I am so unclear as to what is going on with her. Night terrors or panic disorder…either way I’m scared to death. This is night two (this round) of sitting upright in bed yelling “I’m hot, I’m hot!”, or “I’m dizzy, I’m dizzy”! Throughout the night she has awakened kicking her feet violently and then sits up. She is so upset, she vomits. Sometimes I feel she’s asleep and it’s terrors and then another moment it appears differently, like she is aware. The cycle has started both nights at 1:30am and last on and off till sunrise. I’m exhausted and worried. It’s now 4:30, she woke up panicked and scared and threw up (about a tablespoon) for the 3rd time. She’s scared and wants to go to the dr. She laid right back down and went back to sleep. I’m at a loss.

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    • CDM,

      How tough. Wow.

      If you don’t mention her being awake, does she remember the episode(s) in the morning? Does she spontaneously talk about them? I know she will be sleepy and lethargic from a horrible night’s sleep. Also, have you tried taking her to the bathroom and sitting her on the toilet when they first start? Have you taken her temperature?

      My heart goes out to you, @MsGreene
      Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

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    • Amanda Butler

      This is pretty much exactly what my sone does but without the sitting up but alot more frequent outburst we have been battling this for nearly 3 years he is 8yrs old now but it has improved from younger ages where he would wake 15+ times per night whaling screaming shouting thrashing around and yea absolutly no memory of his behaviour at all next day!…id say from maybe age 6 onwatds we now go through waves of these episodes in groups of couple weeks long and then maybe nothing for several weeks and repeat!🙈 and throughout the 4 year battle im still searching for answers as all this does still result in multiple bed wetting episodes per night!🙈 helllp! Xx

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    • Pam

      Hi

      I have just read your post about your 6 year old. My daughter is 5 and is going through the same thing. Apart from she gets this everyday about 1/2 hours after she’s fallen asleep and will then be sick occasionally. Did you find anything to help the situation please?
      Pam

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      • Deni Morris

        They have concluded that it is some type of migraine. We had a sleep study and there is some type of glitch in her brain right after she falls asleep. Only issue is this is not daily. It doesn’t make sense. I cannot remember my post but I was given her baby melatonin (pill form) to get her to sleep. Since this indeed is a hormone I was concerned it was contributing. I now have her on a liquid/honey melatonin and it’s just a tiny bit. My daughter has a very hard time turning her brain off and relaxing. Sleep has never been her friend. It has been since March since we have had any issues. I hope this helps. I would ask for a sleep study for sure.

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  22. Stephanie Danvers

    My daughter has confusional states normally at least once a night. It had been more but her excema seemed to be triggering them at one point when it was very bad when the covers moved over her skin (now thank fully understand control). hers are related to needing the toilet but I wonder if people can help me she groans out but is non vocal and does not respond to gentlet touch to guide her to the toilet..she will hit out. Lights don’t help she then screams she can’t see. She becomes very distressed by intervention but the only way to settle it is to carry her to the bathroom with her protesting and hope it doesn’t wake her brother. If I take her before she needs it she just refuses to go. Any suggestions?

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  23. Kari

    My daughter had night terrors from age 1-8 or so. At some point a light bulb turned on in my head, I had an intuition to get her to use the bathroom. It seemed to work! I then searched night terrors and urination and found something in my search that suggested I was onto something. So for her last few episodes she had, I guided her to the bathroom and it worked every time!!! Just after doing this a few times her night terrors stopped completely! Occasionally I get reminded of our experiences and I try to suggest this strategy to others so I joined a group to share. I decided today to research night terrors and urination again, which led me to this article. I’m excited to see others learning this strategy and it helping. I definitely think some of these children are struggling with their bodies not knowing yet to wake up and empty their bladder and then resulting in these night terror type episodes.

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    • Jaime

      Exactly what we discovered over the years as well!

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  24. Becky

    My 4 1/2 year old daughter has these episodes where I hear a thud from her room- she has fallen out of bed and is seen running in place with a panicked look, usually crying. For the last year or so I have always led her to the bathroom (she doesn’t appear to be able to navigate) and pull her pants down and help her sit on the toilet. She always urinates. Then she would just sit there. I have to wipe her, pull her pants back up and lead her by hand or carry her back to bed. She is unable to vocalize / answer any questions during these episodes and I feel as though she is just staring through me when I ask her questions. Eyes are glassy and she appears “out of it.” She promptly falls back asleep once back in bed. These happen maybe once a month. The episodes still scare me and she does not seem to be able to recall them. Thanks for the great article.

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  25. Siobhan Cole

    My son who is 11 still suffers from these. He sometimes demands to be taking to the doctor as he feels he is dying. All of the time he needs to go to the toilet. He screams for us and is so disillusioned, even if we try talk to him he looks at us but still cries for his mammy/daddy. This has happened 5/7 days this week.

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    • Janene

      My son is doing the same thing . He’s 11 and goes to the bathroom right away too. He’s scarred and asking for mommy and daddy. This has been going on every night for 5 weeks. Have you heard of anything to do to help stop this.?

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      • Taytay

        Sounds like demonic possession honestly if you see your child doing things like this and you don’t wonder if something evil is messing with your kid your crazy I say keep god close to your baby in your babies lives

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  26. Jacob

    When I was a kid from around 5- 10 yes I had night terrors I would walk around the house and scare everyone as if I were possessed i would freak out at people trying to calm me scream and look at them as if they were demons this happened almost every night I would occasionally do it at sleepovers but generally at home in the middle of the night , I remember going to a couple of specialist s but there wasn’t much they could do, the only thing I remember from the events were waking up urinating because my mum had got me to the toilet , I also used to suffer from nightmares so intense and numerous through the night ,I had recurring nightmares which I found a way I could wake myself from by biting my tongue or cheeks until I woke with blood in my mouth, it was terrifying as kid I felt helpless and suicidal because of the torment when I became a teen it started to dull down abit but I would still have the nightmares when I was seventeen I started smoking marijuana daily and all of my dreams stopped I go to sleep deeply and wake up with no dreams I gave up for about 6months a few years ago and my dreams returned back with a vengeance I started smoking again and they went away , i found my cure even it is just temporary

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  27. Joana

    Although at first my 3 year old will refuse to pee, at second or third attempt he will do so and in a matter of seconds the night terror stops. Once I found this out it was definitely a relief. Before, he would keep crying and screaming for more than 20 minutes. I had even tried wetting his hands and feet but with no success. Apparently emptying his bladder works the best, at least for us! Thank you for the article. I will definitely share it!

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  28. Mandy

    Just wondering at what age do night terrors typically occur? Do babies or toddlers have night terrors?

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    • Hi Mandy,

      Dr. Greene says, “The tendency toward sleepwalking, confusional arousals, and true sleep terrors often runs in families. They tend to be more common in boys, and are much less common after age 7.”

      Hope that helps, @MsGreene
      Note: I answer a lot of questions on DrGreene.com, I am the co-founder of DrGreene.com, Dr. Greene’s business partner and wife, but I am a not doctor. Please keep that in mind when reading my comments and replies.

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  29. LBuren

    Recently, my 10 year old son has been waking up every night about an hour after he begins sleeping. He always yells out for us, gets out of bed, and moves quickly to find us. His arms and hands are shaking while he appears very upset. He is inconsolable but talking with eyes open. He uses the bathroom to urinate and sometimes throws up from being so worked up. Shortly after, he returns to his bed and usually does not get up again (except for a few times when he has awoke several times). I’ve thought it was stress induced. His words do not always make sense but sometimes they are related to schoolwork, teachers and classes. He does not remember anything the next morning. This information about a full bladder is very interesting to me and I certainly can not argue against a possible connection based upon my experiences. I still wonder if some of the school issues and his other physical changes might also be factors. It is a helpless feeling as a parent to have to watch your child exhibit these behaviors. I am thankful that he does not recall the events each night.

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    • Here is my response as a mom (note: I am not a doctor):

      I wonder if he isn’t getting enough sleep. Exhaustion may be causing him to sleep deeper than normal. In addition, I wonder if he may be stressed out about school and the combo is coming out in this sleep pattern.

      If this is the case, can you help him get to bed earlier? Perhaps over the weekend he could catch up a bit by also sleeping in?

      Best, @MsGreene
      Co-founder & Executive Producer DrGreene.com, Mom
      Note: I answer a lot of questions on DrGreene.com, I am the co-founder of DrGreene.com, Dr. Greene’s business partner, but I am a not doctor. Please keep that in mind when reading my comments and replies.

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    • MRyan

      Hi,
      My 10 yr old has just started having this same behaviour an 1hr after being asleep. What you have described is exactly on point to what we are currently experiencing. As your situation occurred in 2016 I would be very interested to hear if he outgrew it and the episodes resolved. Living in hope this won’t last forever.
      MRyan

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      • LBuren

        I’m sorry that you are experiencing some of these same events. Thankfully, our night time experience has improved over the past 2.5 years. The night time waking continued for about a year or so. But gradually lessened over time. He still has nights where he seems restless and finds it difficult to sleep but moving to the couch or another location seems to help calm him. Also, he is now fully aware when awake. Looking back, I believe that he was dealing with some anxiety and probably hormonal changes. Talking about the episodes only seemed to make it worse so we rarely discussed what had happened at night with him during the day. It only seemed to made him more anxious about bedtime. However, things have improved and I hope that will be the same for you too.

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        • Amanda

          MRyan
          Has your child outgrown this?
          How long did it last?
          Did you change bed time to earlier to rule out sleep deprivation ?

          My 10yr old has just started waking 1hr after sleeping.
          My son does not need to use the bathroom. He comes looking for me and is talking but makes no sense. I get him back to bed and he usually doesn’t wake again.

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      • Amand

        MRyan
        Has your child outgrown this?
        How long did it last?
        Did you change bed time to earlier to rule out sleep deprivation ?

        My 10yr old has just started waking 1hr after sleeping.
        My son does not need to use the bathroom. He comes looking for me and is talking but makes no sense. I get him back to bed and he usually doesn’t wake again.
        Thanks
        Amanda

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        • Meaghan Ryan

          Hi Amanda, My 10yr old started this waking up 1hr after going to bed about 5 months ago now. He would also come looking for me & would make no sense in whatever he was talking about. Sometimes I would take him to the toilet but most times he would say no. I initially made the mistake of waking him up by questioning him at the time as to what he was doing & why he was getting up. He would start crying become inconsolable & scared to go back to sleep. Apparently waking people when sleep walking is the worst thing you can do. Things have settle considerably since, I just say yeah mate to whatever jibberish he’s talking about & direct him back to bed, where he goes back to sleep quickly & he doesn’t get up again. Probably occurs once every 3-4 weeks now. I think I noticed it was more likely to occur if sleep deprived but we haven’t changed bed time only because it’s already busy with three other younger kids. Now that we’ve discussed it with him & reassured him that it is considered ‘normal’ & that he should grow out of it, we’re all a lot more relaxed. Hope it all settles for you. Meg
          Sent from my iPhone

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  30. AtALoss

    My son is doing the moaning and rolling around about same time every night within a 3 hour window, between 1 and 4 am. Most of the times he needs to pee and wakes up fine to go and then is right back to sleep as soon as head hits the pillow. A few times it’s not so easy and tonight has been the worst of them all.

    Tonight started out with rolling around and moaning and trying to snuggle into my shoulder. I asked if he needed to go potty and he shook his head no and I immediately asked him again and he gets up holding himself and said yes. I asked him if he wanted his potty chair, which is in the room next to the beds, or if he wanted the toilet. He said not his chair so we trekked upstairs to the bathroom and I got his pants down to go to the bathroom and as I was sitting him on the toilet he started freaking out and screaming. He jumped off the toilet ran all over upstairs screaming and telling me no mommy I don’t want to go on there and then he started trying to slam the door and when I held the door so he couldn’t close it he bit me and gave me an instant bruise with some blood and then he started picking up his toys and throwing them across the room, and it was his bigger heavier toys not the little easier to throw ones, while still screaming blood curdling screams. He stopped screaming and throwing stuff after he urinated on my area rug. Then he was crying and when I asked if he was done pottying he said yes so he went and got his underwear and pj pants so I could help him get dressed. He let me help him and then sat in the rocking chair while I did a quick clean up on the rug. I carried him back to bed and he crawled onto his blankets and was snoring in seconds.

    Amongst his screaming and yelling he said I don’t like automatic ones and I kept reassuring him our toilet was not an automatic toilet. He’s terrified of the automatic vacuum suck toilets that are everywhere.

    Would this be an instance of confusional arousal? He gets violent in whatever they are but it’s mostly just hitting and screaming, tonight escalated to biting and throwing his big toys and trying to slam doors. He will be 3 in December.

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    • AtALoss,

      This sounds like a combination of confusional arousal and an irrational fear. (Though in this case, it might be a rational fear. Those automatic toilets, that flush while you’re still sitting on them are at best unpleasant!)

      The key for many kids is not to ask them if they want to sit on the potty, but to gently help them get their clothes in position and sit them on the potty while gently talking with them — “It’s potty time. I’m going to help you. It’s right here. Go ahead and sit. You can pee now.” In the half awake state, they do not need to make a decision and often can’t make one. Or if they try, it sends them over the edge.

      I hope that’s helpful.

      @MsGreene

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  31. Tiredmom

    My 4yo daughter has had two night terrors over the past few months. Both times after a few minutes of intense crying and thrashing and not responding I put her on the potty and as soon as she urinated the night terror immediately stopped and she fell right back asleep. I’m so glad I found your site and tried this tactic.

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    • Tiredmom,

      Thank you so much for letting us know. It’s very rewarding to know people are being helped.

      Best,
      @MsGreene

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  32. margaret

    We’ve had a few isolated episodes of night terrors with our 10 month old son, but after last night’s 2 hour episode, I realize that maybe that’s what has been going on for a few weeks straight. I thought we had just lost any sleeping luck after a vacation, but now I think it’s been smaller episodes every night.
    Our son’s first episode was on a plane(!), the second flight of a long day of travel delays when he was 8 months old. He seemed to wake up on the plane (we thought we were home-free with a sleeping baby), screamed inconsolably for 10 minutes, and then passed out again like nothing happened. Once we put together that he never really saw/heard us or even woke up, we looked up night terrors.
    A few weeks later, he kept waking us up while he tried to scream/crawl in his sleep. Those wakings subsided once he learned to crawl. He was never really one to wake up crying, and the thrashing around made it obvious. I could nurse him back to sleep.
    Then recently, after screwing up schedules with a vacation, I assumed we had ruined any sleep routines we had by sleeping in the same room and/or bed and nursing back to sleep. (And of course, front teeth coming in.) Every night he wakes up crying around 10:30 pretty reliably, after 2 1/2 hours of sleep. He’s sitting up in his crib now, mad he’s alone, which seemed to make sense. I have been nursing him back to sleep, then he does it again at 1-1:30am. Then I nurse him and bring him to our bed, where he’d cries and thrashes before he wakes up in the morning. All this from the baby who had never really had trouble getting through the night, and had been weaned at night. We never even really had to cry-it-out before.
    I’ve been chicken to cry it out this time because he’s older, more vocal, and more mobile. Last night nursing back to sleep didn’t help and he thrashed around for a couple hours, as I said. Is it possible night terrors are the disturbance? We will try to preempt the night terrors starting tonight. We’ll let you know how it goes!

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    • Margaret,

      Oh, I feel your pain. This has got to be tough on you all.

      I think your observation that the last tough time was when he was learning to crawl is very fascinating. By chance, is he trying to learn a new skill now? Walking perhaps?

      It’s very common for kids who are learning to walk to have a period of rough sleep. They go to sleep, but wake up in the middle of the night because they’re so exciting about working on this cool new thing that they almost have. Perhaps your son is going through that, but he’s one of these kids that can’t fully wake up or who get caught between sleep stages.

      Do let us know how it goes!

      Best,
      @MsGreene

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  33. Caroline Ricardson

    Hi help!! My daughter is 6 and has been having night terrors for a year or so now, mostly every night but then sometimes goes a week without one then pop it starts again. We went to a sleep charity and had a sleep study done that found she had 68 episodes of sleep apnea in one night. She also suffered with enlarged tonsils and lots of tonsillitis so she had a tonsillectomy and adenoids out a few months ago. Her tonsils were grade 3 and she had abnormally large adavoids so they definitely needed taking out BUT unfortunately we are still having night terrors.
    We have tried everything I can think of, from no TV, relaxing massages before bed, sleeping in our bed, me sleeping with her in her bed, earlier bedtime, waking her after 40 mins of sleep (just before a terror due) but she would just have one half hour after this
    ..u name it we tried it. We tried taking her to the toilet like this suggests but she does nothing when there and most of the tume its impossible to get her to sit as she is that fraught running round and jumping about. She screams and cries and can’t see us its like were invisible it’s so awful. I have tried waking her for toilet before a terror and then a while after the terror to see if a wee was lurking but she 99% of the time does nothing. BUT she generally always has a wet pull up in the morning which I can only guess happens between 11pm-6am while am asleep cos I check all the other times.
    The only thing I can think of that could trigger the terror is her being too hot, she has always been a hot child and even in winter kicks off her duvet. Every time she has a terror her face is bright red and she is damp with sweat n red hot to touch, even when she is in bed with just a vest n pj’s shorts with a sheet over her why is she so hot on a night?? We have had a fan on her the last week and funnily enough she hasn’t had a terror, yet tonight she went to bed with my husband as he on earlys n had a terror but had no fan on her n was boiling so could this be it?

    Am lost, I hate seeing my child so upset and terrified and I feel so helpless I don’t know what else to do. She is such a bright happy girl, she has loads of friends and is doing so well at school and is always happy, she is a loving healthy girl with a big heart and a great loving family. The only thing is she is quite sensitive and often gets upset about things n takes things to heart, she often questions things about mummy n daddy always being there for her n never going away, she doesn’t want to leave us or grow up or change n never wants us to go to heaven or get older…I think she thinks bout these things too much n not sure why. Could this over thinking n the heat be causing terrors? Also she is scared of being alone n wont be on her own anywhere without someone being with her. So if I go upstairs, she follows etc etc.. anyway I just thought I’d try put this together to see if we could get any suggestions /thoughts / answers? Thank u

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    • Caroline,

      This sounds horrible for all of you!

      The fan sounds very promising. I don’t know why it she may be extra hot, but it doesn’t sound like there is a down side to using the fan.

      One of our guest bloggers wrote a post that may be helpful for you –> How to Stop Night Terrors Now!.

      Please let us know how she’s doing.

      @MsGreene

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    • Ana

      Did you ever find out what to do for your daughter? Your situation sounds very similar to ours with our seven year old. She awakens got as well. Anything you have learned that helps??

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  34. Angie

    Just listened to you on the sleep summit. I was eager to learn about night terrors. My son had them for several years, 9-12, and has outgrown them. We thought he was too hot when he went to bed as he would be sweating. He is 15 now but as I look back, my husband would take him to the bathroom and once he urinated he began to calm down. That was our “go to” in the hopes he’d settle down. I’m so glad that is over. So for any parent going through this, hang in there. The blessing is that they don’t even remember it happening. After a while we didn’t even tell our son he had an episode. When we spoke about it after the fact, we realized he was wondering what was wrong. We didn’t want him to think there was something “wrong with him” as none of us understood at the time what was going on, so we then went through the motions and didn’t discuss it with him.

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    • Thanks so much for providing your input. Your story adds to what we’ve heard from others.

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      • Joni Parks

        My daughter has had night terrors for the last3 years started when she was 7 and still occur. She wakes scared, crying runs from one end of the house to the other and flails her hands yelling no getting her to go to the bathroom has also been my go to resolution and usually always works. This should be made more known to parents! Thanks for the article

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  35. Kelly

    Wow! My daughter has been dry at night for 7 months now… She’s had a few nights where I’ve assumed she’s had night terrors. Many times I’ve googled to just find they start around her age so presumed that was it. Thank god I found this tonight. It’s almost 1am and my daughter was really restless before in bed and ended up getting really upset, eventually waking herself up. Came across the link to your page here and tried her on the potty. Ok it’s not ideal she’s awake at this time but she’s talking nicely now and we should be asleep soon. Thank you!!!

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  36. laura

    I just read your article and couldn’t believe you made a connection between a full bladder and night terrors. That was my cure for my daughter who would get them. I would pick her up and put her on the potty. As soon as she peed terror was over. I thought it was a fluke but it really worked for her.

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    • Thanks for sharing your experience with your daughter. It’s great hearing from parents.

      Best,
      @MsGreene

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  37. A.T.

    Hi I read the article about night terrors and I have the same issue with my son who is now almost 5 but he has had these since he was 3 and I have also came to notice that after I make him go to the toilet he also stops crying quite suddenly and off to sleep he goes again so I believe that this does have something that relates to why they have night terrors.

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  38. Hana

    Thank you Dr Green, Helped me understand my daughter and her shaking at night and then urinating on my lap.

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  39. Nkim

    I just wanted to really thank you for providing the guidance on resolving night terrors.

    My 3 year old started night terrors at about 2 years old – almost every night. They were extremely painful to observe.

    I’ve researched for mnths on this topic and tried many things to resolve it from diet changes, earlier bedtimes, longer naps so he feels more rested and nothing worked. We were almost at the point of going to a sleep clinic to see if it was a sleep apnea issue.

    But then came your article on emptying the bladder. It really was revolutionary. We brought him to the toilet 60 minutes from when he fell asleep. We tried this for a week straight and today we have experienced no night terrors for almost a month!

    We feel even that his speech development is accelerating now that he is getting uninterrupted sleep through the nights.

    Thank you for this. You were the only areticle that suggested the bladder connection and it totally makes sense.

    So glad we found you!

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  40. Sam

    Both my boys suffer from confusional arousal. And both need to be taken to the bathroom or they run around the house screaming and crying and no one can calm them and they don’t recongize me and they will eventually urinate where ever they are standing. And as they are urinating they are calming down and go right back to sleep. So I physically pick them up and put them at the toliet. It happens almost every night between the both of then aged 2 and 5.

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  41. Kim

    Our daughter has had a few of these episodes and it’s always when she has to urinate. She screams and shakes and sweats but wont respond to me. I put her on the toilet and she goes right back to bed immediately afterward without any problems. I’m a nurse and see elderly people act crazy when they have urinary retention. I definitely think there is a correlation!

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  42. Nikki

    My 9 year old son has this, he literally just sprinted from his room 20 minutes ago looking for a bathroom, it’s always when he’s absolutely bursting to use the bathroom and it scares me, I worry for him and my other children. I used to think it was just when he was overtired but it’s always when he needs the bathroom so surely it must be to do with that. I hope if he stops drinking before bed time these will disappear.

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  43. Amber

    This article has hit the nail on the head for our 5 year old daughter. She started having these at age 4, and after many observations and journaling of the terrors…it finally hit me that almost everytime she had a night terror she would soak her pull up. After about a year into them, her pull up leaked one night and got everything wet. After that episode, I started checking her pull-up after she would calm down and everytime it would be soaked. Now when she has a terror I put her on the potty and she always goes, then right back to sleep. I thought I was the only one who thought this could be the reason for her horrible night terrors. Noone else seemed to think they had anything to do with each other. Hopefully we are at the end of these terrible things!

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  44. Katrina May

    Dr Greene , I think you’ve hit the nail on the head with regards to night terrors and their causes/origins! My much younger sister would constantly experience night terrors beginning about age 6 until about 10 or 12 yrs old. We would usually attribute it to a bad nightmare, but it was far more sinister than that because as you said she didn’t recognize us and would be flailing her arms around with her eyes open and talking in a highly anxious and rapid state that was frightening to watch – and if I didn’t know better it appeared to have similar characteristics of a seizure, but it was not because it only happened after she had been asleep for about an hour or two.

    She would start calling out names and then when we would come into the room she would not recognize or connect with anyone as if she were still in the dream. But most of the time she was crying a lot and for no apparent reason as she went to bed fine. If we didn’t get to her quickly enough before realizing she was having one of her night terrors (it didn’t happen every night) she always headed to the bathroom and went in the toilet to urinate. We never put two and two together, but she did outgrow it over time, thank goodness! However you have cleared up a big question for me which I will pass on to her one day – and that is what caused her to have these episodes:; being tired I can see was probably a big contributor but having to go to the bathroom with a full bladder to pee while in a deep sleep was definitely the culprit! After she would go to the bathroom and we’d bring her back to bed – usually having to carry her in both directions until she got too big and heavy – she would then sleep the whole night through.

    So I am convinced that you are absolutely right about the full bladder connection and being very overtired – maybe too tired even to subconsciously make the connection between needing to get up to go to the bathroom to relieve ones self. But it still begs the question: why do some kids get night terrors with a full bladder vs others wetting their beds vs the majority who get up and go to the potty without any night terrors? And what goes on in the mind that causes so much fear and terror in otherwise very normal children? My sister was a very well adjusted child – smart, popular, nice and very attractive and athletic too. But she did have these night terrors that seemed to go on for many years and they were upsetting for all of us to see her suffer through.

    There is some documented research suggesting that mood disorders or bipolar personality disorder is associated with night terrors. If you had asked me if she suffered from either as a child I would say definitely not at all. However, as an adult today she really is struggling with a lot of mood and personality issues that we are at a loss for – I am constantly searching for answers and tell tale clues from the earlier years of our life and the night terrors are the only real significant episodes that we can link back to figure out what may have been abnormal behavior.

    As an older sibling I feel obligated to help her figure out what went wrong so she can get the help she needs now. In my opinion, I think night terrors are linked to full bladders, but they are also indicative of some underlying serious psychological disorders, too. I hope you can weigh in some more on this and educate other parents and family members to be alert to the connections and patterns that link night terrors to a full bladder and a warning sign that things are not all that they seem – and that there are probably other issues going on for the child, too. Reminding these kids to always go to the bathroom right before bed is a key component here!

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  45. Hagar Berlin

    My 10 month old just woke up with what fits the confusion arousal description perfectly. It was very different from any of her previous night waking and a bit scary, except that she was clearly asleep the whole time despite her screams. Is confusion arousal possible so young?

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    • HippieMom

      My daughter’s nighttime crying started somewhere around 3 months old. We didn’t know for a long time that it was night terrors. When she was older and talking it became more obvious that she wasn’t really seeing or hearing me. I’d always read that night terrors were triggered by over tiredness, heat, cold or pain. When we figured it out for my daughter, it was garlic, primarily in spaghetti sauce. When we eliminated fresh garlic and onions from her diet the night terrors virtually went away. I loved garlic before that, so there was likely a lot of garlic in my breastmilk too.

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  46. gortday

    I love this article. I have loved it since my oldest daughter (now 6) was potty training and this helped me stop her confusional arousals in their tracks. I still use this trick on my youngest with great success and again just tonight when my eldest was sleepwalking and not making any sense. Guiding her to the potty helped me get her back into bed quickly without any harm.

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    • muslimah

      my son 5 year old, since 2 weeks ago i notice at his nap , he wake up with eye open wide look like scared and he walk faster and turn back to the bed

      at night also happen 3 to 5 time with open his eyes and sat down and breathe fast and sleep again

      it happen also some time when he awake his eye open wide , breath faster and walk away faster and return back, when i ask him what happen he said he see bird or he fly and after that he laugh

      what i should do..?

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