My Daughter's Nightime Distress

by Maria
(Palo Alto, CA)

I am trying to determine if my 5-year-old is having night terrors or some other middle of the night issue. Her problem is similar to what I have read about night terrors in the following ways:

• She does not seem rational, and cannot be comforted
• She screams and cries
• She is still incontinent at night (uses pull-ups)
• She cannot remember her episodes in the morning

However, it is different in the following ways:

• It does not occur at a regular interval after she goes to sleep (and can occur as much as 6 hours after she has gone to sleep)
• It does not seem much like terror, but resembles a temper tantrum (anger, not fear)
• She recognizes both her parents (does not mistake us for monsters)
• She is somewhat self-aware during the episode, and will sometimes tell me she can't stop or control herself

Also, although she sometimes begins screaming in her bed, at other times she will wander through the house "looking for Mommy" before her screaming begins. She is not rational or fully awake at this time, however. Finding me does not console her, and frequently sets off her screaming.

Do you have any insight into whether these are night terrors or an odd form of temper tantrum?

Thank you.

Kevin's Thoughts

Hey Maria,

Thanks for taking the time to describe your daughter's situation. What you describe surely sounds more involved than temper tantrums, namely because of what you've said about her being amnesic of the events the next day and about her not quite being herself ("She does not seem rational, and cannot be comforted").

But what you mention about her having some self-awareness, showing recognition towards you, displaying anger more than fear, and even wandering through the house makes it sound like some elements of sleepwalking may be at play as well. And sleepwalking, keep in mind, does not necessarily have to involve outright walking around the house. Actually it's a bit of a misnomer in that an episode of sleepwalking can take place fully in the bed. The fact that your daughter does walk around the house on occasion though seems to suggest that sleepwalking may be a factor.

Sleepwalking and sleep terrors are tightly linked too, so it's not impossible to say she may be experiencing elements of both. They both are typically related to deep sleep (NREM stages 3 & 4), so they tend to occur in the first third of the night when those stages happen, but it's not unheard of for episodes to happen later on in the night too. So episodes occurring as late as 6 hours into the night does not necessarily rule these parasomnias out (sleepwalking and sleep terrors are both parasomnias, which basically consists of abnormal physical behaviors during sleep).

Children typically grow out of parasomnias like this, so they are typically not a cause of great concern, despite the fact that it often SEEMS like it should be very concerning in the cases of night terrors and extreme sleepwalking. It's easy to understand why seeing one's child frightened, angry, or out of it in an inconsolable way in the middle of the night can be very worrisome for parents. But it's usually not more than a benign condition that the child simply outgrows as her nervous system develops.

However, with this said, if you think these events are frequent enough to really be consistently disturbing your daughter's and your family's rest and well-being, it can't hurt to go see a sleep specialist or mention it to her pediatrician.

Feel free to keep in touch with any more thoughts or comments you have using the "Post Comments" link below.

Best wishes for you and your daughter!

Kevin
P.S. Good to hear from a fellow Palo Alto resident :)

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