Sleep disorders may manifest in children with problems such as night terrors, sleepwalking, and difficulty falling asleep. These conditions negatively affect both the child’s development and family life. Neurological evaluation is important for an accurate diagnosis.

Night terrors and sleepwalking are among the parasomnias commonly seen in childhood. These conditions are generally associated with the brain’s maturation process, but sometimes they may be a sign of neurological diseases such as epilepsy. A detailed history and EEG examination help with the diagnosis.

The treatment approach is shaped according to the underlying cause. In mild cases, regulating sleep hygiene may be sufficient, while in advanced cases, medication treatment or behavioral therapies are applied. Regular sleep hours and reducing stress factors are important.

Informing families about sleep disorders plays a fundamental role in the treatment process. By ensuring a safe sleep environment for the child and regular physician follow-up, the great majority of these problems can be brought under control.

What Is Night Terror in Children?

Night terror in children is a sudden episode of intense fear and panic arising during the deep stages of sleep. It is as if your child has seen something very frightening in a dream; they scream, cry, sweat, and move restlessly.

How Are Sleep Disorders Managed in Children?

The management of sleep disorders in children generally focuses on reassuring the parents and ensuring the child’s safety. It is important to establish a regular sleep schedule, make sure the child gets enough sleep, reduce stress, and treat other underlying sleep problems. Trying to wake the child during a night terror is usually ineffective, so the best thing is to stay calm and guide them back to bed. In sleepwalking, the most important thing is to take safety measures to prevent the child from getting injured during nighttime wandering. Medication treatment is generally considered only rarely and in very serious cases.

Sleep is a vital need for all age groups, but it plays a critical role especially for children in growth, development, and learning processes. Having a healthy sleep pattern helps children succeed in their daily activities and maintain their physical and mental health. Unfortunately, sleep disorders are quite common in children, and these disorders can deeply affect children’s quality of life. For this reason, it is very important for parents to be informed about sleep disorders and be able to recognize them. After all, sleep disorder is one of the frequently encountered complaints. It can accompany many mental disorders as well as physical ailments. Sometimes, a sleep disorder may be the person’s leading symptom. Sleep disorders can be examined under two groups: dyssomnias and parasomnias. While dyssomnias refer to problems related to falling asleep, the quality, nature, and duration of sleep, parasomnias refer to an abnormal condition seen during sleep. In children, sleep disorders are generally in the form of parasomnias: sleepwalking, nightmares, night terrors, and enuresis (bedwetting). If your child has a sleep problem, insufficient sleep may cause problems such as forgetfulness, irritability, and distractibility. If your child constantly has difficulty falling asleep, sleeps less than expected for their age, wakes up frequently at night, or shows abnormal behavior during sleep, the child may have a sleep disorder. In this case, you can apply to our pediatric neurology department.

What Causes Night Terror in Children?

Although the exact cause of night terror is not fully known, it is thought to be associated with sudden arousals from the deep stages of sleep. These deep sleep stages are generally concentrated in the first few hours after falling asleep. Children’s sleep cycles are different from those of adults, and this may make them more sensitive to night terrors. Just like a car experiencing a brief jolt while changing gears, the child’s brain may sometimes “get stuck” while transitioning between sleep stages, and this may lead to a night terror.

Genetic predisposition is also an important factor. If there is a history of parasomnias such as night terror or sleepwalking in the family, the child may be more likely to experience these conditions. It can be thought of like some families having a talent for certain musical instruments; in some families, similar tendencies related to sleep patterns may also be seen.

Disturbances in sleep patterns, especially sleep deprivation or irregular sleep hours, may trigger night terrors. Just as a tired body gets sick more easily, a sleep-deprived brain may also give abnormal responses during sleep.

Stress and anxiety are also among the psychological factors that can trigger night terrors. Especially children who experience separation anxiety or stressful events during the day may show the effects of this stress in the form of night terrors while sleeping at night. Just as the water in a pot boils when the heat underneath becomes too high, intense stress may also disrupt the child’s sleep pattern.

Physical illnesses, especially febrile illnesses, may also trigger night terrors. The changes the body goes through while fighting infection may also affect the brain’s sleep pattern. Some medications, especially sedating drugs such as antihistamines, may also rarely cause night terrors.

Finally, some underlying sleep disorders, such as sleep apnea, may also increase the risk of night terrors. In such cases, because the child’s sleep is frequently interrupted, sudden arousals from deep sleep stages become more likely.

How Does Sleepwalking Develop in Children?

Sleepwalking, just like night terror, occurs during one of the deep non-REM (non-rapid eye movement) stages of sleep, generally in the first few hours after falling asleep. As a result of the brain’s arousal mechanisms not functioning fully at this stage, the child begins to use motor skills without fully waking up. We can think of it as if some functions of a computer program remain open but the main operating system has not yet been fully loaded.

Genetic factors also play an important role in sleepwalking. Children with a family history of sleepwalking are more likely to experience this condition. This suggests that sleepwalking may be associated with a genetic predisposition.

Disturbances in sleep patterns, especially insomnia and irregular sleep hours, may trigger sleepwalking. The sleep cycles of children who have not slept enough or who go to bed at constantly different times may become unbalanced, and this may increase the risk of sleepwalking. Just like the mechanism of a music box working irregularly, irregular sleep may also disrupt the brain’s sleep pattern.

Stress and anxiety are among the psychological factors that can trigger sleepwalking. Stressful events or anxieties experienced during the day may cause the child to display different behaviors during nighttime sleep.

Physical illnesses, especially febrile illnesses and some medical conditions, may also trigger sleepwalking. Physiological changes in the body may affect the brain’s sleep pattern and lead to sleepwalking.

Some medications, especially some sleep medications and antihistamines, may cause sleepwalking or worsen the existing condition. For this reason, it is important to consult your doctor before giving any medication to your child.

Changes in routine, such as traveling or sleeping in a different environment, may also trigger sleepwalking. Sleeping in a new environment may temporarily disrupt the child’s sleep pattern, and this may increase the risk of sleepwalking.

What Are the Differences Between Night Terror and Sleepwalking?

Although both night terror and sleepwalking are parasomnias that occur during the deep stages of sleep, they have some important differences. Like apples and pears, both are fruits, but their taste and appearance are different.

The most obvious difference is that in night terror, the feeling of intense fear and panic is in the foreground. The child screams, cries, and thrashes about as if terrified. In sleepwalking, however, motor activities are more prominent; the child walks, wanders, or displays other behaviors, but generally does not show a clear expression of fear.

During a night terror, the child is usually difficult to soothe and wake, and these attempts may even make the situation worse. A sleepwalking child, however, can usually be guided more easily and taken back to bed.

In both cases, the child does not remember the event the next morning, but this amnesia is more pronounced in night terror. Sleepwalking children may sometimes remember very brief snapshots, whereas in night terror generally nothing is remembered.

Night terror episodes usually last a shorter time, from a few minutes up to half an hour, while sleepwalking episodes may last longer and may include more complex behaviors such as wandering around the house or even going outside.

Finally, night terror is generally more common in younger children (ages 3–8), while sleepwalking may be seen in a wider age range (ages 4–12) and may even continue until adolescence.

What Should I Do If I Suspect My Child Has a Sleep Disorder?

If you suspect that your child has a sleep disorder such as night terror or sleepwalking, first of all it is important to remain calm and not worry. Remember that these conditions generally do not indicate a serious health problem and most of the time improve on their own. However, it is always the right approach to consult a specialist.

As a first step, it will be useful to note down your child’s sleep pattern and the events experienced during the night in detail. Recording in writing when the episodes started, how often they recur, how long they last, and the behaviors your child displays during them will help you when speaking with your doctor.

It is important to consult your child’s pediatrician or a pediatric neurology specialist. Your doctor will take your child’s medical history, perform a physical examination, and try to make a diagnosis by evaluating your notes. In some cases, they may recommend additional tests or a sleep study (polysomnography) to understand whether there is another underlying health problem.

When talking with your doctor, it is important to provide detailed information about your child’s general health status, the medications they use, whether there is a family history of sleep disorder, daytime stress level, and sleep habits.

After the diagnosis of a sleep disorder is made, your doctor will inform you about appropriate treatment and management strategies. This usually includes behavioral approaches such as taking measures to ensure your child’s safety, establishing a regular sleep schedule, and avoiding triggering factors. Rarely, medication treatment may be considered in very severe cases.

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