How can night terrors be managed in children?
Q: My 7.5 years old son is an active and smart child. He is doing well in his studies. During his recent annual vacation he visited India and spent around 45 days at his grandparents house where he enjoyed a leisure life by getting up late, watching TV mostly, eating all types of food and slept a lot. When he came back home, we noticed a sudden change in his attitude namely he is always sleepy in the daytime in front of TV/ in car / in school wherever he goes. On the other side, we have also noticed that he has night terrors / sleep terrors at nights. He goes to bed at 9 pm (which is unusual compared to past, which was normally around 11 pm) and go to deep sleep until 1 am and then he started moving his body by rolling and blabbering unrecognised words and suddenly wakes up and tell us that somebody is standing near the door and some insect in bed etc. We immediately tell him to sleep then he immediately falls in sleep. Again after 30 minutes this may continue and finally he goes to sleep early morning around 3 am and sleeps till 6.30 am then we wake him for school. When we ask him what has happened and why he talked then he could not recollect what he said last night. During daytime we have noticed some slurred speech while talking. This is happening for the last 2 months after he came back from his grandparents home. Previously he was active / smart / too much talkative boy. Please help.
A:In the case of your child, two important conditions need to be considered. One is night terrors and the other is temporal lobe seizures.
It is very important to observe the child’s behaviour during the episode and record it with a camcorder. A sleep deprived sleep EEG will help to detect epilepsy.
As for night terrors, most episodes last 1-2 minutes, but they may last up to 30 minutes before the child relaxes and returns to normal sleep. They generally occur after 90 minutes of sleep. If the child does awake during a night terror, only small pieces of the episode may be recalled. Usually, the child does not remember the episode upon waking in the morning. Night terrors generally tend to resolve as the child grows, and no treatment is required unless they are very frequent.
The fact that your child remains sleepy and at times has slurred speech during daytime indicates the need for a neurological evaluation. An EEG and if required a sleep polysomnography must be done to determine the problem.