Nighttime Awakenings

Most preschoolers sleep through the night, but often rouse several times to check their surroundings before falling back to sleep. There may be nights; however, when your child's very active dreams awaken him. These vivid dreams often represent the way he viewed some of the events of the day. They may reflect some impulse, aggressive feeling, or inner fear that only comes to the surface by way of these frightening images or dreams.

By the time he's five or a little older, he'll be better able to understand that these images are only dreams, but as a preschooler he may still need to be reassured that they're not real. So, when he wakes up in the middle of the night, afraid and crying, try holding him, talking about the dream, and staying with him until he's calm. For your own peace of mind, don't forget that these are only nightmares and not a serious problem.

To further help your child overcome his nighttime fears, you might read him stories about dreams and sleep. As you talk about these stories together, he'll better understand that everyone has dreams and that he needn't be frightened of them. Some classic children's books on these topics include Maurice Sendak's In the Night Kitchen, Russell Hoban's Bedtime for Frances, Mercer Mayer's There's a Nightmare in My Closet, and Chris van Allsberg's Ben's Dream. Always make sure that these books aren't themselves frightening to him.

Occasionally, your preschooler will be in bed, appearing to be awake and desperately upset, perhaps screaming and thrashing, eyes wide open and terrified, but he won't respond to you. In this case, he's neither awake nor having a nightmare. Rather, you're witnessing something called a "night terror," a mysterious and, to parents, distressing form of sleep behavior common during the preschool and early school years.

Typically, the child falls asleep without difficulty, but wakes up an hour or so later, wide-eyed and terrified. He may have hallucinations, point to imaginary objects, kick, scream, and generally be inconsolable. The only thing you can really do in this situation is hold the child to protect him from hurting himself. Reassure him: "You're fine. Mommy and Daddy are here." After ten to thirty minutes of this, he'll settle down and go back to sleep. The next morning, he'll remember nothing about the occurrence.

Some children may have just one episode of night terrors, while others experience them several times. It's not typical, however, for them to recur frequently or for a prolonged period. In cases of very frequent night terrors, sleep medications prescribed by your pediatrician may be helpful, but the best strategy seems to be to wait them out. They'll disappear naturally as your child grows older.

While nightmares and nightterrors are common causing of nightwaking in children, sometimes it can appear as if there is no reason for your child's frequent wakings. You can never depend on your child to sleep through the night, at least not in these early years. He may go for a few days, weeks, or even months sleeping like an angel, then begin waking up almost as frequently as a newborn.

The most common cause of nighttime awakening is a change in routine. Changing rooms or beds, losing a favorite cuddly toy or blanket, or taking a trip away from home may all disrupt his sleep. If he's ill or cutting a tooth, he might wake up more often. Also, between twelve and fourteen months he'll begin actively dreaming, which can startle or frighten him awake. These are all valid reasons for him to wake up but not for you to pick him up or bring him to your room. He needs to put himself back to sleep, even if it means crying a bit first

If your toddler is used to getting lots of nighttime attention, you'll need to retrain him gradually. Let's say you've been giving him milk when he wakes up. It's time to change first to diluted milk or water, and then to stop it entirely. If you've been turning on the light and playing with him, try to soothe him in the dark instead. If you've been picking him up, restrict yourself to calming him with only your voice from a distance. Above all, don't get angry with him if he continues to protest. You'll need to show him some compassion, even as you remain firm. It's not easy, but in the long run it will improve your sleep as well as his.

Excerpted from "Caring for Your Baby and Young Child: Birth to Age 5" Bantam 1998

© Copyright 2000 American Academy of Pediatrics