Management

In general, sedative medications are not indicated for night waking. Instead, behavior management techniques similar to those outlined for sleep refusal are appropriate for most cases.

There is no specific treatment for night terrors. Parents should be reassured with the explanation that the problem is common and self-limited. They should not try to wake the child up because this may only frighten the child or slow the child's return to sleep. For children who thrash violently, the parent should take precautions to provide protection for them. If the child sleepwalks into potentially dangerous situations, the parents can hang a bell or electronic movement alarm on the child's bedroom door to warn them. Because overtiredness is a major factor in the tendency to have night terrors, increasing the total amount of sleep and keeping a consistent sleep-wake cycle should be emphasized.

Because nightmares tend to occur at times of emotional stress, the focus of treatment should be on assisting parents with effective ways to manage the underlying stress. When a nightmare has occurred, the child is awake and frightened. The parent should comfort the child without a detailed review of the nightmare contents or "flashlight searches for monsters" (Blum and Carey, 1996) which can further increase the child's fears.

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