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Sleep Terrors Treatment & Management

  • Author: Eve G Spratt, MD, MSc; Chief Editor: Caroly Pataki, MD  more...
 
Updated: Jul 06, 2016
 

Approach Considerations

In view of the benign and self-limited nature of sleep terrors, most affected individuals require no specific medical intervention other than reassurance and education.

The use of scheduled awakenings has been suggested as a possible means of reducing sleep terror occurrences.[23] This involves noting what time the episodes usually occur for five nights in a row, then waking the child up 10 to 15 minutes before that time, keeping the child awake for 4 to 5 minutes, then allowing the child to resume sleep.[24]

During episodes, efforts should be made to keep affected individuals from harming themselves or others. These efforts can be supported by removing hazardous objects from the sleep area, securing windows, and impeding exit from the sleep area. Affected children are typically resistant to interference in the midst of a sleep terror event, but patient surveillance to avert injury as permitted may be all that is required.

When the episode has terminated, parents should assist the child back to bed. Discussion of the event immediately or the following day is usually not helpful, because the experience either is not remembered or is only vaguely recalled.Associated comorbid conditions, particularly sleep breathing disorders, should be appropriately treated; this may or may not affect the frequency of sleep terrors.[9] General efforts to promote a stable environment with adequate regular sleep habits are encouraged but may not alter the occurrence of sleep terrors.

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Long-Term Monitoring

Routine follow-up and developmental assessment are indicated for all children, including those affected by sleep terrors.

Continued support and reassurance can be helpful for affected families. Surveillance for deviation from classic sleep terror characteristics or increasing severity of behavior during episodes may prompt reconsideration of the diagnosis or increased protective interventions.

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Contributor Information and Disclosures
Author

Eve G Spratt, MD, MSc Professor of Pediatrics and Psychiatry, Division of Developmental Pediatrics, Medical University of South Carolina; Director, Pediatric Consultation Liaison Psychiatry, Medical University of South Carolina Children's Hospital at Charleston

Eve G Spratt, MD, MSc is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry

Disclosure: Nothing to disclose.

Coauthor(s)

Katherine Harris, MD Medical University of South Carolina College of Medicine

Katherine Harris, MD is a member of the following medical societies: American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD Health Sciences Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Additional Contributors

Martha Karlstad, MD Chief Resident, Child and Adolescent Psychiatry, Medical University of South Carolina College of Medicine

Disclosure: Nothing to disclose.

Acknowledgements

Mark Anderson, MD Lt Col, United States Air Force, 75th Medical Squadron

Disclosure: Nothing to disclose.

Kevin P Connelly, DO Clinical Assistant Professor, Department of Pediatrics, Division of General Pediatrics and Emergency Care, Virginia Commonwealth University School of Medicine; Medical Director, Paws for Health Pet Visitation Program of the Richmond SPCA; Pediatric Emergency Physician, Emergency Consultants Inc, Chippenham Medical Center

Kevin P Connelly, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Osteopathic Pediatricians, and American Osteopathic Association

Disclosure: Nothing to disclose.

Chet Johnson, MD Professor and Chair of Pediatrics, Associate Director, Developmental Pediatrician, Center for Child Health and Development, Shiefelbusch Institute for Life Span Studies, University of Kansas School of Medicine; LEND Director, University of Kansas Medical Center

Chet Johnson, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose

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