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Bed-wetting, night terrors and other childhood sleep problems
From MayoClinic.com
Special to CNN.com

Bed-wetting may be the childhood sleep problem that gets the most attention, but night terrors and other sleep problems affect preschool and elementary school children as well. And if you have one child with a bed-wetting problem or an occasional nightmare, you know how disruptive the situation can be.

Fortunately, most children outgrow bed-wetting and other sleep problems by the time they start school. In the meantime, you can increase your understanding of these problems and take steps to reduce their disruption.

Bed-wetting (enuresis)

Bed-wetting is a common problem that most kids outgrow. About 16 percent of 5-year-old children wet the bed, while only 5 percent of 10-year-olds have this problem. Bed-wetting appears to run in families and is much more common in boys than girls.

Many factors can contribute to bed-wetting, including:

  • An exceptionally small bladder
  • A delay in the maturation of the nerves that control the bladder
  • An imbalance in a hormone that reduces urine production at night

The most effective treatment for bed-wetting seems to be an alarm system that wakes the sleeper when it senses wetness. Medications can be prescribed for short-term use — for outings such as sleepovers and camp attendance. However, doctors typically do not begin treatment for bed-wetting until the child is at least 7 years old.

Bed-wetting has been linked to sleep apnea, a disorder that occurs when throat muscles relax during sleep and obstruct airflow through the nose and throat. This results in labored breathing and loud snoring. People with sleep apnea stop breathing for short periods of time during sleep.

The main cause of sleep apnea in adults — obesity — can also be a factor in children. But the most common cause of childhood sleep apnea is overgrown tonsils and adenoids. Surgery often corrects the problem completely.

Sleepwalking

Sleepwalking usually occurs during deep sleep, early in the night, and most often affects children between the ages of 6 and 12. Episodes typically last less than 30 minutes and may be related to fatigue or anxiety. Sleepwalking also appears to run in families.

Sleepwalkers do more than just walk. They may change their clothes, move furniture or just sit up in bed. Your child may have an occasional episode of sleepwalking without your noticing it. If your child turns up sleeping in an unusual place and can't remember getting there, he or she may have been sleepwalking.

Old wives' tales to the contrary, it is not dangerous to wake a person who is sleepwalking. But it's best to simply lead your child back to bed. Most children outgrow sleepwalking by adolescence.

Sleepwalking can be dangerous. A sleepwalking child may fall down a stairway, run into a wall or wander outside. You may want to consider putting up baby gates at the top of all stairwells or having your child sleep on the ground floor of your home. Doors and windows should be locked.

Night terrors

Night terrors are very different from nightmares, although both can be dangerous. A night terror may cause your child to shriek loudly, sit up in bed, thrash about or even run around the room in an effort to escape. If you try to hold or comfort your child, he or she will probably fight you.

Even if your child's eyes are open, he or she is still fast asleep and will remember nothing specific about the night terror — aside from being afraid. Night terrors occur during a deep phase of sleep, usually an hour or two after the child goes to bed. They can last for a few minutes or up to an hour, and most often affect children between the ages of 3 and 5.

Children who have night terrors may leap out of bed and charge blindly around their rooms or through the house. Gently restrain them and try to get them back into bed. Shaking them or shouting will only make things worse. Turning on the light and speaking calmly and repetitively usually helps.

Night terrors tend to run in families, although fatigue also seems to play a role. Because the episodes tend to occur at the same time of night, you might try waking your child 15 to 30 minutes beforehand, to see if you can disrupt the cycle. Most children outgrow night terrors by the time they start school.

Nightmares

One out of every four children has scary dreams more than once a week. Most of these bad dreams occur late in the sleep cycle, usually between 4 a.m. and 6 a.m. Your child may wake up frightened and come to you for comfort.

The ordinary stresses of daily life can turn dreams into nightmares. A particularly stressful event may provoke nightmares for months. Reading scary books or watching scary movies also can cause nightmares.

It may help to have your child describe the nightmare to you. Some children rewrite their bad dreams by giving them happy endings. Older children may want to keep a dream journal. For children under 5 — an age where magic seems real — you might assign a doll or stuffed animal the job of "staying awake" all night to guard against bad dreams.

If nightmares become so frequent that they interfere with your child's rest, you may want to discuss the matter with your child's doctor.

Be patient

Realize that your child can't control these sleep disturbances. He or she isn't deliberately trying to upset you. Your feelings of frustration are normal, but try to stay calm and collected as you and your child work through the problem together.

  • Child development quiz: Preschool milestones
  • Toe walking in children: A cause for concern?
  • Potty training: How to get the job done
  • Children and constipation: Ways to cope and when to worry
  • September 13, 2005

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