Helping Children Conquer Nightmares

Sleep, to the parents of a newborn, is about as common as unicorns. Actually, chances are they’re more likely to have seen a unicorn during their delirious fumblings to find a bottle at 3 a.m. than to have actually caught any real Z’s. I must say as much as I miss my now 2-year-old being my tiny little baby, I do not miss the up-all-nights that went with it. But just when I think I’m out of the woods…that budding toddler imagination pulls me right back in with just one word: nightmares.

Nightmares are a common occurrence in childhood. The American Academy of Pediatrics defines nightmares as frightening dreams that may awaken a sleeping child, not to be confused with night terrors which consist of a screaming, crying, sleep-like state where the child appears awake but isn’t and doesn’t remember the episode later.

Thankfully so far, my daughter has only suffered from the occasional frightful dream, which her pediatrician says is normal. His office gives out milestone documents at each wellness checkup and her 2-year visit actually mentions nightmares at this stage. It is a little difficult for me to imagine what my 2-year-old could possibly have a nightmare about (Santa Claus Returns—it’s Lap or Nap?). It’s just a guess based on past experience. But, the reality is that nightmares are very real to toddlers, mostly because they have a harder time distinguishing between a dream and real-life. However, the majority of nightmares happen between the ages of 3-6 because this is the age at which normal fears develop and a child’s imagination is very active. Some studies estimate that as many as 50 percent of children in this age group have nightmares.

Exactly why nightmares occur is a mystery. But doctors do recognize some triggers that may increase nightmares, including being too tired, not getting enough sleep, having an irregular routine for sleep, and having stress or anxiety. These dreadful dreams can also be related to the child’s stage of development or as part of coping with life changes such as starting school, moving to a new neighborhood, or living through a family divorce or remarriage. Research has also found that genetic factors can lead to nightmares. Nearly 7 percent of children who have nightmares have a sibling or parent with a history of nightmares too. And not surprisingly, nightmares can also occur after a trauma. These nightmares may indicate post-traumatic stress disorder and are the major focus of a current study at the University of Tulsa (TU).

Dr. Joanne Davis is an associate professor of psychology at TU and serves as co-director of the university’s Institute of Trauma, Abuse & Neglect. She and her colleagues are diving into the topic of dreams, traumatic nightmares in particular, with a study called “Efficacy of Brief Treatment for Nightmares for Children.”

“Nightmares and sleep disturbances frequently follow traumatic or stressful experiences,” Dr. Davis said. “They’re also associated with immediate and long-term psychological and physical health problems, as well as impair functioning in school and at home.”

Dr. Davis also mentions that nightmares don’t just affect the child having them. Serious sleep disturbances can also impact other members of the household, creating parent and sibling stress. Sleep-deprived caregivers may also be less adaptable to the parenting challenges that accompany a child with post-trauma difficulties, possibly leading to more trauma for the child and the family.

The study at TU is hoping to break this negative cycle. It’s designed to test a treatment for nightmares in children who have experienced a trauma or stressful event. The treatment involves the psychological techniques of exposure, relaxation and rescripting therapy and has shown promising results in adults with civilian- and combat-related traumatic experiences.

“This is the first clinical trial to be conducted with children,” Dr. Davis explained. “But similar treatment [with adults] has been successful in decreasing the frequency and intensity of nightmares, improving sleep quantity and quality and improving related symptoms of posttraumatic stress disorder and depression.”

The study at TU is still in the early stages of recruiting subjects for their clinical trial, but Dr. Davis says she has been encouraged by the results in the adult studies because the treatment is quite brief, but seems to have a broad and lasting impact on nightmares.

“In the adult studies, the average length of time participants had experienced nightmares was 16-18 years for the civilian study and 40 years for the veteran study,” Dr. Davis said, “but in just a few sessions, they are significantly decreased or gone altogether.”

Although this study only focuses on nightmares caused by traumatic events, there are things you can do to help comfort your little one from the occasional boogie man too.

Most importantly, go to your child when she cries out. Physical reassurance is important, so hold her or rub her back until she calms down. You can also give the child a favorite stuffed animal or toy and double-check that the nightlight is on. Talk about the nightmare if the child is old enough to understand, but keep in mind that saying, “It’s only a dream” won’t be much consolation for a child younger than age 3.

One tip I recently received from an experienced mom was using air freshener as monster repellant. If her daughter wakes up with a nightmare, the mom said she sprays the room with the “repellant” and as long as the child can smell it, the monsters stay away. She swears it has worked miracles.

Other tips include keeping a peaceful bedtime routine such as a warm bath, upbeat story and happy song before bedtime. But if your child suffers from persistent bad dreams, it may be time for a trip to the doctor. Nightmares might signal that there’s something going on in his waking life that needs to be addressed.

Sleep is a vital part of maintaining good physical and mental health for children and parents. And, while everyone experiences the occasional nightmare, working through it is key. After all, a healthy happy family is the sweetest dream anyone could ask for.

**To obtain information about the study, please call the University of Tulsa Institute of Trauma, Abuse & Neglect [TITAN] at: 918-631-2543.