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$Title{Medical Advice:  Nightmares}
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Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Nightmare Nightmares awakens screaming awakening wake scream wakes
confused Confusion Frantic Sleepwalking stress school social family pressures
television bad dreams horrible dream night terrors fever illness delirium
confused awaken frantically Sleepwalker Sleepwalkers fear failure conflicts
peer pressure peers bullied bullies sexual experimentation alcoholism
emotional abuse divorce hospitalization death anxieties sleepwalk sleepwalks}
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Your Child:  A Medical Guide


Nightmares


     Quick Reference

     SYMPTOMS
     - Child awakens screaming
     - Confusion on awakening
     - Frantic activity on awakening
     - Sleepwalking

     HOME CARE
     - Rouse the child slowly and gently.
     - Hold the child and speak soothingly and reassuringly.
     - If the child is sleepwalking, make sure he or she cannot fall or get
       hurt.

     PRECAUTIONS
     - Frequent nightmares indicate that the child is under excessive stress.
       Try to identify and relieve the problem.  If necessary, enlist the
       doctor and school personnel to help pinpoint the source of the child's
       distress.
     - Be alert to the school, social, and family pressures that can cause a
       child to have nightmares.
     - Be sure you know how much television your child is watching and that
       the program content is suitable.
     - A child who sleepwalks must be protected from falls and other injuries.


     Some experts distinguish bad dreams from nightmares and night terrors.
For all practical purposes, however, all three have the same cause and
treatment; they differ only in degree.
     In a nightmare, the mind relives the fears and anxieties that were
experienced during the waking hours.  Occasionally, a nightmare may be the
result of the usual stresses a child encounters in daily life.  Frequent
nightmares, however, are abnormal and indicate that there are unreasonable
pressures on the child.
     High fever and illness (for example, measles) have been known to induce
nightmares.  When this happens, the condition resembles delirium; it should
not recur once the child is well again.  If no illness is involved, a
nightmare is easily identified.

SIGNS AND SYMPTOMS

     A child experiencing a terrifying dream may wake up screaming,
frightened, and wild-eyed.  The child may be confused or frantically active
for several minutes and may not immediately recall the details of the dream.
Often the incident will be forgotten by the next morning.  Nightmares may also
cause the child to sleepwalk.

HOME CARE

     Immediate treatment involves holding and hugging the distraught child and
speaking calmly and soothingly.  Do not try to rouse the child to full
consciousness too quickly.  Sleepwalkers must be protected from falls and
other injuries.
     The basic home treatment is to identify and relieve the stress that is
causing the child to have nightmares.  Some situations that commonly underlie
such stress include the following:  school problems (fear of failure,
teacher-student conflicts); problems in relating with peers (playing with
older children, being bullied, sexual experimentation); and family pressures
(marital friction, alcoholism, physical or emotional abuse, divorce,
hospitalization, death).  Watching too much television--or the wrong type of
program--can also cause enough anxiety to give a child nightmares.

PRECAUTIONS

  -  Be aware of school, social, and family pressures that can cause a child
     to have nightmares.
  -  Be sure you know how much television your child is watching and what
     kinds of programs.
  -  Protect a sleepwalking child from injury.

MEDICAL TREATMENT

     Your doctor will try to uncover the cause of your child's anxieties by
getting the child to talk about his or her daily relationships and
experiences.  The doctor may ask for assistance from school personnel in
identifying the reason for the child's nightmares.