My best guess is that the Very Hungry Caterpillar is really terrifying.

April 9, 2012 2:10 PM

Toddler nightmares: what helped you calm the shrieking beast?

My 13mo. old son has been waking up screaming and upon taking him into the pediatrician to get checked for an ear infection (of which he's already had two in his short life), he was diagnosed with nightmares.

His night wakings fit the profile of nightmares in that he wakes up *screaming* (not crying) and is fairly inconsolable. They're not night terrors in that he is truly awake and responsive when I go in to try and help him - he reaches for me and responds, though usually by screaming and crying more. Unfortunately for everyone involved, this happens many times per night.

I'm at a loss as to how to help him. The pediatrician suggested a white noise machine and a nightlight - both of which he already has and we've used every night since birth.

One of the unique challenges with this particular kiddo is that cuddling him does not help him in any way. He's never been soothed by snuggles and when I hold him and try to get him to relax, he responds by trying to throw himself out of my arms. At best, he wakes up *more* and wants to play when I hold him. I can't bring him into bed with me as he thinks that's a great party and does not settle down and go to sleep, but rather crawls all over everything and pokes at the eyes of any residents of the bed, who then obviously are no longer sleeping themselves. He no longer breastfeeds and giving him a bottle doesn't do any good when he's not hungry as he just won't take it.

Given that we have the nightlight and noise machine and he can't be soothed by snuggles, I'm totally at a loss. If you've dealt with this with your own kiddos, what's helped you? Is it better to go in and try to soothe him anyway or to let him wear himself out? (He can, under normal circumstances, self-soothe.)

posted by sonika to health & fitness (35 answers total)

My son did this just last night! I chalked it up to teething pain - he is usually a solid 12-hour sleeper (16 months old). Have you tried giving Advil just to be on the safe side if it's teething?

I usually do a thing where I reposition him for sleep and then rub/pat his back gently and either hum a tune or softly recite his favorite bedtime story (The Little Fur Family). Once his breathing is calm I slip out of the room...which might set him off again, but if given <5>
I do not take him out of his crib unless he gets up and stands in his crib, in which case I hold him (while standing up) and rock or pace back and forth for a few minutes with his head on my shoulder.
posted by handful of rain at 2:21 PM on April 9, 2012 [1 favorite]

Does he remember his nightmares in day time? If he's verbal enough, he might have some ideas when it's more calm for how he wants you to help him.

Some people suggest "monster spray" (which can just be water with glitter in it, poured into a spray bottle) or a particular song, or a ritual. But. It's different for every kid.

He might let you rub his back, his hair, or his feet. He might respond to a breathing exercise or some meditation music/prompts.

A hot water bottle to warm the bed back up might help (I used to sleep in a ball, and then when I'd stretch my feet down toward the end of the bed, the icy sheets would freak me out!)

Changing the position or brightness of the nightlight, volume or position or sound of the noise machine worked for one friend.

Just like with adults, asking kids what they need when they're freaked out can be very overwhelming for them. But asking when he's calm may provide some real insight into what's happening. Of course, nightmares are developmentally appropriate.

Another thing that has worked for a mother I know, her kid was dreaming that she was being chased, and waking up because she was afraid the dog would catch her. My brilliant friend suggested that her daughter could fly in her dreams, and thus escape any dog that would come to her in a dream. It worked and she stopped waking up from the nightmares! Now, if your son isn't talking or signing enough for any of this, my sincere apologies.
posted by bilabial at 2:24 PM on April 9, 2012

Formatting mesed up - he usually can self-calm in less than five, or else I go back in.
posted by handful of rain at 2:26 PM on April 9, 2012

Is he being exposed to something on tv or in a book or story that could be construed as scary at his age? That might be an avenue to explore.
posted by St. Alia of the Bunnies at 2:26 PM on April 9, 2012

So, so sorry. You must be exhausted.

How is his daytime sleep?

How is his daytime behavior and mood? Does he seem sleepy?

How long has this been going on?

How long does the screaming last if you ignore it?

Would you be willing to give him tylenol before bed in case he's in physical pain?

(I also have a baby who does not like cuddling. He gets "snuggled" facing away from us with one arm lightly around his belly--that's about it!)
posted by the young rope-rider at 2:29 PM on April 9, 2012

Both of our sons have experienced this (but not to the same degree that you're talking about). I would say that teething was one cause (as teething can cause mild fevers that stimulate this sort of behaviour), and last week a mild cold (with a fever) caused night terrors.

So in those cases, some sort of children's cold medicine does the trick rather nicely.

In other cases, often stimulation before bedtime results in restless sleep and night terrors. So we try to do turn the tv off (if it's on at all) 90 minutes before bed, and dim the lights around an hour before bed.

We also co-sleep, which means we never have to worry about getting up to go to another room.
posted by KokuRyu at 2:29 PM on April 9, 2012

Oh, and has he ever have signs of reflux or food allergies?

If this continues for a significant amount of time I would think about seeing a pediatric sleep specialist. It doesn't seem at all normal in my experience with that age group.
posted by the young rope-rider at 2:30 PM on April 9, 2012

My son still goes through this and he's 3, and yeah, cuddling doesn't help. But most of the time, just sitting on the bed and saying (in a soothing voice), "You're having a bad dream. It's not real. It's okay. Just a dream," etc, a few times without touching him will calm him back down.
posted by Mchelly at 2:31 PM on April 9, 2012

Also, does he snore or have allergies?

Good luck with this. Sleep deprivation is the worst.
posted by the young rope-rider at 2:33 PM on April 9, 2012

At best, he wakes up *more* and wants to play when I hold him. I can't bring him into bed with me as he thinks that's a great party

After you rule out anything medical, keep in mind that at some point, he may be doing it from a sense of routine and attention-seeking. "Oh, I'm awake in the middle of the night. Time to start screaming, because that's when Mom comes to get me. You know, just like the other X times."
posted by Cool Papa Bell at 2:49 PM on April 9, 2012

To answer questions:

Have you tried giving Advil just to be on the safe side if it's teething?

Yes, it doesn't help and teething has been officially ruled out by the pediatrician.

Does he remember his nightmares in day time? If he's verbal enough, he might have some ideas when it's more calm for how he wants you to help him.

He's 13mos and his verbal skills are limited to "mama, dada, keeeee (kitty), bye-bye" - so, no, no way to ask him what's going on.

Is he being exposed to something on tv or in a book or story that could be construed as scary at his age? That might be an avenue to explore.

I've thought about this and he only reads board books (Eric Carle is his favorite) and watches Sesame Street, Blue's Clues, and Kipper. He's not in any way exposed to adult TV and his books/stories are all pretty much pictures of animals and food. If any of these are scary to him, I have absolutely no way of narrowing it down as they're all seemingly benign - no chasing, screaming, separation, or violent themes.

How is his daytime sleep?

Erratic. He's been transitioning from two naps to one for about six weeks now and refuses to commit to any specific nap schedule. He does eventually take at least a two hour nap at some point, but there's no way of telling WHEN. When he does nap, he naps solidly and does not wake up crying or screaming at any point during the day.

How is his daytime behavior and mood? Does he seem sleepy?

He's fussier than normal, but does not seem sleepy and does not take more naps if given the opportunity. I've tried putting him to bed more often which usually yields a few minutes of quiet followed by chatting to his "friends." (He sleeps with a small army of stuffed creatures.) It can calm him down to spend time in his crib, but he's no more tired than usual during the day and doesn't sleep more.

How long does the screaming last if you ignore it?

Over an hour. I tried this last night after running out of other options. He did eventually just scream himself to sleep, but it took a VERY long time.

Would you be willing to give him tylenol before bed in case he's in physical pain?

As mentioned, we've been doing this a few times and no, it doesn't help any. The pediatrician has ruled out physical causes for his night wakings. His ears and throat are fine and his gums aren't even swollen - he's not teething. He's not congested or coughing - it's not a cold or other illness. So, cold medicine wouldn't help except to possibly make him drowsy.

As for TV and co-sleeping: he only watches about an hour total of TV per day, the latest that TV is ever on is hours before he goes to bed if I'm cooking something for his dinner and his father isn't yet home to hang out with him. He only ever watches toddler-appropriate shows and never immediately before bed. His bedtime routine is fairly well established as bath, pjs, bottle, teeth brushed, bed. He doesn't ever want a bedtime story or lullabies and actively eschews them.

Oh, and has he ever have signs of reflux or food allergies?

Nope. And again, the pediatrician has ruled out any physical cause for his night wakings. He hasn't had any changes to his diet lately and eats a typical well-balanced toddler diet: yogurt, water, some juice, formula (we tried switching to whole milk and he wasn't ready for it quite yet - seemed to give him a tummy ache), table foods (pasta w/sauce, chicken, beef, rice, mild curries, the occasional french fry), fruits (bananas, assorted berries), crackers... there's zero indication that he's had any reactions to food.

After you rule out anything medical, keep in mind that at some point, he may be doing it from a sense of routine and attention-seeking. "Oh, I'm awake in the middle of the night. Time to start screaming, because that's when Mom comes to get me. You know, just like the other X times."

Right, and this is something I'd like to avoid. So it's hard for me to tell if I should be soothing him or not.
posted by sonika at 2:52 PM on April 9, 2012

I think the first thing I'm going to try tonight is to keep him in his bed and rub his back to try and soothe him without getting him to associate waking up with getting to get out of bed. I'll report back on how this goes.
posted by sonika at 2:59 PM on April 9, 2012

You can try the Ferber method. It's geared towards not getting to sleep, but if it's an "I get lonely at night and this is a good way to get a parent to come visit" it has been effective for many families. It was not successful when my son had colic.

Other options - bring the crib into your room for a while. Use the soothing parent voice if he wakes up at all - You're safe, Mommy & Daddy are right here; it's all okay, etc. You can keep the room a bit warmer, but you've likely tried all the comfort options.

Talk to your doctor about using real benadryl, which can be a sleep aid.

I'm convinced my son's colic was a reaction to having lots of stimulation, and not being able to process it. I'm not sure what would have made it better, although co-sleeping is a big possibility.

Constant exposure to a screaming toddler, and lack of sleep can make you unhinged. Do whatever you can do to cope, and get whatever help is available.
posted by theora55 at 3:01 PM on April 9, 2012

Does it happen at a repeating time? Eg a particular clock-time or at a certain interval after he's gone to sleep? My child was a terrible sleeper from 0-18 months, and we had to go full-blackout (no light whatsoever) and use two noise machines in order to prevent tiny wakings from turning into major ones. Our kid had a period of waking every 45 minutes (sleep cycle thing?), and if there was any disturbance happening at that time, such as the heater clicking on, he'd wake up fully. If you find that there's a connection to his sleep cycle, I've seen strategies for that in a book called "No Cry Sleep Solution." (In short, you slightly pre-disturb the child 10 minutes before they were waking on their own, causing them to shift into the next sleep phase a little early.)

Since gastric disturbance and teething has been ruled out, to me it sounds like it's of a piece with the nap changes, and maybe it'll resolve on its own as the naps get sorted out.
posted by xo at 3:02 PM on April 9, 2012

That's what I was going to suggest (sorry for the twenty questions). I don't think he'll associate waking with playtime if you do that. Ferber actually suggests that as a method of teaching self-soothing without reinforcing wakefulness and has a schedule and everything for doing it gradually, if that interests you at all. Weissbluth says check once a night and then ignore, but he's on the hard core extinction train.
posted by the young rope-rider at 3:03 PM on April 9, 2012

Other options - bring the crib into your room for a while.

This isn't an actual option. We once shared a room with him out of necessity and *seeing* us made it impossible for him to sleep as, again, PARTY TIME ZOMG MOM AND DAD WHY ARE WE NOT PARTYING RIGHT NOW?!

Does it happen at a repeating time? Eg a particular clock-time or at a certain interval after he's gone to sleep?

Yes, usually around 10-11PM (he goes to bed between 7 and 8) and then again between 2 and 4. The earlier wakings usually last about twenty minutes with the later wakings lasting up to an hour or more. There are no causes I can associate with this, although the first waking very VERY often coincides with the EXACT moment when I lie down to go to sleep myself, making me think that just like my cat - my son is kind of a jerk. (In the nicest possible way.)

maybe it'll resolve on its own as the naps get sorted out.

I hope this is it! Though the nap changes started weeks *before* the night wakings. So, I dunno if they're directly related.

Looks we'll try the Ferber "going in and soothing without picking him" for a bit and see if it works. We really haven't had trouble with night wakings before and I know he's absolutely capable of self-soothing under normal circumstances.
posted by sonika at 3:09 PM on April 9, 2012

My 13 month old does exactly this at the same times with the same bedtime and nothing other than nursing gets him to calm. We have tried everything else but nothing has taken. He's never been a good sleeper and has had frequent night wakings since birth. My current plan is to hope he grows out of it! Good luck. Hopefully there will be some good suggestions. Also they really do seem to know when we sleep. He wakes about 15 min after I fall aleep, ugh.
posted by saradarlin at 3:19 PM on April 9, 2012

According to Weissbluth the pattern you're describing means that he needs an earlier bedtime to help compensate for missed daytime sleep. He kinda thinks that about everything, though.
posted by the young rope-rider at 3:23 PM on April 9, 2012

We take "train breaths" when my toddler is hysterical -- big deep breath in, then say "choo choo!" quietly as we breathe out. As he loves trains, he starts to calm down and say "choo" raggedly. It's my sneaky way of getting him to take calm, meditative breaths when he's too young to understand the idea. Thirteen months is probably a little young, but it's another tool for your toolbox.
posted by Eyebrows McGee at 3:24 PM on April 9, 2012 [6 favorites]

I know this sounds a little simple, but after some serious googling, we started keeping her room a little cool by keeping a ceiling fan on all night, and the problem went away.
posted by 4ster at 3:32 PM on April 9, 2012

I was keeping my fingers crossed that you had an early super talker or signer.

In light of the added information, I vote for the train breaths, feet or back rubbing, and checking for cold spots in the bed, or maybe checking if he's getting too warm instead.

Does he ever rub his eyes in the 5pm to 7pm range? If so, I'd agree with Weisswhoever that an earlier bedtime might benefit. Actually. Maybe try putting him down for sleep earlier anyway for a few weeks and see if it helps. Several friends balked at the idea, not wanting their 6 or 7 am wakers to become 5 or 6am wakers, all but one sheepishly reported that they wished they had done it sooner. (I really want kids. I'm in the habit of asking nosy questions that might help me if/when the time comes!) the one whose kid was waking earlier just moved the crying sessions to later, so cry session #2 was too close to the start of everyone else's day for her to bother soothing back to sleep for an hour.
posted by bilabial at 3:38 PM on April 9, 2012

You could try a clock that ticks or the radio playing a very neutral or music station softly. That is what my parents did. I had tinnitus as a child and if there was silence then after a while it became unbearable. No idea why, but I also hated being snuggled.
posted by meepmeow at 4:01 PM on April 9, 2012

How long has this been going on? My one-year-old does for a week at a time every 3 months or so, and it seems to go away on its own with no action on our part (mostly because no action we take helps!)
posted by snickerdoodle at 4:03 PM on April 9, 2012

Have you taken your child to see an Ear, Nose and Throat specialist? It's probably a long shot, but my daughter had similar problems sleeping and it ended up being related to swollen adenoids AND tonsils; she could barely breathe past the obstruction and it affected her sleep quality.
posted by lekvar at 4:46 PM on April 9, 2012

Does he ever rub his eyes in the 5pm to 7pm range? If so, I'd agree with Weisswhoever that an earlier bedtime might benefit. Actually. Maybe try putting him down for sleep earlier anyway for a few weeks and see if it helps.

We've done this - he's consistently then awake at 10PM happily chattering, but hard to get back down. We put him to sleep at the first signs of being tired, which hit around 7PM - 6:30 at the earliest. He's very distinctly not tired before then.

How long has this been going on?

It's pretty recent that the night wakings aren't related to teething - just a week or so. It's really new.

Have you taken your child to see an Ear, Nose and Throat specialist?

No reason to do so - initial exam shows no problems with any of those areas. I had that checked out today specifically due to past ear infections on his part and mild sore throats in other family members.

The cooler room sounds like a good idea - there's no fan in his room, but we keep the house super warm due to my husband preferring to live in a sauna. I'll turn the heat down a few notches tonight and see if that helps.
posted by sonika at 5:10 PM on April 9, 2012

Already up once tonight - went down at 7, up at 8:20 shrieking. Tried rubbing his back, but he kept standing and grabbing me. Picked him up and tried swaying with him - just tried to fling himself to freedom. He took an ounce of formula and went back to bed calmed down a bit.

Next time I'll just turn on the night light (we have Twilight Turtle which turns off after 45min to save battery - if this becomes an ongoing thing, I'll get a standard plug in nightlight) and try the bot - if he doesn't take it, I'll just put him back in the crib and leave quietly. It looks like for this kiddo the solution is going to be doing nothing as my presence is ramping him up not calming him down.

Thanks for all the help so far! It's definitely helpful to get feedback, even if the ultimate answer turns out to be letting him work it out on his own.
posted by sonika at 5:46 PM on April 9, 2012

Does he go from zero to nightmare instantly? West will sometimes wake up (or come out of deep sleep) and if he does not have a sense that somebody is around, he'll flip out. I've already had to play the part of Creepy Dude Watching His Son sleep tonight to get him to go back down.

It feels like Paulo is of the age where he realizes that Mom and Dad are not parts of himself and sometimes go away, so it's pretty scary when he comes towards wakefulness alone. Try an experiment. Position yourself (with headphones and a podcast, maybe) in his room before his now regular freak out. Does the freak still happen if you are in the room?
posted by robocop is bleeding at 6:24 PM on April 9, 2012

Does he go from zero to nightmare instantly?

Yep. No build-up, just silence and then ZOMG SOUND THE ALARMS THE WORLD IS ENDING.

The idea of being in his room isn't a bad one, except that opening his door will wake him up. It's tricky as leaving the door open invites cats into the room... but our room is right next to his, so the elapsed time for me to get there when he starts shrieking is approximately six nanoseconds.

The pediatrician did say that separation anxiety could be a part of this, so if I can get into his room for a little bit - I'm willing to do it if it helps. That will just be one of those fun logistical challenges.
posted by sonika at 6:29 PM on April 9, 2012

What is the cat doing during this time? I seem to recall your cat can be a bit of a jerk. ; ) Is it possible the white noise machine keeps your son from hearing kitty come in, and when kitty jumps on his bed your son is scared? He screams, kitty runs away, son is soothed--until later, when kitty tries it again? Just a thought.

Have you tried NOT having the white noise machine on? Maybe getting used to the normal noises in the home will help him to self-soothe (there's Mommy and Daddy getting ready for bed, that's kitty meowing, etc.).
posted by misha at 7:07 PM on April 9, 2012

What is the cat doing during this time? I seem to recall your cat can be a bit of a jerk. ; )

Yes, my cat is a total asshole. (Or rather, cat-hole.) She, however, isn't doing anything at this time and has no access to his room. He never wakes up when she is throwing her own tantrums about the unfairness of the world.

I think we're going to keep the white noise machine as part of the routine as sound travels really well through our house and it has been known to wake him up if we're speaking too loud or someone turns the volume up on the TV or whatnot. Those wakings are very easily solved by a quick pick-up-get-a-drink-go-back-down. The nightmares are a different issue. He's also ALWAYS had it, as in ALWAYS. I had it when I was pregnant (in addition to the white-noise of the womb) and he's had it in his room since birth. We have found that if we have a machine on a timer (which we did once when traveling) that he wakes up the *second* that it goes off. So, for now, the white noise reigns supreme.
posted by sonika at 7:19 PM on April 9, 2012 [1 favorite]

He's not walking yet, right? Maybe this is one of those things where sleep patterns go awry because of a developmental milestone on the very near horizon.
posted by chiababe at 8:21 PM on April 9, 2012

Long-shot that sounds like it might not work for you given your son's anti-holding policy, but when my (now 14 month old) had screaming fits at night, vigorous swaying/swinging in arms calmed him almost instantly. We'd go in, he'd reach for us, we'd pick him up and either support his head with one hand and hold him under his bum with the other arm, and basically do side-to-side lunges while rocking him in time as well. For reference, the motion was fast enough to get his hair flying around a bit. Of course, you need to be careful, and aware of his head and hold him gently but firmly so he won't fall.

Hope you find the magic cure. Sounds really hard.
posted by that's candlepin at 9:16 AM on April 10, 2012

Last night went ok... another screaming episode around 11ish, when I was trying to go to bed. Turned on the nightlight and left. He screamed for another 10mins or so and fell asleep and slept until his normal 7AM wakeup.

Today... he's just a cranky, irritable mess. If he's anything like me, this is the result of the wakings night before. It's always the second day after a bad night that's worst for me, not the day immediately after. Or he's possessed by goblins. No idea. He was given a clean bill of health by the pediatrician yesterday, so I've got nothing to pin his bad mood on other than "He's just in a really awful mood."

Turned down the heat a bit last night - not sure if it helped. Will keep that going tonight and keep on with the "turn on Twilight Turtle, offer a bottle, and leave" strategy.
posted by sonika at 3:08 PM on April 10, 2012

I have a friend whose (older, around 3 years) child had night terrors and they resolved it by doing LATER bedtimes. So... something else to try if nothing works?
posted by rabbitrabbit at 4:01 PM on April 10, 2012

Turned heat down and put him in lighter pajamas last night. Two wakings - the first he took an ounce of formula and went right back down. The second, I turned his turtle light on, blew him a kiss, and left. He screamed for five minutes and fell asleep. Which is a VAST improvement.

So, I'm going to say that for us, a cooler room and the nightlight are what worked. If anyone else has this problem, I hope this thread is useful - there were a lot of good suggestions!
posted by sonika at 5:49 AM on April 11, 2012 [1 favorite]