Oct 28, 2013 — Nightmares are very common in kids. Seeing scary and unfamiliar images in movies or on TV can trigger bad dreams. Dr. Benjamin Chan talks about how you can help your child cope when things go bump in the night.

Interview

Host: It's Halloween time. They're showing more and more scary movies on TV right now. It could cause kids to have nightmares or could it?

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Host: Dr. Benjamin Chan, child psychiatry at the University of Utah, thanks for taking time to talk about scary things, nightmares.

Dr. Chan: Thank you, it's good to be here.

Host: So, watching scary movies, will that give kids nightmares?

Dr. Chan: It can. It's not definite, but it definitely can. So, all children, they're afraid of the unknown, be it afraid of going to a new store, a disruption in the routine, things like that. But then you kind of times that by a thousand and if they're seeing images, either in movies or in TV shows that are scary and unfamiliar, yeah, that can definitely cause nightmares.

Host: So, let's talk about nightmares in general. Are they fairly common with kids?

Dr. Chan: Very common in kids. So, all of us dreamed, kind of take a step back. All of us go through what we call it rapid eye movement, or REM. All of us don't remember our dreams, but each of us dreams every night. Most of our dreaming happens in the second half of the night, so in the early morning hours, and kids, because they sleep longer, they actually have more dreams and more nightmares.
Sometimes kids have nightmares about things that aren't scary. There are nightmares about going to the store and maybe their favorite cupcake wasn't on sale that day and they'll have nightmares about that.

Host: Sure.

Dr. Chan: Kids will be upset by various things and definitely scary movies, scary images can be part of that.

Host: So, your kid has a nightmare, do you let them crawl into bed with you? I mean, how should you handle that?

Dr. Chan: So, how you handle nightmares? So, first of all, validate your kid's concerns. Listen to what the nightmare was. Let them kind of explain how they feel. Never shh a kid. Never cut them off and say, "Oh, I don't want to hear about." So, first of all let them explain how they feel.

Host: Even if it's 2:00 a.m. in the morning?

Dr. Chan: Even if it's 2 a.m. in the morning.

Host: Okay.

Dr. Chan: If it goes on and on and on, you can cut them off then. Give the child a chance to kind of say what happened.

Host: Okay.

Dr. Chan: Second thing is, to answer your question, I strongly recommend you do not let them crawl in bed with you. It's better for the adult to stay in the child's room, okay? You never want a nightmare to be a trigger to reinforce a behavior that you're going to have difficulty winding back one day, alright?
So, parents often ask me, "My child is scared. It's 2:00 in the morning. Should I have them come into my bedroom and sleep with me?" I always say it's better for you just to pull up like a mattress or an air mattress or things like that and put it in the child's room and sleep with them there. But make sure that doesn't happen every night because then again you don't want to reinforce this behavior that, oh, the child claims they had a nightmare and then all of the sudden I want to spend more time with mom and dad.

Host: Yeah, sure.

Dr. Chan: It's like crying wolf in a way.

Host: So, how do you as a parent make that call, this nightmare is worthy of me going into the room and sleeping with them that night, this one's not?

Dr. Chan: It really depends on their stress. To me, sleeping with a child, that's kind of an emergency response. You need to teach good coping skills leading up to that moment, right?
So, what are some good coping skills with young kids with nightmares? Listen to what the nightmare was and then you as a parent create an alternative ending, alright? Let's pretend that your child has a nightmare about a scary monster in the closet and they kind of tell you about the monster and then that's when you kind of encourage them, "Okay, how could the story end in a happy way?" Then you have the child recreate an ending that's happy. So, in the crisis, in the moment, you have the child kind of refocus their efforts and talk about a happy ending.
Other ways you can go about doing this. Read lots of stories to your children. I always recommend parents should always read to their children. Talk about stories where the kids are brave in the story, where they overcome some obstacle, things like that. So, in that moment like when the child's upset at 2:00 in the morning before you even say, "Okay, I'm spending the night in your room," you can say, "Well, how did little Timmy or little Susie in the story, how did they overcome their monster?" And then have the child say that out loud.
It takes a lot of work. It's not easy. These are pretty tough coping skills to teach in the middle of the night. So, before you just go right to sleeping with your child and providing that extra security blanket, there's a multitude of things you can do.

Host: Alright, any other things that you'd want to parent to know about to nightmares and kids?

Dr. Chan: Very common. As kids get older they'll become less frequent. There is a different between nightmares and something that we call in psychiatry sleep terrors. Sleep terrors is when a child is screaming in the middle of the night, is inconsolable, cannot be woken up, and then it abruptly stops. Next morning, they don't remember anything about it.

Host: Wow.

Dr. Chan: Nightmares, the kids can be woken up. They're usually the ones that wake themselves up. They remember the story in detail and they're not as out of control, I would say.
Sleep terrors are incredibly rare, but is a diagnosable condition found in the DSM, which is kind of the Diagnostic and Statistical Manual for psychiatry. But, if your child is having sleep terrors, I would recommend you talk to your pediatrician or a psychologist about that because it is something to keep your eye on. So, garden variety nightmares, not a concern. Sleep terrors, especially if they persist, that is more of a concern.

Host: Could nightmares be caused by some other sort of medical condition other than sleep terrors? Is there anything else other than that?

Dr. Chan: Well, it's funny you mention Halloween. What I've noticed during this time of year is, because it's getting cooler, it's getting colder, kids are having a little more difficulty sleeping at night because maybe mom and dad haven't gotten around turning on the heat. So you say if there's something else that can be going on, I always kind of look at the environment.

Host: Okay, interesting.

Dr. Chan: So, I think this is a good kind of jumping off point to talk about sleep hygiene, which I'm very interested in. So, what sleep hygiene means is how do you as a child, as an adolescent, or even an adult, how do you have a good night of sleep?There are certain bedrock principles which are very important.
Number one: you only use the bed for sleeping or sex. But if it's a kid, the kid should not be having sex. So, only use the bed for sleeping. That means no eating in bed, no doing homework in bed. There should not be a television in the child's room. There should be no working out or eating one hour before going to bed.
Everyone should go to bed roughly at the same time and get up at the same time every day. The room should be cool. It should be dark. So, these things are pretty common, but then when you start digging deeper, you start to like, "Oh, I send my child to bed, but they turn on the TV and they watch TV until like 2:00 in the morning and then they fall asleep." My first question is why is there a TV in the room?

Host: Yeah.

Dr. Chan: Another bedrock principle is all children love structure. All children love routine. They'll never tell you that, but that's what they crave. So, going back, they need a firm and consistent bedtime.

Host: Okay.

Dr. Chan: There are usually rituals associated with going to bed: brushing your teeth, maybe a bedtime story, change into your pajamas, things like that. I would recommend doing the exact same thing every night in the same order because children kind of need to know what to expect. Once you do that, bedtimes go much, much easier.

Host: Alright, so it sounds like if kids are having nightmares, it could be sleep hygiene issues as well. That would be another thing to look at and that could actually solve the problem.

Dr. Chan: Correct. Yeah.

Host: And give you a better night's sleep too because you don't have the kid coming in at 2:00 in the morning.

Dr. Chan: So, let me just say this. Even though it's Halloween, nightmares are completely normal. You might see an uptick in nightmares during this time period, but even if your child continues to experience these phenomena it's completely normal.

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