Simple new remedy for night terrors

Press, 20 February 1989, Page 9

Simple new remedy for night terrors

Screaming, extreme distress, even sweating, rapid pulse and increased body movements — sometimes to the point of sleepwalking — are typical of night terrors.

About three per cent of children are affected, and in these children they may happen every night, usually within two hours of falling asleep. The child cannot be comforted or woken, and has no memory of the episode the next day. There is rarely any psychiatric disorder, and the attacks are thought to represent a fault in that stage of sleep called "slow-wave sleep.” Many medicines have been used in treatment, but there is no really good evidence that they are effective, and several carry at least a potential risk of habituation, so that most doctors and paretns are wary of suggesting them.

Now Dr Bryan Lask, of the Great Ormond Street Hospital for Sick Children in London, has come up with a simple and effective remedy. His report was published in the “British Medial Journal” of September 3, 1988. He examined 19 children with night terrors, found none to have a significant physical or psychiatric disorder, and found all to be of average or above average intelligence.

The terrors had been happening for between four and 37 months, four or five nights a week.

His treatment was as follows: parents were asked to make a note for five nights of the time that terrors happened, and whether there was sweating, rapid pulse or increased movement.

They were then in-

From Dr kin St George for the Royal New Zealand College of General Practitioners

tremely distressing ..for parents and children, and there are dangers in sleepwalking. This interruption of faulty slow-wave sleep is a simple but important new self-help form of treatment. Save the foreskin Most boys sent to hospital outpatients departments for circumcision cannot pull back their foreskins because they are stuck to the tip of their penises. This is in itself not a problem — in fact many would regard it as normal before puberty — but it can cause infection (“balanitis”) with redness and swelling of the foreskin. Recurrent balanitis has been until now regarded as good reason for circumcision.

Now G. A. MacKinlay, of the Edinburgh Royal Hospital for Sick Children, writes in the same issue of the “British Medical Journal” that if the doctor simply applies a special local anaesthetic cream under occlusive dressings for an hour, there is sufficient anaesthesia for the adhesions to be broken down painlessly in most. After the procedure the patient should pull back his foreskin regularly for three weeks.

With this technique only one of 39 boys with recurrent foreskin infections had to have a circumcision.

Family Doctor

structed to wake their child fully 10 or 15 minutes before the terror was due, or if this was too difficult to specify, as soon as movements increased or there was sweating or increase in pulse rate.

After five minutes the child was allowed to return to sleep. The parents were told to stop waking their child when the night terrors stopped, and they were given no other instructions than these.

In each child the night terrors stopped within a week. Three of the 19 children relapsed within a couple of months, but their terrors were completely eliminated with a further week of 'being woken.

At follow-up a year later there were no relapses, and no signs of psychological disturbance in any child. Treatment with drugs is no longer necessary for this common disorder. One might say that no treatment is really necessary, for the problem does not generally last more than a year or two, but night terrors are ex-