Part 1 of this series on Night Tremors (NT) addressed the manifestions of NTs and Part 2 the differences between a NT and a nightmare. Please refer to each of these posts for more information on these topics.
Background on Alice-in-Wonderland Syndrome (AIWS):
Alice-in-Wonderland Syndrome aka “Todd’s Syndrome” is named after the popular children’s novel in which Alice becomes trapped in a world of distortions. AIWS is a temporary condition that results in changes in one’s visual perception causing objects to look larger or smaller than normal. There are many commonly associated reasons for this syndrome’s occurrence including the use of psychotropic drugs (LSD), migraines, seizures, and even being subjected to certain toxins and viruses.
What role does Alice play in night terrors (NTs)?
The exact role of Alice-In-Wonderland Syndrome (AIWS) in night terrors has not been flushed out but there is a large faction of people, children in particular, who report changes in their vision that preceed their night terrors. Most people who reported personal accounts of AIWS or those of their children describe being terrified of the sudden change in perception while a small percent said they enjoyed these distortions. Generally, though, AIWS symptoms are considered a prelude to night terrors. Because of the similarity between the onset of these visual-perceptual changes and the onset of seizures, AIWS is considered to be a part of the aura preceding a night terror.
Applying AIWS to night terrors:
Parents of young children should watch for agitation or excitation immediately prior to bed as well as dysmetric motions, which include attempting to put large objects in small spaces, (eg. the child trying to crawl into a space that they would ordinarly never attempt to fit in) or reaching for things that are well beyond that which is reachable.
Preventing the onset of AIWS and night terrors:
Since there no definitive root causes of night terrors and associated AIWS have been identified, prevention remains somewhat elusive. Numerous parents of children with symptoms of night terrors/AIMS report that their children were prescribed antiseizure medications that they maintain actually caused a worsening of symptom frequency and intensity. Anectdotal evidence suggests that the best method of preventing night terrors and AIWS is to keep children on fairly strict sleep regimens including pre-bed activities, familiar sleeping arrangements, consistent lighting, and ambient noise generators (ie. white noise). According to Marc Weissbluth, the author of “Healthy Sleep Habits, Happy Child,
The best way to ensure better sleeping habits in children is to insistent on structured nap schedules. “Sleep begets sleep.”
Practical Application of night terror prevention strategies: a personal note
Our daughter has a morning nap which lasts roughly 2 hours, a late afternoon nap spanning 1-2 hours, and a bedtime about three hours after she wakes from her afternoon nap. Preparation for bed begins immediately following dinner with a period of playtime before bed, then she is removed from the hustle and bustle of our family room and taken to her bedroom where the lights are off, whitenose and nightlight are on, she is changed into her pajamas and sleepsack.
She is then given her pre-bed bottle and rocked in a recliner while she is sung lullabies and wished sweet dreams before being placed in her crib with her mobile lulling her into relaxation and a plethora of pacifiers awaiting her arrival. We do not rock her to sleep but rather put her into her crib relaxed but awake. We strive to maintain the same bedtime rituals regardless of who puts her to bed or where we are and have found that doing so has decreased the incidence of her night terrors. Adherance to this pattern has taken some real planning and diligence on our part but the night terrors lessening has made all of this worth it!