The intense terror that dominates a child’s night is called night terrors in modern medicine, and it is regarded as a type of sleep disorder completely distinct from simple nightmares. Night terrors mostly occur during the deep non-rapid eye movement sleep stage, particularly within the first few hours after falling asleep. The child may suddenly scream while sleeping or thrash about as if frozen in extreme terror, with eyes open but unable to recognize parents or converse. Interestingly, by the next morning, the child remembers nothing of what happened during the night.
Why then does this phenomenon occur? Night terrors are known to happen during a process where the brain does not fully transition from a sleep stage to an arousal stage, but wakes up only partially. In this process, emotional processing hubs like the amygdala become overly active, whereas the prefrontal cortex responsible for rational judgment and memory is still asleep, meaning the child experiences extreme terror without being able to perceive or remember the situation. It is similar to a runaway vehicle with an overheated engine while the driver at the steering wheel is asleep.
In particular, because children’s brains are still immature compared to adults, the nervous system regulating the sleep-wake cycle can be unstable. Stress, sleep deprivation, fever, irregular sleep habits, and even respiratory system issues such as snoring or sleep apnea can become factors that trigger or worsen night terrors. The upward flaring of heart fire mentioned in Donguibogam can be compared to the hyperactivation of the sympathetic nervous system or excessive brain arousal explained in modern medicine. If a child looks at a smartphone late at night or plays vigorously, the brain fails to calm down sufficiently and goes to bed while maintaining an excited state, which hinders the transition into deep sleep and induces heart fire.
Furthermore, gallbladder qi deficiency with timidity can be linked to the state where the brain functions of children—who are not yet fully developed or are vulnerable to stress—remain immature in their capacity to regulate emotions and cope with threats. Daytime anxiety or the stress of a new environment experienced by children becomes magnified at night, manifesting as night terrors.
In most cases, night terrors disappear naturally as the brain matures with the child’s growth, but the fear experienced by the child can be larger than imagined, making attentive care from parents essential. When a child experiences a night terror, rather than trying to wake them, it is important to stay quietly beside them and create a safe environment.
