美国医院:孩子做噩梦怎么办、要看医生吗?

最近 Ethan 有时做恶梦,我们想着要不要去看儿医。在网上简单搜了下,看到 Cleveland Clinic 官网有篇介绍文章,编译如下。 Cleveland Clinic 是全美最好的医院系统之一,有 3 万多雇员(Cleveland 最大的雇主),年营收近百亿美元。他们的医疗资料可信度是比较高的。原文参见这里

3-6 岁的孩子有 10%-50% 在睡觉时会做足以让父母担忧的恶梦。轻松愉快的睡前准备有助于缓解。

什么是噩梦?

所谓 「nightmare」 是指那些吓人、往往会把孩子吓醒的梦。年纪小的孩子可能无法区分恶梦与真实,包括在醒来之后。孩子可能会因此发脾气、害怕、不肯睡觉。

噩梦的成因

噩梦形成的准确原因现在还不知道:它可能会来自于孩子白天看到、或听到的事情,也可能毫无来由。创伤性的事故、或精神疾病,可能引起噩梦。一些改变大脑神经递质、或导致深睡的药物,也可能引发噩梦。

噩梦通常于 3-6 岁开始出现,但也有早至 1-2 岁的 「toddler」 。 3-6 岁的孩子,有 10%-50% 会做足以让父母开始担忧的噩梦。噩梦的类型经常与孩子的发育阶段有关:比如说,1-2 岁的 toddler 可能会梦到与父母分离;小一点的孩子可能会梦到走丢、死亡、危险;而大一点的孩子可能会因为看恐怖电影而做噩梦。

噩梦通常在后半夜发生;若孩子被吓醒后,往往能记得内容、甚至栩栩如生;孩子通常不会困惑。这几个特点有助于区分「噩梦」「nightmare」 与「夜惊」「night terror」,后者常在上半夜发生、往往回忆不起来内容、孩子可能会意识朦胧困惑。

如何缓解孩子的噩梦?

  • 保证充足睡眠。充足睡眠、固定的入睡习惯,可能有助于减少噩梦的频率和强度。
  • 让睡前准备轻松、快乐、好玩。入睡前的 30-60 分钟,不要看恐怖电影、电视,不要给孩子讲吓人的故事、放吓人的音乐,以及做其他可能让孩子不安的事情。
  • 在白天与孩子聊聊噩梦。如果噩梦经常发生,跟孩子聊聊,看这些噩梦是否有固定的主题。如果有固定主题,可能有什么事情困扰着孩子 — 搞明白是什么、想办法与孩子一起减少这些困扰。
  • 抚慰。这可能是最好的方法。孩子做噩梦惊醒之后,陪孩子呆一会。可以允许他抱自己喜欢的玩具或毯子(security blanket)睡觉。如果他想开灯睡觉的话,把灯调到最低的亮度,或买小夜灯。可以把门打开。告诉孩子、让他相信家里很安全。
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  • 和孩子一起尝试克服噩梦恐惧的方法。比如阅读如何克服噩梦的书籍;把噩梦画出来、然后撕掉;有些父母甚至发现在孩子床前挂印第安人挂件(native American charms)有效!

帮助孩子克服噩梦的儿童书籍

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Sweet Dreams, Curious George
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  • Rey, H. A. (Author)
  • English (Publication Language)

是否有必要给儿医打电话?

如果出现以下情形,可考虑给儿医打电话:

  • 孩子的噩梦加重、或更频繁了。
  • 孩子对噩梦的恐惧影响到了他白天的行为。
  • 孩子反复做噩梦、非常压抑;或涉及心理健康问题。这些情形建议寻求专业人士帮助。
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