By Dr. Tamara Zach MD — June 14, 2026
when nighttime behavior worries parents
It's 2 a.m., and you hear your child crying out from their bedroom. You rush in to find them sitting up in bed, eyes wide open, seemingly terrified, but they don't recognize you and can't be comforted. Or maybe they're walking through the house with a blank expression, completely unresponsive. Your first instinct is fear. Your second question is always the same: Was that a seizure?
Dr. Tamara Zach MD, a pediatric neurologist serving families across the Phoenix area at Rose Medical Pavilion, gets this question all the time. Night terrors, sleepwalking, and nocturnal seizures can look almost identical to a frightened parent standing in a dark hallway. Telling them apart matters, because the causes, risks, and treatments differ completely.
Here's how Phoenix-area families can figure out what they're seeing, and when to get a professional evaluation.
what night terrors are
Night terrors (also called sleep terrors) are a parasomnia, a disruptive sleep behavior, and they show up most often in children between ages 2 and 12. They happen during the transition out of deep, non-REM sleep, usually in the first few hours after your child falls asleep.
what night terrors look like
- Child screams, cries, or thrashes intensely
- Eyes may be open, but the child appears confused or "glazed"
- Child does not recognize parents or respond to comfort
- Episode typically lasts 5 to 30 minutes
- Child returns to sleep on their own and has no memory of the event in the morning
- Episodes often occur at the same time each night
Night terrors aren't dangerous on their own, and most children outgrow them. Arizona's heat plays a part here. Heat-related sleep disruption and inconsistent sleep schedules, both common during long Phoenix summers when children stay up later, can make night terrors more frequent. A consistent sleep routine and a cool bedroom make a real difference.
what sleepwalking is
Sleepwalking is another non-REM parasomnia, and it often runs in families. Like night terrors, it happens during the deeper stages of sleep and shows up most often in school-age children.
what sleepwalking looks like
- Child gets out of bed and moves around the home
- Eyes are open but glassy or unfocused
- Child may mumble or speak nonsensically
- Child does not respond normally to questions
- Episodes last a few minutes up to 30 minutes
- Child returns to bed and has no memory of the episode
Safety is the main worry with sleepwalking. Children can fall down stairs, walk into furniture, or in some Phoenix-area homes, try to go outside. Door alarms, stair gates, and locked exterior doors all help.
what nocturnal seizures are
Nocturnal seizures are pediatric seizures that happen during sleep. They can be part of a broader epilepsy diagnosis, or they may occur only at night, which makes them especially hard to spot. Some forms of childhood epilepsy, such as Self-Limited Epilepsy with Centrotemporal Spikes (formerly called BECTS), are tied specifically to sleep-related seizures.
what nocturnal seizures look like
- Stiffening or jerking of the limbs, face, or entire body
- Drooling, gurgling, or unusual breathing sounds
- Child may fall out of bed
- Tongue biting or bed-wetting during the episode
- A period of deep sleep or confusion after the event (called the postictal phase)
- Child may complain of headache or muscle soreness the next morning
- Events can occur multiple times per night
The most telling difference is what happens afterward. A child who has a seizure at night often looks physically exhausted and confused after the episode, unlike the quick return to normal sleep you see with parasomnias. Watch for a wet pillow, unusual soreness, or rhythmic jerking movements.
how to tell them apart
timing
Night terrors and sleepwalking almost always happen in the first third of the night, during deep sleep. Nocturnal seizures can strike at any point, including the early morning hours just before waking.
memory of the event
Children almost never remember night terrors or sleepwalking. A child who has a nocturnal seizure may also have no memory of the event itself, but they might notice the aftereffects, like soreness, headache, or fatigue, the next day.
physical signs
Parasomnias rarely leave physical evidence. Seizures may leave bitten tongues, muscle soreness, bed-wetting, or signs of a fall. If you're asking yourself, "Was my child waking at night from a seizure?", these physical clues are what to look for.
response to comfort
Children having night terrors don't respond to soothing during the episode, but they aren't in physical danger. Children having a seizure may need safety positioning and monitoring.
when to see a pediatric neurologist
Get a professional evaluation if your child's nighttime events include any of these:
- Rhythmic or repetitive jerking movements
- Stiffening of the body
- Changes in skin color (pallor or bluish tinge)
- Unusual sounds like gurgling or gasping
- Bed-wetting in a child who is normally dry at night
- Unexplained morning fatigue, headache, or muscle soreness
- Events that are increasing in frequency or duration
- Any episode that lasts longer than 5 minutes
Dr. Tamara Zach MD usually starts with a thorough history and neurological examination. Often she'll recommend a pediatric EEG (electroencephalogram) to record the brain's electrical activity during sleep and find abnormal patterns consistent with pediatric epilepsy. An overnight or extended EEG is especially useful when events happen only during sleep and are hard to capture on a standard recording.
For Arizona families enrolled in AHCCCS (Arizona's Medicaid program), many of these diagnostic evaluations are covered. Families with younger children who have developmental concerns can also look into the Arizona Early Intervention Program (AzEIP) when neurological conditions are identified early.
take the guesswork out of nighttime events
No parent should lie awake wondering whether their child's nighttime behaviors are harmless developmental phases or signs of something neurological. Most parasomnias are benign and manageable, and when seizures are
Schedule an Appointment
Questions about your child's neurological health? Dr. Tamara Zach MD at Rose Medical Pavilion is here to help. Call (623) 257-ROSE (7673) or schedule online.