Night Terrors

What are night terrors?

Night terrors, or sleep terrors, are brief episodes of intense fear or dread while still asleep. Night terrors are often accompanied with screaming, flailing, sweating, and even sleepwalking. The main difference between nightmares and night terrors is the time of occurrence. Night terrors generally happen during the first hours of non-rapid eye movement sleep, making this sleep disorder a parasomnia. Nightmares, on the other hand, occur during the last hours of REM sleep, which can cause the sleeper to wake up with vivid visuals of the dream. Night terrors will not trigger the sleeper to wake up.

There are several factors that can contribute to the onset of night terrors, but the most common include:

  • Sleep deprivation and extreme exhaustion
  • Stress
  • Sleeping in unfamiliar surroundings
  • Lights or noise
  • An overfull bladder
  • Fever

Like other sleeping disorders, such as insomnia, night terrors can be caused or exacerbated by a few common underlying health conditions, such as:

  • Migraines or intense headaches
  • Head injuries
  • Abnormal breathing patterns during sleep (sleep apnea)
  • Restless legs syndrome
  • Some medications (check with your doctor)

Unlike nightmares, night terrors are generally forgotten upon waking. Adults will occasionally remember a dream fragment of their night terror, but vivid images and remembrance of fear will normally dissipate by morning.

So, how do you know if you’ve had a night terror? Often, a family member will be the first to address someone having night terrors, as the person experiencing the night terror is unlikely to wake up during an episode. During a sleep terror episode, a person might:

  • Scream or shout
  • Kick and thrash (flailing in bed)
  • Sweat and breathe heavily
  • Show an increased heart rate
  • Become increasingly aggressive
  • Sit up in bed
  • Sleepwalk

While they can be frightening and inconvenient to others, occasional night terrors should not be considered cause for alarm. However, if your episodes become frequent, disrupt your (or others’) sleep at night, lead to unsettling amounts of stress or fear, or continue into adulthood, please consult your doctor.

Leading up to your doctor’s appointment, keeping a sleep diary to help track your sleep patterns and descriptions of episodes might be a good idea to help convey your exact symptoms to your doctor. Depending on the symptoms you describe, your doctor may do a physical or psychological exam to help identify exactly what might be contributing to your night terrors. At your doctor’s discretion, a sleep study may be conducted to further examine the problem.

Since medication is rarely used to treat night terrors, there are some everyday activities that you can do to help slow down the regularity of your episodes, such as:

  • Improving sleep habits. This can be as simple as going to bed earlier, or avoiding the use of electronics for at least half an hour before laying down to sleep.
  • Addressing stress. The build-up of stress can lead to numerous health problems, including sleep disorders. Addressing stress and anxiety through therapy and counseling could help reduce night terror episodes.
  • Treating an underlying condition. Depending on your symptoms, your doctor may move on to treating the underlying condition that could be the cause of your night terrors, such as sleep apnea or irregular breathing.

Night terrors are the most common in children ages 3 to 12 , with the peak onset for most at age 3 ½. It has been estimated that one to six percent of children experience night terrors. Both boys and girls are equally affected by night terrors. Night terrors normally subside by adolescence, though teenagers and adults are both subject to night terror episodes as well.

In children younger than 3 ½ years old, at least one night terror episode per week is common. In older children, however, the frequency begins to decline. The peak frequency of night terror episodes for older children is just one or two per month.

While night terrors in children are more common, night terrors in adults are often triggered by a less healthy lifestyle (not eating a nutrient-rich diet, for example) or not getting enough sleep. During an adult night terror, it is more common for the affected person to get out of bed and run out of the house, which can ultimately lead to violent behavior.

Because night terrors in adults are less common, episodes should be treated by a doctor as soon as possible. Studies have shown that night terrors in adults can be symptomatic of neurological disease. If further investigation is needed, your doctor may suggest an MRI procedure.

Studies have shown that night terrors are roughly 10 times greater in those whose immediate  relatives were also affected compared to the general population. However, genetics are just a piece of the puzzle. Environmental factors, such as lifestyle and sleep schedule, are also significant factors in the frequency of night terror episodes.

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