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Night Terrors

What are night terrors?

Key points

  1. Night terrors are a form of sleep disorder in which a person partially awakens from sleep in a state of terror.
  2. Night terrors are not nightmares, which are a form of dreaming.
  3. Night terrors in children are not usually caused by an underlying condition. In adults, they may be caused by an anxiety disorder or substance abuse.

Night terrors are a form of sleep disorder in which a person partially awakens from sleep in a state of terror. A sufferer of night terrors experiences an activation of his or her fight-or-flight system.

Children may sit up crying or screaming.

Night terrors usually occur during the deepest stage of sleep, which is typically the first half of the sleep cycle. Night terrors are not nightmares, which are a form of dreaming. Because the person may still be partially asleep during a night terror, they can be inconsolable and unaware of their surroundings. They may have no memory of the episode when they awaken.

Night terrors are relatively uncommon and predominantly affect children under the age of 12, according to the Mayo Clinic. Children typically grow out of night terrors. Children with night terrors often also sleepwalk.

Who is affected by night terrors?

Risk Factors

According to the American Academy of Sleep Medicine, night terrors affect as many as 6.5 percent of children and 2.2 percent of adults.

Night terrors in children

Night terrors occur in children of both genders aged 4 to 12 years, after which they become less common.

There is some evidence that night terrors run in families. It is rare for night terrors to persist beyond the age of 12.

Night terrors in adults

Night terrors occur less frequently in adults. They can be a result of anxiety disorders or substance abuse.

What causes night terrors?

Causes

The cause of night terrors is often unknown, but the condition may result from lack of sleep or high levels of stress. Conflict and tension in the home is one example of a stressor that may bring on night terrors in children. They can also be caused by:

  • fever
  • being overly tired
  • medications
  • migraines
  • head injuries

Night terrors in children

Childhood night terrors appear to be a normal part of the immature nervous system developing. This development may cause the fight-or-flight response to occur at the wrong times. Children spending the night in an unfamiliar place may be more likely to experience night terrors.

Children typically grow out of night terrors without psychiatric intervention. However, there are times when you should talk to your child’s doctor. Contact a medical professional when:

  • night terrors happen frequently
  • they regularly interrupt your child’s sleep
  • your child becomes afraid to go to sleep
  • you are worried your child may hurt themselves during a night terror
  • the night terrors seem to follow a pattern

Night terrors that continue after your child’s teen years or that begin happening as an adult are also cause for medical concern.

Night terrors in adults

According to the American Academy of Family Physicians, possible causes of night terrors in adults are:

  • post-traumatic stress disorder (PTSD)
  • bipolar disorder
  • some depressive disorders
  • general anxiety disorder
  • substance abuse, particularly alcohol abuse

In adults, night terrors are usually more severe and often accompany other sleep disturbances, such as insomnia or sleep apnea. Insomnia means that you regularly have trouble falling asleep, staying asleep, or wake up too early. Sleep apnea is a condition where your breathing is interrupted periodically as you sleep. Apnea is usually caused by the back of the tongue or tissue from the throat area blocking the airway when you are asleep.

In these cases, medical intervention may help. Insomnia is usually treated with medications, cognitive behavioral therapy (CBT), or a change in bedtime habits and routine.

Sleep apnea can be treated with CPAP (continuous positive airway pressure) therapy, an oral device, or in some cases, surgery.

What are the symptoms of night terrors?

Symptoms

Possible symptoms of night terrors include:

  • partially or fully awakening from sleep very suddenly
  • screaming or thrashing
  • intense fear or terror from an unknown source
  • wide eyes with dilated pupils
  • rapid breathing
  • racing heart
  • elevated blood pressure
  • sweating

If the person has only partially awakened, he or she may not be aware of surroundings or remember the episode the next morning. Adults are more likely to remember their night terrors.

How are night terrors treated?

Treatment

Children with night terrors generally require only comfort. If a child is unresponsive during night terrors, parents should not try to wake the child, but hold them firmly and speak soothingly until the episode ends. Usually, the child will ease back to sleep afterward.

Parents should seek medical care for their child if the night terrors are caused by an underlying condition or are the result of a head injury.

Therapy

Relaxation techniques or talk therapy may help a person cope with the stress causing the night terrors. Therapy may include CBT, biofeedback, and hypnosis. Therapy is also necessary in cases where night terrors are caused by panic attacks, depression, or trauma of some kind.

Medication

In rare cases, a doctor may prescribe benzodiazepine tranquilizers to help the patient relax and sleep without interruption.

Learn more: Benzodiazepines »

Relaxation

Relaxing prior to going to bed can sometimes be helpful in relieving night terrors. You can start by establishing a routine of relaxing activities before bed. This may include:

  • meditation
  • taking a warm bath or shower
  • reading a book
  • practicing relaxing yoga poses

Can lifestyle changes help night terrors?

home treatment

There are lifestyle changes you can try that can help reduce the frequency of night terrors. One way to start is by creating a safe and calm environment in your bedroom. Afterward, incorporate your relaxation routine each night before bed.

Getting more sleep is another change that may help. A lack of sleep can be a cause or contributor to night terrors.

You should also try dealing with stressors in your life. Look at what causes your stress and learn ways to handle the stress more effectively or, if possible, eliminate it. In some cases, therapy is helpful.

You can also look for a pattern in your night terrors. Look for activities or actions that seem to happen prior to a night terror episode. Once you have identified some of these, you can either eliminate them from your life or move those activities to an earlier part of the day.

How can I cope with night terrors?

Coping

Adults with night terrors should seek medical help to determine the cause. You and your doctor can look for a pattern in your night terrors.

You should then follow your doctor’s treatment plan. Also, ensure that your sleeping area is free of anything that could cause you physical harm during a sleep terror episode. You may want to create some sort of barrier that will keep you from wandering into danger (such as down a flight of stairs) as well.

Parents with children who have night terrors can provide support and reassure their children when they experience a night terror. Since night terrors in children are not usually caused by an underlying condition, comforting them is the best way to help your child cope.

What is the outlook for night terrors?

Outlook

Children typically grow out of night terrors on their own as they enter adolescence. Most symptoms disappear by the age of 10.

Adults with night terrors can expect them to diminish once they receive treatment for the condition causing them.

It is sort of like being inside of a scary movie only it is not a movie. It is real, at least for as long as you are in it. And, when I do wake up or am woken up by someone else in the house who heard me calling out, I can't always tell that I am awake.
– Diana K. Wells, living with night terrors

Read This Next

The Ferber Method: Does Crying It Out Really Work?
Sleep Disorders in Children: Symptoms, Causes, and Treatments
What to Do if Your Baby Is Having Night Terrors
What You Should Know About Your Child’s Nightmares
ADHD: Cause & Effect of Sleep Troubles
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