Sleep terrors, also called night terrors, are a type of parasomnia. These sleep disorders cause irregular behavior during sleep.
While some people might describe sleep terrors as a more dramatic or intense nightmare, these are two different things.
Sleep terrors happen shortly after you fall asleep, during non-rapid eye movement (NREM) sleep. Nightmares happen during REM sleep.
It’s also pretty typical to wake up during or after a bad dream. But after a sleep terror, you might return to a natural sleep without ever fully waking up.
Sleep terrors also aren’t the same as sleep paralysis, another parasomnia that happens during the transition between sleeping and waking.
During an episode of sleep paralysis, you might have the sensation of a harmful presence in your bedroom, or pressing down on you — but you can’t move or scream. This experience can feel pretty darn terrifying, but it typically ends within a minute or two, if not sooner.
To contrast, screaming and moving are very much a part of sleep terrors. You might cry out, flail, or even get of bed.
Read on to get the details on sleep terrors, including:
- why they happen
- how to cope
- when to consider reaching out to a professional
Most people who have sleep terrors don’t remember anything about the episode. It’s often others in the household, like parents or romantic partners, who first notice the sleep disturbance.
During a sleep terror, you (or your child) might:
- appear to wake up abruptly by sitting up or jumping out of bed
- flail and thrash about
- scream in fear or call out for help
- have a frightened expression on their face
- lash out by kicking and punching
- seem flushed or sweaty
- have dilated pupils
- breathe heavily
- have a rapid heart rate
- seem confused and panicked
- speak incoherently
- be difficult to wake and console
After a sleep terror, which can last
- fall back to sleep as if nothing happened
- have little or no memory of the experience
- feel tired or sleepy the following day
Sleep terrors usually happen within the
- under physical or emotional stress
- overly stimulated
- sleep deprived
- running a fever
- sleeping in a new environment
- under the influence of alcohol or drugs
Other factors known to contribute to sleep terrors include:
Sleep terrors are more likely to happen when you get poor sleep.
Any number of things can disrupt your rest by keeping you from falling or staying asleep, including:
- jet lag or other changes to your sleep schedule
- alcohol or drug use
- certain medications, like antidepressants and stimulants
- a bright, noisy, or overly warm sleeping environment
Other sleep disorders
Having another disruptive sleep disorder may also increase your chances of having sleep terrors.
These sleep conditions include:
Mental health conditions
You may have a higher chance of experiencing sleep terrors if you live with certain mental health conditions, including:
Some medications can contribute to other parasomnias, like vivid dreams, nightmares, and sleepwalking. They could also contribute to sleep terrors in some people.
These medications include:
According to the Parkinson’s Foundation, sleep issues are common in people living with this condition, in part due to brain changes it causes. But the medications used to treat Parkinson’s disease can also have sleep-disrupting side effects.
To contrast, only around 1 to 4 percent of adults have sleep terrors.
So, while anyone can experience sleep terrors, they’re much more common in children:
Even when you don’t remember your sleep terrors, they can still have a lasting impact on health and well-being.
Sleep terrors can lead to:
Loss of sleep
Since they can affect your sleep quality, you might feel tired and find it difficult to focus the next day.
And of course, sleep terrors might not wake up whoever has them — but other people in the household might wake up, especially those sleeping in the same room. To put it another way, everyone in the house might have trouble sleeping.
If your child has a sleep terror, you might worry it could happen again and have trouble sleeping as a result of your concern.
When you get sleep terrors regularly, you might feel a little embarrassed or guilty because they disrupt everyone’s sleep. (It goes without saying, though, that sleep terrors aren’t your fault.)
If you remember the sleep terrors, you might feel anxious and fearful, because, well, they can be pretty terrifying. Worrying about them happening again could make it difficult for you to fall asleep.
The possibility of injury is one the most serious potential complications of sleep terrors.
People who have sleep terrors may:
- injure themselves or someone else by thrashing and flailing in bed
- get out of bed and crash into furniture or walls, fall from windows, or tumble down stairs
- struggle or react aggressively when someone tries to intervene
Generally speaking, it’s best to avoid waking someone during a sleep terror. Instead, stay close to monitor their movements so you can step in if they seem at risk of getting hurt. When it’s over, you can gently guide them back to bed.
In search of strategies to help manage sleep terrors for you or your child? Try starting with these:
- Improve sleep hygiene. Creating a relaxing sleep environment and going to bed and waking up at the same time every day can lead to better sleep.
- Avoid stimulants before sleep. Skip stimulants like caffeine in the hours leading up to bedtime — or consider ditching them altogether. Also check the ingredients of over-the-counter (OTC) allergy and cold medications for decongestants that might produce a stimulant effect.
- Consider your alcohol intake. Alcohol is a depressant that initially has stimulant effects, so limiting your alcohol intake, especially before bedtime, could improve sleep and reduce your chances of having sleep terrors. Limiting or avoiding recreational drugs may also help prevent sleep terrors.
- Create a relaxing bedtime routine. Quiet, soothing activities like taking a hot bath, listening to music, and meditating can help you relax and unwind before bed.
- Use relaxation techniques. You have plenty of options to help relieve stress and promote relaxation. Consider incorporating different techniques, like massage or yoga, into your day. Deep breathing exercises, progressive muscle relaxation, and journaling can also help you decompress as bedtime approaches.
- Try scheduled awakening. If your sleep terrors tend to happen around the same time, set an alarm or ask someone to wake you up around 15 minutes beforehand. Staying awake for about 10 minutes could help prevent a sleep terror.
Helping your child with sleep terrors
Most of the above tips also work well for children with sleep terrors.
A few additional considerations to keep in mind:
- Remember that as scary as they are to witness, sleep terrors won’t actually harm your child. Try to stay calm while they ride it out.
- Don’t attempt to wake them during an episode because it can make them more agitated.
- Don’t intervene during an episode unless they seem in danger of hurting themselves or someone else.
- Talk to your child the morning after to find out if any specific fears or worries might have triggered the sleep terror.
- Make their environment safer by locking doors and windows and blocking potential hazards, like access to staircases if they tend to sleepwalk (or run) during a sleep terror.
Diagnosing sleep terrors can be tricky because the people who have them don’t usually remember them. What’s more, they happen sporadically and can come and go over time.
That said, reaching out to a healthcare professional could help you identify any contributing factors. A therapist can also help you identify potential sources of stress or anxiety, or any other underlying conditions that might play a part in sleep terrors.
It never hurts to connect with a sleep specialist or other healthcare professional if sleep terrors cause lasting daytime distress or persistent:
- lack of sleep
- daytime sleepiness, fatigue, and other signs of sleep deprivation
- difficulty focusing on daily tasks and routines
- relationship issues
Experts have yet to find a cure for sleep terrors. Still, you have options to help prevent them and improve your rest.
Taking steps to improve sleep and relieve stress in your life can make a difference.
If the sleep terrors continue, it may be worth connecting with a healthcare professional to explore potential causes and helpful approaches to managing them.
Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.