Night Terrors

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Night terrors are sudden awakenings (or they look like awakenings) from sleep with fear, sweating, rapid heart rate, and confusion.  Kids who have night terrors scream and wake the whole house, and attempts to console them are ineffective.  Indeed, the kids (or adults) who wake with night terrors may not even hear and understand what others are saying to them, because they are not really awake.

The Latin name for night terror is the rather cool pavor nocturnus. It’s also called sleep terror disorder. Although one of the more disturbing parasomnias for family members of the afflicted, children who get them usually outgrow them. Night terrors strike 6.5% of children and less than 1% of adults.

Both adults and children can get night terrors, but they are more common in children, especially in those age three to seven. A person experiencing a sleep terror sits up in bed and/or flails around and screams.  Sometimes the subject gets out of bed and runs around the house. The person may appear to be awake, but is confused and unable to communicate. He or she may be sweating and breathing fast and the pupils may be dilated. Although the eyes are open, the person is often still asleep. Night terrors last about 10 to 20 minutes.  The subject then calms down and goes back to normal sleep. The attack typically occurs 30 minutes to 3 hours after bedtime.

The person usually cannot remember the night terror the next morning, which can make it all the more frustrating for the family members who are awoken by the person in the middle of the night. This amnesia has given rise to myths about possession, which makes night terrors all the more scary. This is a potentially dangerous disorder, especially if adults get it because the flailing limbs can hurt others or the sleeper.  This sleep disorder may run in families.

Night terrors occur during Stage 3 sleep (deep sleep). Episodes are most common in the first third of the night. The etiology (cause) is unknown.  Stress may trigger it, and running short of sleep (sleep debt) may induce it, although experts are not sure how.

Treatment

There is no physical test for night terrors.  Diagnosis is from family reports of events.

In many cases, comfort and reassurance are the only treatment required. Psychotherapy and counseling are sometimes used. Stress reduction and/or psychotherapy may be helpful for night terror in adults. Hypnosis and guided imagery techniques have also been used.

Prescription sleeping pills can reduce the incidence of night terrors, but doctors are reluctant to prescribe these drugs because of their side effects. Most experts feel a preferable drug is an over-the-counter antihistamine, although even these should be taken only occasionally and in moderation.

Most children outgrow night terrors. There is usually no recall of the individual pavor nocturnus events and no long-term effects on the person’s psyche or health.

The difference between Nightmares and Night Terrors

Strictly speaking, there is a difference between nightmares and night terrors, although the two are often used interchangeably in common conversation. Nightmares are dreams that happen to be frightening or scary.

As dreams, nightmares usually (not always) occur in REM sleep and typically late in the sleep period (early morning). Night terrors aren’t really dreams.  Night terrors happen in deep Stage 3 Non-REM sleep and earlier in the night.

People can remember their nightmares (as much as they can remember any dreams) and can describe them. People cannot remember any narrative from night terrors when they wake up.

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