Night Terrors – Symptoms, Causes and Treatments

Night terrors.

The phrase in and of itself sounds frightening. But that’s nothing compared to the intense fear a person actually having night terror episode can feel.

Night terrors can affect people of all ages, from small children to full grown adults. This sleep disorder also affects people of both genders. Yet most don’t know much about this condition.

Read on to find out what night terrors are, some possible causes of night terror episodes, and how this condition can be treated.

What Are Night Terrors?

Night terrors (also known as sleep terrors) are a somewhat rare sleep disorder.

Someone experiencing a night terror episode will wake up, at least partially, in a state of terror. During an episode, an individual will often scream and flail about. And they will experience feelings of fear intense enough to activate their fight-or-flight response.

A night terror episode usually lasts from a few seconds to 2 or 3 minutes. However, some have had night terrors that lasted for half an hour, or even more.

Night terrors usually happen in the deepest stage of the sleep cycle. And they often start about 90 minutes after a person has fallen asleep. 

This sleep disorder is classified as a type of parasomnia, an undesirable occurrence that takes place while you sleep. With night terrors, this “undesirable occurrence” can be a behavior or an experience.

Who Is Affected by Night Terrors?

Night terrors aren’t as common as some other sleep-related medical conditions. It’s estimated that less than 7% of children experience night terrors. And this sleep disorder doesn’t discriminate on the basis of gender. Both boys and girls are affected in equal numbers.

Night terrors are most common among children between the ages of 3 and 12. A child with this condition will typically start experiencing night terrors when they are about 3 or 4 years old. And by the time they reach their teens, the night terrors will either have stopped, or decreased in frequency.

Night terrors are even rarer among adults, with less than 3% being affected.

While night terrors aren’t exactly common, they also aren’t considered abnormal, especially in children.

What’s the Difference between Night Terrors and Nightmares?

Some people think night terrors are just more intense nightmares. But night terrors and nightmares are not the same thing.

During the sleep cycle, we move through several stages, some deeper than others. The one most people are familiar with is the Rapid Eye Movement (or REM) sleep stage. Non-rapid eye movement (or non-REM) is another stage of the sleep cycle.

Nightmares occur during REM sleep, which is when we do most of our dreaming.

Night terrors happen during the non-REM stage of the sleep cycle.

Night terrors and nightmares are also different in other ways.

Someone having a nightmare will usually wake up from the dream, and will be aware of their surroundings. And most people remember the details of their nightmares, even though those details will soon begin to fade.

Someone experiencing a night terror episode will remain mostly asleep. Even if they seem to be awake, they won’t truly be aware of their surroundings.

Children usually don’t remember anything that happened during a night terror episode, including what they were dreaming about, or what they might have done during the experience.

Adults who experience night terrors will sometimes remember a few fragments of the dream they were having during the episode. They might also have some vague memories about their behavior during event. But, more often than not, adults also won’t remember anything that happened during a night terror episode.

What Are the Symptoms Of Night Terrors?

Night terrors can have many unpleasant side effects.

Many people who experience night terrors suffer from excessive daytime sleepiness (or EDS). They are often so sleepy during their waking hours that they can’t function to the best of their ability.

Sleep deprivation is another common symptom of this sleep disorder. Common symptoms of sleep deprivation include an inability to focus or concentrate, memory problems, and irritability. People who are sleep deprived are also more likely to make mistakes and have accidents.

Many people who experience night terrors also sleepwalk. This is especially true among children.

Are there any dangers regarding night terrors?

Well, it’s not unheard for someone having a night terror episode to hurt him or herself. It’s also possible that they could hurt someone else inadvertently. This rarely happens, but it does happen.

The physical signs that someone is experiencing a night terror include:

• Sweating.
• Heavy or rapid breathing.
• Dilated pupils.
• Flushed skin.
• A racing heart.

What Happens During a Night Terror Episode?

Night terror episodes are frightening and disturbing occurrences. And not just for the person having the experience, but also to outside observers. Children especially can be frightened if they see someone, like a parent or sibling, have a night terror episode.

Most night terror episodes begin with a frightened scream or shout. The person having the experience will feel intense terror or fear, and might flail about in bed, kicking and thrashing.

The person might sit up in bed and even open their eyes. To an outside observer, they will look terrified, and might seem to be staring, wide-eyed, at nothing. It’s at this point that some, especially children, might start to cry.

It is difficult to wake someone up when they are having a night terror. While they might seem to be awake, they won’t respond to outside stimuli (like someone calling their name).

If you do manage to partially wake them up, they will seem confused, disoriented, and unaware of their surroundings. And it’s very unlikely that they will talk.

A person having a night terror episode might actually get out of bed, run around, and try to leave the room. This is because the night terror has activated their fight-or-flight response, and they are trying to get away. And if you try to hold on to them, or block them from leaving the room, they might become aggressive.

As dramatic as the experience can be, most people who have night terror episodes have little to no memory of the experience when they wake up the next day.

What Can Cause Night Terrors?

Night terrors are experienced by people of all ages and both genders. However, children are more likely to experience night terrors than adults.

You are more likely to experience night terrors if you sleepwalk. In fact, these two sleep disorders often seem to go hand in hand.

Do night terrors run in families?

That definitely seems to be the case. In fact, you are more likely to experience night terrors if you have one or more family members who sleepwalk or have night terrors themselves.

It is often unclear what causes a person to experience a night terror episode on one night as opposed to another. But experts have pinpointed many things that can trigger night terrors, including:

• Sleep deprivation.
• Extreme fatigue.
• Fever.
• Stress.
• Anxiety.
• Changes in your sleep schedule (like what you might experience while traveling).
• Disruptions in your sleep schedule (like being woken up in the middle of the night).
• Other sleep disorders, like obstructive sleep apnea, insomnia, and restless leg syndrome.
• Taking certain medications, especially those that affect the central nervous system.
• An anesthetic you were given during surgery.
• Substance abuse, especially alcohol abuse.
• A head injury.
• Migraines.
• Spending the night in a new or unfamiliar place (a trigger that more often affects children).

Along with the possible triggers listed above, there are many mental health disorders that can cause or contribute to night terrors, including:

• Bipolar disorder.
• Depression.
• General anxiety disorder.
• Post Traumatic Stress Disorder (also known as PTSD).
• Panic attacks.

Should You See a Doctor for Night Terrors

While they can be disturbing, night terrors are usually nothing to worry about, especially if they aren’t a regular occurrence. In fact, among children, they are rarely considered a cause for alarm.

However, you might want to see a doctor about your night terrors if:

• Your night terror episodes have increased in frequency.
• Night terrors are preventing you from getting enough sleep, and you feel too tired to fully function during the day.
• You can’t concentrate at work or school, and your performance is suffering.
• You, or someone else, have been injured during one of your night terror episodes.
• You’re so worried about hurting yourself or someone else during a night terror episode that it’s causing you a great deal of anxiety.
• You’re an adult or teen who has just started experiencing night terrors.
• You’re an adult and haven’t outgrown the night terrors you started having when you were a child.
• You believe your night terrors are caused by something else, like a head injury.

Many children try not to sleep because they are afraid they will have a night terror episode. The result can be sleep deprivation, behavior problems, and poor school performance.

In such cases, the child should probably see a doctor about their night terrors.

Diagnosis

A doctor diagnosis night terrors by considering your symptoms and sleep patterns, and reviewing your medical history.

Diagnosis will usually involve a physical exam. This will help to determine whether or not you suffer from any medical conditions associated with night terrors.

The doctor might also review your family history. He’ll especially want to know if anyone in your family suffers from a sleep disorder, like obstructive sleep apnea, sleepwalking, or night terrors.

The doctor might also want to interview other members of your household, like your partner. After all, you’re usually asleep and unaware during night terror episodes. Even if you do remember anything about the experiences, those memories will probably be vague and fragmented. An outside observer will be able to give the doctor more details about your sleep behavior.

If your doctor suspects an underlying condition is causing your night terrors, he might schedule you for further testing.

One test commonly used in the diagnosis of night terrors is a polysomnography. This is an overnight sleep study performed in a sleep clinic or other medical facility.

While you sleep, your brain waves, blood oxygen levels, heart rate and eye movements are monitored. During the test, videotape might also be used to record your sleep behaviors.

What’s the Best Treatment?

What can stop night terrors?

The truth is there’s no “one size fits all” cure for this sleep disorder. And, for the most part, children and adults can live with night terrors just fine without requiring any treatment. This is especially true if they don’t experience night terror episodes that often, and the episodes are relatively mild.

However, there are plenty of good reasons to seek treatment for this condition.

For one, night terror episode can be extremely frightening, both to the person having the episode, and any outside observer who witnesses it.

Some of the symptoms of night terrors, like excessive daytime sleepiness and sleep deprivation, can be debilitating enough to negatively affect your quality of life. And night terrors can be dangerous, at least indirectly. Many who suffer from this sleep disorder have been injured during night terror episodes.

So, while it is possible to live with this condition, most sufferers would welcome any treatment that would either get rid of their night terrors, or decrease the frequency of their night terror episodes.

Here are some treatments that can be used to combat night terrors.

Treating Underlying Conditions

Night terrors are often caused by or connected to some other. And sometimes, receiving proper treatment for that underlying medical or mental health condition will either eliminate an individual’s night terrors altogether, or reduce the frequency of night terror episodes.

Therapy

For many people, night terror episodes are often triggered by stress or anxiety.  And the night terrors themselves can cause them even more stress, which makes the situation even worse.

For these individuals, receiving therapy to help them deal with stress or anxiety could help to stop their night terrors.

Therapy can also help deal with any underlying mental health issues, like depression, that could make a person more likely to experience night terrors.

Some therapies commonly used to treat patients suffering from this sleep disorder include CBT (Cognitive Behavioral Therapy), biofeedback, hypnosis, and various other relaxation therapies.

Medications

Medications are rarely used to treat night terrors. This is especially true when dealing with childhood night terrors. But if night terrors are having a severely negative affect on a person’s daily life, a doctor might prescribe medications to help them find relief.

Some medications, like benzodiazepine tranquilizers, can help you relax. This will not only decrease your chances of experiencing night terror episodes, it will also help you sleep through the night, without interruptions.

Some tricyclic antidepressants have also proven effective in the treatment of night terrors. 

How Can Someone Cope With Night Terrors?

Do you suffer from night terrors? Or maybe it’s your child, or someone else who lives in your household. If so, there are things you can do to manage this condition.

Below, you will find some lifestyle changes that can help decrease the frequency of night terror episodes, maybe even stop them altogether in some cases. There are also tips on making the environment safer to cut down on the risk of injury during a night terror. And, if your child has a night terror episode, you’ll find tips on the best ways to deal with the situation.

Get Enough Sleep

As strange as it sounds, it’s possible to go to bed too tired. And going to bed when you feel extremely fatigued can trigger a night terror episode.

If you regularly feel exhausted by the time you usually go to bed, you might consider going to bed an hour or two earlier than your current bedtime. And if you don’t have a regular bedtime already, consider adopting one.

Do you sometimes feel exhausted long before you could reasonably go to bed? If so, consider working a nap into your daily routine. The nap doesn’t have to be long. Even a 10 or 20 minute catnap can make a difference.

Relax Before Going to Bed

Taking the time to wind down and relax before you go to bed can help prevent night terror episodes. So, before you go to bed, try to do something you find relaxing. Some possibilities include:

• Working on a jigsaw puzzle.
• Meditating.
• Taking a warm shower or bath.
• Listening to soothing music.
• Reading a book.
• Doing breathing exercises.
• Doing relaxation exercises.
• Doing yoga stretches.

Identify Points of Stress

Many night terror episodes are triggered by stress. So one way to prevent night terrors is to identify what’s causing your stress, and then taking steps to deal with those stressors.

In some cases, you can actually eliminate the cause of the stress from your life. For example, if work is stressing you out, you can try to find a less stressful job.

Other stressors are things that won’t just go away, so you will have to learn to deal with them more effectively.

If eliminating a stressor from your life isn’t possible, and you can’t seem to deal with the resulting stress on your own, therapy could help.

Childhood night terrors can be caused by stress too.

Observe your child closely, and look for any signs that something is bothering them. If you start to think your child is troubled about something, try to get them to talk about it. Sometimes, just talking about their worries can help alleviate a child’s stress.

Identify Possible Patterns

Sometimes, a specific thing will trigger night terror episodes. So, if you have night terrors, try to identify any reoccurring triggers.

Start a sleep diary. When you have a night terror episode, make a note of the activities or events that preceded it.

After a few night terror episodes, look over your sleep diary to see if you can spot any patterns. There might be certain things that often seem to happen, or that you often seem to do, before you have a night terror episode. Now that you’ve spotted the pattern, you can try to remove as many of these triggers from your life as possible.

But what if one of your triggers is an activity you have to do? In that case, try to perform the activity as early in the day as you can.

Learn to Deal with Your Child’s Night Terrors

Do you wake someone from a night terror?

The answer, especially when it comes to children, is no. If your child is having a night terror episode, trying to wake them up by yelling at them or shaking them will only make things worse. Instead, let the episode run its course, and let it end in its own time.

However, you can try to comfort the child. Hold them gently but firmly, and keep your voice calm and soothing when you speak to them.

If they’ve gotten up, you can try to gently guide them back into bed. But if they are resistant, don’t try to force the issue.

Soon, the episode will end and your child will settle back into sleep.

If you notice that your child’s night terrors seem to start at the same time every night, you can try anticipatory awakenings.

About 10 or 15 minutes before the child’s night terrors usually start, wake them up. Urge them to get out of bed, and try to keep them awake. After 5 minutes, let them get back into bed and go back to sleep.

Safety-Proof Your Sleeping Area

If someone gets out of bed during night terror episodes, it’s important to make their sleeping environment safe, and cut down on the risk of them hurting themselves.

Here are some things you can do to safety-proof a sleeping area.

• Remove anything potentially harmful from the environment.
• Put anything sharp or breakable up high, so it can’t be reached easily.
• Use gates or other barriers to block off stairways. Also block off entryways that don’t have doors.
• Make sure all exterior doors and windows are closed and locked.
• Consider locking the bedroom door.
• Make sure the floor is free of tripping hazards, like electrical cords, shoes, and random clutter.