Night Terrors

Night terrors, also called sleep terrors, are episodes of extreme distress that occur while you’re asleep. This sleep disorder occurs during the non-REM stages of sleep when your body is in between wakefulness and deep sleep. 

You may lash out physically and typically won’t remember the episode when you wake up. Night terrors can be terrifying for both the person experiencing them and those around them, but there are ways to lessen their intensity and frequency.

What are Night Terrors?

A night terror is considered a parasomnia. That means it’s an abnormal or unwanted behavior during sleep. During a night terror, the sleeper experiences a fearful state that can trigger screaming, kicking, and thrashing.

These episodes are not your average nightmare. Unlike a scary dream where you may jolt awake and remember what you were dreaming about, night terrors won’t wake you up and you likely won’t remember what happened in them. 

Sleep terrors are associated with non-REM sleep stages and episodes can last anywhere from a few seconds to a few minutes.

No two night terrors are the same, but there are some common symptoms, including:

• Screaming or shouting
• Suddenly sitting up in bed
• A wide-eyed, frightened stare
• Sweating
• Heavy breathing
• Increased heart rate
• Dilated pupils
• Flushed face
• Kicking and thrashing
• Aggressive behavior
• Sleepwalking

It’s incredibly difficult, and not recommended, to wake someone up from a night terror. If you try, they may become agitated and confused and could become aggressive toward you. 

Night terrors are often associated with young children, but they can affect people of any age. Episodes are typically rare, but if they’re disrupting your sleep (and overall mental health) to the point that it affects your quality of life, it’s important to seek medical attention.

Causes of Night Terrors

Scientists still aren’t exactly sure what causes night terrors, but an over-aroused central nervous system (CNS) may play a role. This means that anything that causes stress, anxiety, or general stimulation could trigger night terrors. They’re also more common in children.

Kids

One study found that approximately 56 percent of children 13 years old and younger have had at least one night terror. 

Anything that interrupts a child’s normal sleep patterns and puts their CNS into overdrive can contribute to night terrors. Night terrors tend to be more common in kids who are:

• Sick
• Stressed
• Sleep deprived
• Sleeping in a new environment (either from a big move or just being away from home)
• Taking a new medication
• Ingesting too much caffeine

Adults

Night terrors are rare in adults. Usually, the episodes are infrequent and happen before the age of 25. Some risk factors include:

• Depression
• Anxiety
• Bipolar disorder
• Migraine
• Obstructive sleep apnea 
• Travel
• Sleeping in unfamiliar environments

Genetics and family history also seem to play a role in whether or not you experience night terrors as an adult. One study found that 96 percent of people who had sleep terrors had at least one relative that had them, too.

Management and Prevention

The occasional night terror might be scary, but it isn’t a cause for alarm. You really only need to seek out medical help if you’re experiencing them frequently or if the episodes have the potential to harm you or others in your household.

If you do consult your doctor, they will do a physical exam and ask you questions about your sleep habits, health history, and any medications you’re taking to identify any potential causes. For more information, they may refer you to a sleep specialist who can order a sleep study to analyze what’s happening while you sleep.

From there, your treatment options include:

• Addressing any related medical issues 
• Cognitive behavioral therapy to alleviate stress
• Having someone wake you up about 15 minutes before an expected night terror
• Benzodiazepines (like Valium) or antidepressants (like Prozac)

Unfortunately, there’s no known way to completely prevent sleep terrors. However, you can do your best to manage them by:

• Maintaining a consistent sleep schedule
• Getting enough rest
• Reducing stress
• Keeping a sleep diary and writing down any potential triggers

If you think your child may be experiencing sleep terrors, talk to their pediatrician. Night terrors usually go away on their own and don’t require any treatment, but their doctor may have some suggestions to help your little one (and you) get a better night’s sleep.

Night Terrors vs. Nightmares

Nightmares and night terrors might seem similar, but they’re two very different things. First, nightmares aren’t characterized as a disorder unless they frequently disrupt your sleep. Even though they can be distressing, they also usually won’t cause any physical movements or vocalizations.

Night terrors, on the other hand, are considered a sleep disorder. They can cause physical thrashing and shouting. Think of them like next-level nightmares that feel way more intense and real. Unlike a nightmare, though, where the fear usually prompts you to wake up, night terrors are much harder to come out of.

While pretty much everyone experiences nightmares at some point in their lives, night terrors are far less common. So, if you’re not sure which one you’re dealing with, ask yourself these questions:

• Do I immediately remember the dream upon waking up? 
• Do I move around or thrash in my sleep during the episode?
• Am I hard to wake up during or after the event?

You can also ask a friend or family member to watch you sleep to see if they notice any physical movement or vocalizations.

Takeaway

Night terrors can be very frightening, especially if you don’t know what they are. The good news, though, is that night terrors usually don’t have any lasting effects and typically go away on their own. 

If you’re concerned about your sleep terrors, talk to your doctor. They may be able to help you find a way to manage or prevent them so you can stop fearing sleep and get the rest you need.

Source List

American Sleep Association. (2022). Nightmares vs Night Terrors.  https://www.sleepassociation.org/blog-post/is-it-a-nightmare-or-is-it-a-night-terror/

Fleetham JA, et al. (2014). Parasomnias. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4016090/

Leung AKC, et al. (2020). Sleep Terrors: An Updated Review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193803/

Nemours KidsHealth. (2017). Night Terrors.  https://kidshealth.org/en/parents/terrors.html

Petit D. (2015). Childhood Sleepwalking and Sleep Terrors. https://jamanetwork.com/journals/jamapediatrics/fullarticle/2281574

Van Horn NL, et al. (2022). Night Terrors. https://www.ncbi.nlm.nih.gov/books/NBK493222/