Night terror
    
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Night terror

Definition

Night terrors are a sleep disorder in which a person quickly awakens from sleep in a terrified state.

Alternative Names

Pavor nocturnus; Sleep terror disorder

Causes

The normal sleep cycle involves distinct stages, from light drowsiness to deep sleep. During rapid eye movement (REM) sleep, the eyes move quickly and vivid dreaming is most common. Each night there are several cycles of non-REM and REM sleep.

Night terrors (sleep terrors) occur during stage 3 and stage 4 sleep (deep sleep). The cause is unknown but night terrors are often triggered by fever, lack of sleep, or periods of emotional tension, stress, or conflict.

Night terrors are like nightmares, except that nightmares usually occur during REM sleep and include unpleasant or frightening dreams. Nightmares are most common in the early morning.

Night terrors usually happen in the first half of the night. The child often screams, and will usually not remember the details of the scare. You may be unable to talk to a child who is having a night terror. In contrast, nightmares are normal on occasion, especially after someone watches frightening movies/TV shows or has an emotional experience. A person may remember the details of a dream upon awakening, and will not be disoriented after the episode.

Night terrors are most common in preadolescent boys, although they also can occur in girls and in adults. They are fairly common in children 3 - 5 years old, and much less common after that. Night terrors may run in families. They can occur in adults, especially with emotional tension and/or the use of alcohol.

Symptoms

  • Sudden awakening from sleep
  • Persistent fear or terror that occurs at night
  • Screaming
  • Sweating
  • Confusion
  • Rapid heart rate
  • No recall of "bad dreams" or nightmares
    • Unable to explain what happened
    • May have a sense of frightening images
    • No memory of the event when they awaken the next day
  • Unable to fully wake up
  • Difficult to comfort

Note: Episodes are most common in the first third of the night. They may last 10 - 20 minutes, then normal sleep returns.

Exams and Tests

In many cases, no further examination or testing is needed. If the night terror is severe or prolonged, the child may need a psychological evaluation.

Treatment

In many cases, a child who has a night terror only needs comfort and reassurance. Psychotherapy or counseling may be appropriate in some cases. Benzodiazepine medications (such as diazepam) used at bedtime will often reduce night terrors; however, medication is not usually recommended to treat this disorder.

Outlook (Prognosis)

Most children outgrow night terrors. They don't usually remember the event. Stress reduction and/or psychotherapy may be helpful for night terror in adults.

Possible Complications

  • Insomnia (unusual)

When to Contact a Medical Professional

Call for an appointment with your health care provider if the night terrors are persistent or frequent, or occur often enough to regularly disrupt sleep.

Also call if other symptoms occur with the night terror or if the night terror causes, or almost causes, injuries.

Prevention

Minimizing stress or using coping mechanisms may reduce night terrors. The number of episodes usually decreases after age 10.

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