Night terrors: What Are They and How do I Deal With Them?

Have you ever experienced a night terror or observed someone else experiencing an episode? It can be, no pun intended, terrorizing. Night terrors occur at the slow-wave sleep cycle which is usually at the beginning of the night. These experiences can include episodes of screaming, crying, intense fear, and oftentimes sleepwalking, all while you’re asleep. Night terrors (also referred to as sleep terrors) typically affect children and a small percentage of adults. Each experience an individual endures is unique, however, a night terror episode generally lasts from seconds to minutes, but it can vary.

 

Symptoms of Night Terrors

As mentioned earlier, night terrors occur during the first third to first half of the night (slow-wave sleep cycle) and it is uncommon to have them occur multiple times throughout the night, though it is possible. The first sign of an episode of a night terror is typically sitting up in bed and crying out.

Other symptoms to look out for are:

  • Staring blankly
  • Uncontrollable sweating, flushed face, and dilated pupils
  • Breathing heavily
  • Confusion 
  • Flailing and thrashing
  • Getting out of bed and exhibiting aggressive behavior towards a partner or family member if they try to prevent you from running around

After experiencing a night terror, individuals do not usually remember the episode. It is common to lie back down and fall back asleep, not remembering anything when they wake up in the morning. The rate at which an individual can experience a night terror varies; you can experience a night terror every night or occasionally throughout the year.

While someone is experiencing a night terror, it is natural to want to wake them up and provide comfort. However, it is not advised. Trying to wake someone up who is experiencing a night terror can result in a physical response that can lead to injury, or make the episode last longer. It is most important for you to stand by to ensure they are safe and do not cause harm to themselves or others.

Additionally, it is advised to reach out to your medical team if your night terrors:

  • Persist daily
  • Disrupt the sleep of the individual or family members
  • Cause injury
  • Result in disruption of daytime functioning
  • Extend into the teen years or start in adulthood

 

Night Terrors in Adults

It is most common for children to experience night terrors, but it is not uncommon for adults to experience them as well; about 2.2% of adults experience episodes of night terrors. Though that number may seem low, you are not alone. It is often hard to research night terrors in adults because we do not remember them, therefore accounts of episodes go unreported or they are often diagnosed as nightmares.

The exact cause of night terrors in adults is unknown, however, adults with a childhood history of night terrors are more likely to have a recurrence of episodes in adulthood. Additionally, stress, sleep deprivation, or development of a more complicated health condition can be attributed to the cause of night terrors in adults. Researchers have also linked night terrors and genes, meaning night terrors can be hereditary.

The symptoms of night terrors in adults are similar to those exhibited in children, however, since night terrors in adults are relatively associated with trauma and mental illness, many endure aggression, anxiety, memory loss, and self-injury. Night terrors in adults are of greater concern due to the increased risk of injury. Due to the risk of injury, it is best to keep a distance from one exhibiting aggressive behavior and ensure a safe environment for them (e.g., removing all trip hazards and dangerous objects).

 

Why Do I Get Night Terrors?

Night terrors fall under the category of an arousal disorder, a type of parasomnia. A parasomnia is a sleep disorder that produces abnormal behavior (e.g., undesired events or activities) during sleep. Two to three hours after we have fallen asleep, we transition from the deepest stage of non-rapid eye movement (non-REM) to a lighter REM sleep. This transition is often effortless, but sometimes an individual can become frightened and that reaction causes a night terror.

Additional factors that can trigger night terrors are:

  • Stress
  • Sleep deprivation 
  • Sleep disruption (e.g., travel)
  • Trauma
  • Medication
  • Alcohol use 

While the factors described above can trigger someone, several conditions can predispose someone to night terrors:

  • A family history
  • Obstructive sleep apnea (OSA)
  • Restless leg syndrome
  • Gastroesophageal reflux
  • Underlying mental health conditions

Though there are many explanations for what can trigger or predispose someone to a night terror, the exact cause of why it happens is not known. 

 

Night Terrors VS Nightmares: What is the difference?

Night terrors involve abnormal movements, behaviors, and emotions that occur while we are asleep; we have no recollection of the event happening in the morning. In contrast, after awakening from a nightmare, we often remember partial fragments of the dream. Night terrors are not necessarily a dream, they are a sudden reaction of fear during the transition of one sleep stage to another. Nightmares on the other hand are dreams that are frightening. The biggest difference between nightmares and night terrors is the memory involved. In night terrors, we remain asleep, but in nightmares, we are awakened from the dream and remember limited details.

Treatment for Night Terrors

While there is no specific treatment for night terrors, it is advised to reach out to your medical team to discuss specialized treatment for your specific needs. Treatment can include being referred to a sleep specialist, learning how to respond to prevent adverse events, keeping a sleep diary, and improving sleep hygiene. Additionally, addressing underlying health conditions can play a key role in treating your night terrors and may even help stop them altogether.

In cases of persistent night terrors, medication may be considered for treatment, though it is not usually needed. Medication such as benzodiazepines and certain antidepressants will be prescribed case by case. A number of simple at home remedies may also help relieve night terrors such as melatonin. Melatonin is a naturally produced hormone that regulates the sleep-wake cycle, but it is also a dietary supplement that can be used in the short term treatment of sleep disorders.

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References:
Mayo Clinic. (2018, March 09). Sleep terrors (night terrors). Retrieved January 10, 2021, from https://www.mayoclinic.org/diseases-conditions/sleep-terrors/symptoms-causes/syc-20353524#:~:text=Overview,an%20undesired%20occurrence%20during%20sleep.
Newman, T. (2020). Night terrors: Causes, symptoms, and treatment. Retrieved January 10, 2021, from https://www.medicalnewstoday.com/articles/301893#night_terrors_in_adults
Raypole, C. (2019, April 3). Adult Night Terrors: Why They Happen and What You Can Do. Retrieved January 10, 2021, from https://www.healthline.com/health/night-terrors-in-adults

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