You wake up in the morning covered in sweat, with the bedsheets tangled on the floor, and your partner telling you about the screaming, kicking, and thrashing you did during the night. For most people, sleep is a time for rest and dreaming. But for those who suffer from night terrors, it’s far from relaxing.
While night terrors are most common in children, they also affect about 3 percent of adults in the United States, according to the American Academy of Sleep Medicine (AASM) in 2023. This sleep disorder, known as parasomnia, can turn nights into a source of fear and stress.
What Are Night Terrors?
Night terrors, also referred to as sleep terrors, are a type of sleep disorder characterized by sudden and intense episodes of fear, panic, or terror during sleep. Unlike nightmares, which typically occur during REM (rapid eye movement) sleep and are often vividly remembered upon waking, night terrors occur during non-REM sleep stages, usually within the first few hours of falling asleep.
Reasons
Here are some common reasons for night terrors:
1. Sleep Deprivation
Sleep deprivation or irregular sleep patterns can increase the likelihood of night terrors. When sleep cycles are disrupted, it can affect the transition between different sleep stages, potentially triggering night terrors.
2. Stress and Anxiety
High levels of stress or anxiety can contribute to night terrors. Emotional stress during the day may manifest in disrupted sleep patterns at night, leading to these episodes.
3. Fever or Illness
Night terrors can be triggered by high fever or illness, especially in children. The body’s physical stress response to illness can disturb normal sleep patterns.
4. Medications or Substances
Certain medications or substances, such as alcohol or drugs, can interfere with sleep and increase the risk of night terrors. These substances may alter brain chemistry or disrupt normal sleep architecture.
5. Family History
A family history of night terrors or other sleep disorders can be a contributing factor. Genetics can play a role in determining an individual’s predisposition to these types of parasomnias.
6. Sleep Disorders
Other sleep disorders, such as sleep apnea or restless legs syndrome, can disrupt sleep and potentially lead to night terrors. Addressing these underlying conditions may reduce the frequency of night terrors.
7. Stressful Events or Trauma
Experiencing a traumatic event or significant stressors in life can lead to night terrors. The emotional impact of trauma can manifest in sleep disturbances, including night terrors.
8. Environmental Factors
Environmental factors like excessive noise, uncomfortable room temperature, or bright lights can disrupt sleep and contribute to night terrors. Creating a calm and soothing sleep environment can help minimize this risk.
Symptoms
Night terrors, also known as sleep terrors, are a type of parasomnia (sleep disorder) characterized by sudden and intense episodes of fear or panic during sleep. They typically occur during non-REM (rapid eye movement) sleep, often in the first few hours of the night.
Here are some common symptoms of night terrors:
- Sudden Awakening with Fear: The individual often wakes abruptly, usually accompanied by a scream or shout.
- Intense Panic or Fear: During an episode, the person exhibits signs of extreme fear or panic.
- Confusion or Disorientation: The individual may be confused or disoriented during the episode, with limited awareness of their surroundings.
- Increased Heart Rate and Breathing: Night terrors often cause a rapid heart rate, heavy breathing, or sweating due to the intense fear.
- Lack of Memory of the Episode: The individual usually has no memory of the night terror upon waking up the next morning.
- Physical Agitation: During an episode, the person may thrash, sit up abruptly, or show other physical signs of distress.
- Resistance to Comforting: The individual may be inconsolable or resistant to calming efforts during the night terror.
- Incoherent Speech or Sounds: Night terrors can be accompanied by incoherent speech or unintelligible sounds.
Effects
Night terrors can have a significant impact on individuals experiencing them and their families or caregivers. The effects can range from immediate disturbances during the episodes to longer-term consequences if the night terrors persist.
Here are some of the common effects of night terrors:
1. Sleep Disruption
Night terrors can cause significant sleep disruption for both the individual and those around them. This can lead to sleep deprivation, which may contribute to other health problems.
2. Daytime Fatigue
Disrupted sleep due to night terrors can lead to daytime fatigue, reduced alertness, and decreased energy levels. This can impact work, school, or other daily activities.
3. Emotional Distress
Experiencing or witnessing night terrors can cause emotional distress. For the person with night terrors, waking up disoriented or experiencing intense fear can be frightening. Family members or caregivers might also feel anxious or stressed by the episodes.
4. Behavioral Changes
Children who experience frequent night terrors might exhibit behavioral changes, such as irritability, mood swings, or difficulty concentrating at school. In adults, night terrors may contribute to increased stress, anxiety, or depression.
5. Risk of Injury
During night terrors, individuals may exhibit physical movements like thrashing, kicking, or running. This can increase the risk of injury to themselves or others. Children may fall out of bed or run into objects, while adults could injure themselves or damage their surroundings.
6. Relationship Strain
Night terrors can cause strain in relationships, particularly if they disrupt the sleep of a partner or family members. The stress and emotional toll of frequent night terrors can affect relationships over time.
7. Reduced Quality of Life
Persistent night terrors can lead to a reduced quality of life due to the cumulative effects of sleep disruption, emotional stress, and behavioral changes. This can impact overall well-being and daily functioning.
8. Increased Anxiety about Sleep
Individuals who experience night terrors might develop anxiety or fear about going to sleep, which can lead to further sleep disturbances or insomnia. This anxiety can create a cycle that perpetuates sleep issues.
Treatment
Night terrors can be distressing, but several treatment strategies can help manage or reduce their frequency. The choice of treatment often depends on the underlying cause, the age of the individual, and the severity of the night terrors.
Here are common treatment approaches:
1. Improving Sleep Hygiene
Creating a consistent and calming bedtime routine can help reduce night terrors.
This includes:
- Establishing a regular sleep schedule.
- Creating a comfortable sleep environment (e.g., room temperature, noise, lighting).
- Limiting stimulating activities before bed (e.g., screen time, caffeine, or intense exercise).
2. Addressing Underlying Stress or Anxiety
Managing stress and anxiety can help decrease the frequency of night terrors.
Strategies include:
- Relaxation techniques like deep breathing, meditation, or progressive muscle relaxation.
- Counseling or therapy to address underlying stressors or emotional issues.
- Stress management through hobbies, exercise, or other activities that promote relaxation.
3. Scheduled Awakenings
This technique involves waking the individual 10-15 minutes before their usual night terror time and keeping them awake for a few minutes. It can help disrupt the sleep cycle and prevent the night terror from occurring.
4. Medication
In some cases, medication may be prescribed to manage night terrors. This is generally considered when other approaches are ineffective or if night terrors significantly impact the quality of life.
Medications that may be used include:
- Benzodiazepines can help calm the nervous system.
- Antidepressants, particularly if night terrors are linked to mood disorders.
- Medication should be prescribed and monitored by a healthcare provider.
5. Treatment of Underlying Sleep Disorders
If an underlying sleep disorder, such as sleep apnea or restless legs syndrome, is causing night terrors, treating that condition can reduce night terrors.
6. Behavioral Therapy
For children, behavioral therapy may involve reassurance and ensuring a sense of safety to reduce fear-related night terrors. Cognitive-behavioral therapy (CBT) can also help manage anxiety and reduce the frequency of night terrors in adults.
7. Education and Support
Educating families about night terrors and providing support can help manage the impact on household members. Support groups or counseling for caregivers can also be beneficial.
Final Thought
Night terrors, a type of parasomnia, can be distressing for those experiencing them and their loved ones. Typically occurring during non-REM sleep, they involve sudden episodes of intense fear, often accompanied by screams, physical agitation, and confusion. While more common in children, adults can also be affected, with potential triggers ranging from stress and sleep deprivation to medications and underlying health conditions. Effective management often involves improving sleep hygiene, addressing stress or anxiety, and, in some cases, medical treatment. If sleep terrors persist or significantly impact the quality of life, seeking professional help from a sleep specialist or healthcare provider is crucial to addressing underlying causes and reducing their impact.
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