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David Baxter PhD

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Night terrors
By Mayo Clinic staff
Aug. 15, 2009

Night terrors are episodes of fear, flailing and screaming while asleep. Night terrors often are paired with sleepwalking.

Although night terrors are more common in children, they also can affect adults. A night terror episode usually lasts only a few minutes.

Night terrors are relatively rare, affecting only a small percentage of children ? often between ages 4 and 12 ? and a smaller percentage of adults. However frightening, night terrors aren't usually a cause for concern. Most children outgrow night terrors by adolescence.

Night terrors differ from nightmares. Whereas the dreamer of a nightmare wakes up from the dream and remembers details, people with night terrors remain asleep. Children usually don't remember anything about their night terrors in the morning. Adults may recall a dream fragment they had during the night terrors.

Like sleepwalking and nightmares, night terrors are a parasomnia ? an undesired occurrence during sleep. Night terrors usually occur during the first third of the sleep period for children. For adults, night terrors can happen anytime during the night.

During a night terror episode, a person might:

  • Sit up in bed
  • Scream or shout
  • Kick and thrash
  • Sweat, breathe heavily and have a racing pulse
  • Be hard to awaken
  • Get out of bed and run around the house (more common in adults)
  • Engage in violent behavior (more common in adults)
  • Stare wide-eyed
When to see a doctor
Occasional night terrors aren't usually a cause for concern. If your child has night terrors, you can simply mention them at a routine well-child exam.

Consult your doctor if your or your child's night terrors:

  • Become more frequent
  • Routinely disrupt sleep
  • Cause you or your child to fear going to sleep
  • Lead to dangerous behavior or injury
  • Appear to follow the same pattern each time
Various factors can contribute to night terrors, including:

  • Sleep deprivation
  • Fatigue
  • Stress
  • Anxiety
  • Fever
  • Sleeping in unfamiliar surroundings
Night terrors sometimes are associated with underlying conditions that affect sleep, such as:

  • Seizure disorders
  • Sleep-disordered breathing ? a group of disorders characterized by abnormal breathing patterns during sleep, the most common of which is obstructive sleep apnea
  • Migraines
  • Stroke
  • Hyperthyroidism (overactive thyroid)
  • Head injuries or brain swelling
  • Premenstrual period
In other cases, use of alcohol, illicit drugs or certain medications ? including some antibiotics, antihistamines, sedatives and sleeping pills ? can trigger night terror episodes.

Risk factors
Night terrors tend to run in families. Adults who have night terrors may have a history of bipolar disorder or some depressive or anxiety disorders, although it's unclear how strong the association is.

Night terrors aren't necessarily a concern, but regularly disrupted sleep can be. It can cause excessive daytime sleepiness, which can lead to difficulties at school or work, or problems with everyday tasks such as driving.

Harming self or others is another possible complication during night terrors.

Preparing for your appointment
For children, night terrors tend to decrease by the time they're adolescents. However, if you have concerns about safety or underlying conditions for you or your child, you may want to consult your or your child's doctor, who may refer you to a sleep specialist.

Your doctor also will need to know:

  • When the night terrors began
  • How often the night terrors occur
  • Your medical history
  • Any medications you're taking or have taken
  • Whether you have or have had any other sleep problems
  • Whether you have family members with sleep problems
It's a good idea to keep a sleep diary for two weeks before your appointment to help your doctor understand your sleeping pattern. In the morning, you record as much as you know of your bedtime ritual, quality of sleep, and so on. At the end of the day, you record behaviors that may affect your sleep, such as caffeine consumption (chocolate and cola count) and any medications taken. The same applies to your child.

Tests and diagnosis
Night terrors are usually self-diagnosed. Your doctor may do a physical or psychological exam to identify any conditions that may be contributing to the night terrors. In some cases, observation or tests in an overnight sleep lab may be recommended.

Treatments and drugs
Treatment for night terrors isn't usually necessary. If your child has a night terror, simply wait it out. You might gently restrain your child and try to get him or her back into bed. Speak softly and calmly. Shaking your child or shouting may only make things worse.

If the night terrors are associated with an underlying medical or mental health condition, treatment is aimed at the underlying problem. If stress or anxiety seems to be contributing to the night terrors, your doctor may suggest meeting with a therapist or counselor.

Medication is rarely used to treat night terrors. If necessary, however, short-term use of benzodiazepines may help reduce night terrors.

Lifestyle and home remedies
If night terrors are a problem for you or your child, here are some things to try:

  • Make the environment safe. To help prevent injury, close and lock all windows and exterior doors at night. You might even lock interior doors or place alarms or bells on the doors. Block doorways or stairways with a gate, and move electrical cords or other objects that pose a tripping hazard. If your child has night terrors, don't let him or her sleep in a bunk bed. Place any sharp or fragile objects out of reach.
  • Get more sleep. Fatigue can contribute to night terrors. Try an earlier bedtime or a more regular sleep schedule.
  • Establish a regular, relaxing routine before bedtime. Do quiet, calming activities ? such as reading books, doing puzzles or soaking in a warm bath ? before bed. Meditation or relaxation exercises may help, too.
  • Put stress in its place. Identify the things that stress you out, and brainstorm possible ways to handle the stress. If your child seems anxious or stressed, talk about what's bothering him or her.
  • Look for a pattern. If your child has night terrors, keep a sleep diary. For several nights, note how many minutes after bedtime a night terror episode occurs. If the timing is fairly consistent, wake your child about 15 minutes before you expect a night terror episode. Keep your child awake for five minutes, and then let him or her fall asleep again.
Above all, be positive. However disruptive, night terrors aren't a serious condition ? and they usually go away on their own.

Symptoms References

It amazes me how i am not able to recall usually anything i did or said in these episodes. It is also very upsetting the things my husband has told be i have screamed about as i would never do those things in real life. It keeps him awake most nights and for that i am sorry as he has to work quite early in am. Why is it the person affected cannot remember anything what was said what was done. I tell him to wake me up with this happens don't let me go there but he says in some instances it happens so fast he has no time too. Most the time my words are just mumbles loud noises but when words are heard they are usually threatful. I do think stress does play alot into triggering these episodes I just wish i knew how to stop them it is quite frightening to the other people in the household when these happen.
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