What Are Night Terrors?

Night terrors are short-lived states of agitation and extreme fear experienced while asleep. Episodes are marked by screaming, sweating, flailing, and bolting upright in bed. People experiencing night terrors often have no memory of them. Night terrors can occur at any age, but are most common in children, who typically outgrow them. Though unpleasant, night terrors rarely pose a threat to health. An exception would be a recurrent condition, which results in sleep deprivation and may signal a more serious underlying medical issue. 

What Are Night Terror Symptoms? 

Night terrors typically occur in the early part of the sleep cycle, during the non-rapid eye movement or NREM phase. This is the deep sleep phase of rest, important in the formation of long-term memory. The time of occurrence helps distinguish a night terror from a nightmare, which, like other forms of dreaming, takes place during the rapid eye movement (REM) phase of the sleep cycle. A night-terror episode might last between one and 10 minutes.

Night terror symptoms include:

• Moans, shouts, or screams
• Sitting upright in bed, sometimes with eyes wide open
• Flailing arms and legs
• Sweating
• Elevated pulse
• Resistance to waking 
• Powerful feelings of fear, dread, or remorse
• Lashing out, as if defending one’s self from an attacker

People experiencing a night terror typically remain asleep through the whole episode. This is different from nightmares, from which sleepers usually awake.

What Causes Night Terrors?

Night terrors can have several causes. One of these is hereditary. Studies have shown that the category of sleep disorders known as a parasomnias, including night terrors and sleepwalking, tend to cluster within family groups. 

There are several other factors that may play a causal role in night terrors:

• Feelings of stress and anxiety
• Fevers
• Alcohol consumption
• Certain medications
• Sleep deprivation
• Irregular sleeping schedules

Several underlying medical issues can also have an impact, including obstructive sleep apnea, restless legs syndrome, and depression. Undergoing night terrors in conjunction with any of these conditions may indicate a need for medical care. 

How Are Night Terrors Diagnosed?

There are a number of steps in the diagnosis of night terrors:

• Documentation of symptoms: Your physician will make a record of your symptoms, including the nature and frequency of your night-terror episodes. He or she may also conduct a physical exam, to look for evidence of an underlying medical conditions that is contributing to your condition. 
• Questioning an observer: Since you’re unconscious during night terrors, your physician may want to question your spouse or another relevant individual who’s observed you during an episode. 
• Sleep study: Depending on the severity of your symptoms, you may be asked to undergo a sleep study. Brain waves, heart rate, blood oxygen levels, eye and limb movements, and other physiological behaviors will be monitored and recorded during a period of rest. Sleep studies of this type are typically conducted in specialized medical facilities. 

How Are Night Terrors Treated?

In those cases where it’s deemed beneficial, medical treatment for night terrors may include:

• Addressing associated health conditions: Night terrors are often linked to other sleep disorders. If your physician finds evidence for this, he or she will focus on that as a root cause of the problem. 
• Pattern interruption: If night terrors are occurring at similar times every night, it sometimes helps to interrupt the pattern by waking the patient a few minutes before each episode would normally begin. Your physician can help you identify if this is the case. 
• Medication management: Your physician may prescribe certain medications for underlying conditions, such as depression, or adjust medications already being taken.
• Counseling: Counselors can assist with the treatment of night terrors through the introduction of stress-reduction and relaxation techniques, including self-hypnosis.

Helping Those with Night Terrors

Because bodily agitation and flailing are common symptoms of night terrors, there exists a potential for accidental injury. There are several things you can do to reduce the risk of self-harm or harm to others:

• Sleep longer and more regular hours: People with sleep disorders, such as night terrors, are often short on healthy, restful sleep. Sleeping longer hours on a regular basis can reduce the likelihood of chronic night-terror attacks. 
• Establish a pre-bedtime routine: Routines can help with stress. Try quiet activities before bedtime, as a means of calming yourself before sleep.
• Learn to control stress: Researchers have identified anxiety as one cause of night terrors. Talk out problems with a loved one or learn to control your stress reactions for a better night’s sleep.
• Decrease alcohol intake: One way not to deal with stress is to drink alcoholic beverages before bed. The consumption of beer, wine, or other spirits is thought to contribute to the incidence of night terrors.
• Provide comfort: If someone in your family is suffering from night terrors, it’s often best to wait out the episode, and then offer comfort and consolation (especially to children). Because people waking from a night-terror episode are commonly disoriented and confused. It may also be helpful to explain what happened and why there’s no real danger involved. 
• Write down your observations: If a loved one falls into a pattern of night terrors, make careful note of his or her behaviors. Your physician will find information of this type valuable in making a diagnosis.

Learn More About Night Terrors from Baptist Health

If you or a loved one is experiencing night terrors, schedule an appointment with a Baptist Health primary care or sleep specialist today.