A terrifying experience for both the person experiencing it and those around them, night terrors are episodes that happen while we sleep. These episodes usually occur non-REM sleep stage, when we are deep asleep, about two to three hours after falling asleep. They're characterized by bouts of screaming, thrashing & kicking which typically last about 5 minutes.

A night terror episode can be a terrifying experience, especially on witnesses as they watch their loved ones struggle in a state where there appears no hope for escape--a stressful situation that can easily lead a witness to panic or even developing night terror episodes themselves. It can also make you wake up feeling really tired.

Sleep terror is most common in children who might continue to have episodes until their teens, but then they gradually disappear. It occurs in adults but very rarely. It can be very distressing for parents to see their child so upset, and usually, they need to be calmed and comforted until they will return to sleep. See also our article on children snoring.

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What Are Night Terrors?

Night terrors sometimes called sleep terrors or pavor nocturnus (Latin for "night fear"), are a type of parasomnia characterized by screaming episodes during the night.

They typically occur in children and adults who have just gone to bed, although they can also happen at other times.

During this time, they will often scream and act out while still sleeping. Night terrors usually last less than 10 minutes and may not be remembered after waking up, but they can cause significant distress to those experiencing them.

In this article, we will discuss what causes night terrors, how often they happen, and ways that people can get relief from these terrifying events.

Night Terrors Vs. Night Tremors.

Scientifically known as sleep myoclonus, night tremors are involuntary rhythmic movements of one limb or part of your body during sleep. It is often confused with night terrors which cause thrashing, kicking, and other body movements. The difference is that night tremors happen during lighter stages of sleep, and do not involve the feelings of panic felt by a person who has night terrors.

A night tremor occurs usually as a result of a problem in the nervous system. In most cases, tremors are can't be easily treated but they eventually fade away on their own.

Tremors are not always serious, but in some cases, they may indicate a serious disorder. Most night tremors can’t be easily treated, but they’ll often go away on their own.

Night Terrors Vs. Nightmares

Nightmares and night terrors are both types of dreams that occur during sleep, but they involve different aspects of the sleeping process.

A nightmare is a frightening dream that usually causes emotional distress. They are typically related to everyday events.  Dreams occurring in this manner are more common among children than adults because their young minds can become deeply disturbed by seemingly minor issues.  Unlike night terrors, nightmares mainly occur during REM sleep. Nightmares rarely include physical or vocal behaviors.

A night terror occurs when an individual experiences intense feelings of fear while still asleep; it often involves screaming and thrashing around physical activity, disrupting the restful quality of sleep, especially for those witnessing such episodes.

Who Is Affected by Night Terrors?

Night terrors are more common in children than adults. If you have a child between the ages of three and 12 years old, chances are they will experience night terrors at least once. A study published by JAMA Pediatrics showed that children at the age of 1.5 years have a 35% chance more likelihood of experiencing night terrors.

Night Terrors in Adolescents

Night terrors are also common in adolescents. Adolescents between the ages of 12 and 18 rarely experience night terrors because their brains have developed more control over nighttime behavior than children. Only about 4% of night terrors will persist past adolescence. New-onset on night terror occurrences in teenagers may be related to trauma or a psychiatric disorder.

Night Terrors in adults

recurrence of night terrors in adults is often common in people who have a history of trauma or psychiatric disorders, such as post-traumatic stress disorder (PTSD) and bipolar II triggered by stress, sleep deprivation, or the development of another sleep disorder like sleep apnea. Veterans can be suspect to these symptoms. See also our article on how diet can effect sleep apnea.

Night Terrors in the Elderly

Older men and women over the age of 65 rarely suffer (<1%) from night terrors because their brains naturally produce less melatonin during sleep transitions. However, if an older person does happen to experience this parasomnia, it is usually related to dementia or other degenerative neurological conditions like Parkinson’s disease.

What are the symptoms of night terrors?

Night terror symptoms will vary by person. Kids might sit up and be screaming or shouting like they are in deep distress. Their breathing and heartbeat might be faster, and they could be sweating or crying. Usually, they might thrash around and generally be scared and upset.

Usually, they will calm down after a while and go back to sleep, but some children have difficulty returning to sleep as it is very traumatic for them – and for the parents too. Usually, the child will not remember any specifics of what the night terror was about, unlike a nightmare that they might remember parts of.

Some of the other common physical symptoms that are also common in adults include:

• Frightening screams and vocalizations.
• Breathing rapidly during sleep
• Blank stare or dilated pupils during sleep
• Flailing or thrashing in bed
• Increased heart rate
• Sweaty rigid body
• Sitting up in bed while asleep
• Seem awake but be confused

What is the cause of night terrors?

There are a few major hypotheses on the causes of night terrors.

Like other disruptive sleep-related disorders, people who have a family history of parasomnia are more likely to experience night terrors as well. Some researchers believe that night terrors may be linked to a lack of sleep, leading to hallucinations and vivid dreams that cause people to wake up abruptly with an intense feeling of fear or terror.

The second theory suggests that people who experience these episodes have an irregular heart rate while in REM sleep, disrupting normal functioning and triggering bad dreams or nightmares.

Other studies show that a majority of people who have other sleep disorders like gastroesophageal reflux, nocturnal asthma, restless leg syndrome, or sleep apnea are most likely to experience night terrors. Obstructive sleep apnea (OSA) has particularly been identified to be more prevalent in more than one-half of children who are diagnosed with sleep terrors.

Other causes & triggers:

• Sleep deprivation
• Depression, stress, or anxiety
• Fever
• Medications that could have side effects on the central nervous system.
• Excessive caffeine
• Sleeping in a new environment away from home
• Lack of adequate sleep
• Sleep problems like sleep apnea
• Restless legs syndrome
• Recent heavy anesthesia for surgery

Risk Factors

Some of the complications that can arise from night terrors include:

• Self-harm during sleep or harm to someone nearby.
• Sleep paralysis, which can make it difficult to breathe.
• Heightened fear of sleep or nightmares and a reluctance to go into any dark place.
• Disturbed sleep.
• Inability to return to deep sleep leads to increased daytime fatigue, drowsiness, and difficulty concentrating on everyday tasks.
• Increased risk for developing chronic insomnia over time.

Read: Acid reflux & snoring.

How Are Night Terrors Prevented and Treated?

Children

In most cases, children who experience night terrors less than twice per month only need treatment if they cannot sleep during the day or after being woken up from a deep sleep. Most kids naturally outgrow these episodes as the nervous system develops with age and time.

If the episodes occur consistently, for three or more times a month, it is recommended that a doctor evaluate the child for appropriate medical advice.

There are some medications and behavioral therapy treatments for children with frequent night terror episodes, such as improving sleep habits, using relaxation techniques before bedtime, keeping a regular bedtime routine, avoiding screen time before bedtime, and keeping their bedroom cool and comfortable.

Night terrors caused by underlying medical conditions can only be treated or reduced by treating that medical condition.

A professional diagnosis by a doctor can help determine whether there are any underlying medical conditions that could be contributing to the parasomnia. In some cases, certain medications, like sedatives or antidepressants, may be considered for kids with persistent night terrors.

Things To Consider:

• Try not to wake up your kid during an episode. It will make them more confused, and they could have more difficulty falling back to sleep. Instead, make sure they don't hurt themselves by thrashing around and try to wait it out.
• If you do decide to wake them, don't shake or shout at the child to get them to wake them up.
• In some extreme cases, night terror could cause the child to sleepwalk. Try to clear the room of any clutter they the could cause them to fall.
• Avoid over-the-counter medicines, sleep or sleep-related (such as cough syrup or anti-allergy medicine). Such medications may cause other severe problems in the long run, such as sleep apnea. Only use doctor-approved treatment options or suggestions.

You can also use preventative measures to avoid sleep terror. If the episodes frequently occur, start by observing your child for about a week or two. Note down how many minutes after bedtime the episodes occur. After that, wake up the child about 15 minutes before the estimated time for the sleep terror episode and keep them awake for about 5 minutes. Continue with this routine for 7-14 days.

Teenagers & Adults

Night terrors are often harmless and require no treatment past the age of 13 years. But it might be to seek treatment options if:

• the episodes harm your partner, relationship, or your health.
• You don't get adequate rest at night.
• actions during an episode (such as thrashing, kicking, sleepwalking, etc.) could harm you or your partner

An underlying condition usually causes sleep terrors in teenagers and adults. In order to identify and treat an underlying diagnosis, it's important to work with a sleep specialist. They will evaluate your condition in order to understand whether you have an underlying cause that may be contributing to your night terrors. They will advise on treatment options or prescribe therapy to help address those causes. This can reduce the episodes or may even help them stop entirely.

The doctor is likely to ask:

• When did the night terrors begin?
• How often do the episodes occur?
• Have you had sleep problems in the past?
• Is there anyone else in your family who has sleep problems?

Sleep specialists may also suggest that you keep a sleep diary to help record your recent sleep habits. They may ask for information from your partner or close family member wh bed partner or family member who has witnessed the episodes.

In a few rare cases, individuals with more than average episodes may be referred for a sleep study to help further evaluate & diagnose underlying/concurrent sleep disorders.

Night Terrors: FAQs Answered.

What causes night terror in adults?

Adult night terrors are typically triggered by stressful events such as traumatic brain injury, significant stress like divorce or death; medical conditions including major depression, insomnia, and other mental illnesses; severe-to-excessive alcohol use; jet lag, and side effects of medication used to treat physical problems like Parkinson disease".

How do I deal with night terrors PTSD?

Treatment for PTSD-induced night terrors should begin with making simple lifestyle changes such as getting a good night's sleep, exercising more, and becoming aware of triggers.

Another way to reduce the risk and severity of PTSD-induced night terrors is by reducing the amount of stress in your life. This can be done by finding ways to enjoy yourself - with activities like painting, reading, or listening to soothing music. Eating healthy, nourishing foods and getting enough sleep can also help. It's worth considering a snoring solution mouthpiece if you have sleep issues.

How long does a night terror last?

Night terrors typically last no more than five minutes.

Can diet affect night terrors?

While there is no adequate evidence that diet can cause night terrors, most kids who experience night terrors have been found to have some level of sensitivity to food coloring and additives, in particular MSG & Red Dye.

However, this does not apply to all. Some children may also experience episodes due to medication additives or amines (commonly found in aged meat, chocolate, some fruit & vegetables) or salicylates.

If you are unsure what meals to eliminate, you can try the FAILSAFE diet/RPAH elimination diet with challenges to find out exactly what foods could be causing the problems. See our snoring mouthpiece on Amazon.

References

Guilleminault, C., Palombini, L., Pelayo, R., & Chervin, R. D. (2003). Sleepwalking and sleep terrors in prepubertal children: what triggers them?. Pediatrics, 111(1), e17-e25.

Sleepwalking, C., & Terrors, S. (2015). JAMA Pediatrics. JAMA, 169(7), 615.

Petit, D., Pennestri, M. H., Paquet, J., Desautels, A., Zadra, A., Vitaro, F., ... & Montplaisir, J. (2015). Childhood sleepwalking and sleep terrors: a longitudinal study of prevalence and familial aggregation. JAMA pediatrics, 169(7), 653-658.

Dhawan, V., Healy, D. G., Pal, S., & Chaudhuri, K. R. (2006). Sleep-related problems of Parkinson’s disease. Age and ageing, 35(3), 220-228.

Germain, A., Hall, M., Krakow, B., Shear, M. K., & Buysse, D. J. (2005). A brief sleep scale for posttraumatic stress disorder: Pittsburgh Sleep Quality Index Addendum for PTSD. Journal of anxiety disorders, 19(2), 233-244.

Lopez, R., Jaussent, I., & Dauvilliers, Y. (2014). Objective daytime sleepiness in patients with somnambulism or sleep terrors. Neurology, 83(22), 2070-2076.