Night terrors or sleep terrors are a parasomnia, which is an undesired behavior during sleep. Night terrors are different than nightmares in that they involve someone screaming and/or flailing while asleep, and often occur with sleepwalking. Episodes usually last for seconds to a few minutes and are more common in children than adults, with most children outgrowing the behavior by their teen years.
Night terrors are similar to sleepwalking in that they occur usually during the earlier part of the night, and very rarely during naps. Children who experience a night terror usually don't remember anything about it, while adults may remember a small part of a dream they had during an episode.
Common occurrences during a sleep terror include:
- kicking, thrashing, and flailing arms
- sweating, increased heart rate and respiration
- sit up in bed looking fearful
- sometimes paired with sleepwalking where they may get up and walk around, and can include aggressive and violent behavior
As almost 40% of children experience occasional sleep terrors, it's not a big cause for concern. If they are happening often, and the child or adult is not getting enough quality sleep, or if they're getting injured, you may want to talk to a sleep specialist about it.
Night terrors are caused by stimulation of the central nervous system (CNS) during deep sleep. It's where most of the brain is asleep, except the person can scream and move.
According to Seattle Children's Hospital, night terrors can be triggered by:
- sleep deprivation
- irregular sleep schedule (due to travel for example)
- stress during the day
- full bladder
- anesthesia from surgery
- sleep apnea
And the combination of stress, medication, being overtired, and having a heavy meal before bed increases the risk of having night terrors that night.
Night terrors also look to have a genetic component. Some people that have night terrors don't know that others in their family have experienced them as well, because they thought the episodes were just nightmares.
What to do During a Night Terror
Don't try to awaken a person experiencing a night terror. It's better to do things that will help calm them down, such as talking calmly, hugging them, or touching them in a way that relaxes them. The Night Terror Resource Center recommends agreeing with what they are saying or doing and don't yell or force physical contact.
If your child experiences night terrors, and you have a grandparent or babysitter watching them, inform them of what may happen and what to do.
How to Help a Person with Night Terrors
If you can isolate triggers that help bring on night terrors, reducing or eliminating the trigger can stop night terrors. Common strategies are:
- reduce daytime stress
- establish a stress-reducing routine every night before bed
- follow a good sleep hygiene program
- get adequate sleep
- reduce or eliminate alcohol
Scheduled awakening therapy has been shown to cure night terrors in 9 out of 10 children. It involves waking the child up 15 to 30 minutes before the night terrors usually occur.
A product that was developed by post-graduates of Stanford University's Biodesign Innovation Fellowship is called the Lully Sleep Guardian. It's placed under the mattress and will vibrate enough to partially awake a sleep terror sufferer from going into deep sleep, right at the time that the episodes usually happen, yet it doesn't prevent the person from getting quality sleep. The vibration happens for about 3 minutes and the device has a smart algorithm that learns the person's sleep habits and notifies parents when to turn the device on, which they can do via a smartphone app. The device has so far been very successful in preventing sleep terrors in many children.
It's also important that you make your home safe for someone whose night terrors may be accompanied by sleepwalking:
- Hide car keys before you go to bed, so your sleepwalker doesn't drive.
- Block stairs entrances so they don't fall down them. Otherwise, have the sleepwalker sleep on the first floor if possible.
- Lock doors and windows, and if possible, put an alarm on them to prevent them from leaving.
- Removes obstacles to prevent tripping, such as items on the floor, cords, etc.
- Make sure all weapons, as well as sharp or fragile items are out of reach.
- Children who sleepwalk shouldn't be in a bunk bed.
When to See a Doctor
According to Stanford Children's Health, night terrors usually aren't a cause for big concern. But if any of the following occur, you should call a doctor:
- episodes last more than 30 minutes
- the person with night terrors has drools, stiffens, or jerks during night terrors
- night terrors are happening on a regular basis
- the sufferer does something dangerous during episodes
- other symptoms occur with night terrors
- your child or person with night terrors has daytime fears
- you feel family stress may be contributing to the episodes
A doctor will review medical history and may include a physical exam to look for any possible causes or contributors. Sometimes a doctor may recommend a sleep study which may include a polysomnography, where sensors will record brain waves and vital signs. The sleep session may also be recorded.