What are sleep terrors? Causes, Symptoms, Diagnosis and More

Sleep terrors are terrifying episodes of screaming, panic, and flailing that occur while you're still sleeping. Sleep terrors are also known as night terrors and are associated with sleepwalking. 

Sleepwalking and sleep terrors are both parasomnia events— unwelcome happenings during sleep. Sleep terrors generally last between seconds and a few minutes, although episodes may endure longer.

Sleep terrors affect around 40% of children and less than 10% of adults. Sleep terrors are not generally a cause for concern, even though they are frightening. Most children outgrow sleep terrors by their teenage years.

If a child's recurring nocturnal fears interfere with getting enough sleep, or if they put the youngster in danger, they should be treated.

What Are Night Terrors?

Night terrors are defined as frightening nightmares that happen at night and cause your child to cry out in terror. The nightmare may be so intense that it wakes your child up. 

These dreams typically involve vivid images of monsters, animals, or scary people. Children who have night terrors tend to be afraid of their shadows and find sleeping difficult.

Night terrors are also known as parasomnias. This term refers to any dream-related behaviour that occurs during sleep. It includes nightmares, night terrors, and sleepwalking.

The most common form of parasomnia is REM (rapid eye movement) sleep behaviour disorder, which involves acting out one’s dreams. Other forms include sleep talking and sleepwalking.What are the symptoms of Night Terrors?

Sleep terror differs from a nightmare in that the dreamer awakes during a nightmare and may recall details, but the person experiencing a sleep terror episode remains asleep. 

Children seldom recall anything about their nocturnal terrors when they wake up. Adults may recall a dream fragment they had during sleep terrors. Sleep terrors generally occur in the first third to first half of the night, and naps are rare exceptions. 

Sleep terror might cause sleepwalking.

A person experiencing a sleep terror episode may:

• Wake up with a terrifying scream or shout.
• Sit upright in bed, frightened
• Stare wide-eyed
• Sweaty palms, a rapid pulse, flushed cheeks and dilated pupils are common signs.
• Kick, thrash or teeth grinding
• It will be difficult to arouse, and you'll be bewildered if you are.
• Be inconsolable
• You don't have much memory of the incident or a vague recollection of the following day.
• If blocked or bound, you may get out of bed, run around the house, or engage in angry behaviour.

How Do You Know if Your Child Has Night Terrors?

When you suspect your child has night terrors, the first thing you should do is to make sure they are safe. 

Make sure there are no loose objects around your child, especially sharp ones like knives or scissors. 

Also, check for pets that could injure your child.

If you think your child might have night terrors, keep an eye on them throughout the night. When you notice signs of distress, such as sweating, trembling, or gasping for breath, take action immediately. 

Night terrors and nightmares - The difference between the two

Although both night terrors and nightmares are unpleasant experiences, they differ in many ways. 

Nightmares are more likely to occur after waking up from deep sleep, whereas night terrors are less likely to occur during deep sleep. Nightmares are generally triggered by external stimuli such as loud noises or bright lights. 

However, night terrors are often triggered by internal factors such as emotions or fears.

Nightmares are more frequent than night terrors. Most children have nightmares once every few weeks, but only about 1% of children have night terrors.

Nightmares can last anywhere from seconds to minutes. A single night of terror lasts for just a few minutes.

Nightmares are almost always associated with feelings of fear. Although night terrors may feel frightening, they are not accompanied by strong emotions.

Nightmares are usually remembered by the person experiencing them. Although night terrors are forgotten quickly, they can sometimes trigger memories of past events.

Nightmares are associated with physical symptoms such as shaking, sweating, and rapid breathing. Because these symptoms are similar to those experienced during a panic attack, they can be mistaken for a heart attack. If your child seems to be having a heart attack, call 911 right away.

What are the causes of Night Terror?

Sleep terrors are parasomnia, which is bad behaviour or occurrence during sleep. Sleep terrors are being awake during N3 sleep, the deepest stage of non-rapid eye movement (NREM) sleep. 

Sleepwalking can also be considered an NREM problem in conjunction with sleep terrors.

Various factors can contribute to sleep terrors, such as:

• Sleep deprivation and intense tiredness are both symptoms.
• Stress
• Sleeping schedule disruptions, travelling, and sleep interruptions are common sleep problems.
• Fever

Sleep terrors can be induced by a variety of issues that disturb sleep, such as:

• The most frequent form of sleep apnea is obstructive sleep apnea, which involves abnormal breathing patterns during sleep.
• Restless legs syndrome
• Some medications
• Depression and anxiety are examples of mood difficulties.
• In adults, alcohol use

Risk factors

If your family has a history of sleep terrors or sleepwalking, you're more likely to have sleep terrors. Sleep terrors are more prevalent in girls than boys.

Complications

Sleep terrors are potentially dangerous, as they may induce various issues. Some of the possible consequences associated with them include:

• Excessive daytime drowsiness, which might result in problems at school or at work, as well as difficulties with ordinary activities
• Disturbed sleep
• Regret about the sleep terrors or difficulties in personal relationships
• Injury to oneself or rarely anyone close by

Who gets the Night terror?

Night terrors have been noted in kids who are:

• Overtired, ill, or stressed out.
• taking a new prescription
• Moving to a new place or away from home may cause you to lose sleep for the first several nights.
• insufficient sleep
• having too much coffee or caffeine-high drinks

The incidence of night terrors is relatively low: only 3% to 6%, whereas nearly every youngster, will have a nightmare once in a while. 

Night terrors typically occur in children between the ages of four and twelve, although they have been observed in babies as young as 18 months. Boys appear to be more prone to experience them.

Some youngsters may be predisposed to night terrors, according to research. Night terrors are about 80 per cent inherited; those who suffer from them have a family member who also did so or sleepwalking (a similar type of sleep disorder).

Before the experience of a nightmare completely fades, a child might have only one-night terror or many. When the nervous system matures, most night terrors go away on their own.

How Can You Help Your Child Manage Their Night Terrors?

When your child has night terries, try to help them calm down. Try to stay close to your child and reassure them that everything will be fine. 

Avoid scolding your child. Instead, tell your child what happened in their dream. Ask your child questions about the dream. 

For example, ask: "What did you see? What was happening? Who were you with? Why were you scared? How did it end?"

If your child can talk about their dream, encourage them to describe it in detail. Encourage your child to use words rather than images.

Try to avoid making sudden movements or startling sounds. This can startle your child and increase anxiety.

Try to distract your child from their nightmare by talking calmly and reassuringly. Tell your child that you love them and that nothing wrong will ever happen.

You can also offer comforting touch. Hold your child gently and let them know that you are there.

If your child cannot fall asleep, don't force them to go back to bed. Give your child time to rest. Offer your child something to eat or drink if they feel hungry or thirsty.

Diagnosis

Your doctor will examine your medical history and symptoms to determine whether you have a sleep terror. Your evaluation may include:

• Physical exam. Your doctor may conduct a physical examination to determine if any underlying issues contribute to sleep or terrors.

• You are discussing your symptoms. Your doctor will diagnose bedtime panic attacks based on your account of the events. 

Your doctor may investigate your family's history of sleeplessness. Your physician or partner may also request a questionnaire about sleep habits

• A nocturnal sleep study (polysomnography). Your doctor may advise an overnight study in a sleep lab in some situations. 

While you sleep, sensors placed on your body record and monitor your brain waves, blood oxygen levels, heart rate, breathing pattern, eye movements, and leg movements. You may be filmed during the sleeping phases to document your actions.

Treatment

Infrequent sleep terrors seldom require treatment.

If the sleep terrors lead to or are caused by physical harm, family discord, embarrassment or disrupted sleep for the person who has them, and if the episodes cause property damage or other issues that need to be addressed (e.g., injuries), therapy may be required. 

Treatment generally aims to enhance safety and reduce causes or triggers.

Treatment options may include:

• They are treating any underlying condition. The underlying issue is treated if the sleep terrors are linked to a medical or mental health condition or another sleep problem like obstructive sleep apnea

• You are addressing stress. Your doctor may recommend that you see a therapist or counsellor if stress or worry appears to be causing sleep terrors. Cognitive-behavioural therapy, hypnosis, biofeedback, or relaxation treatment might all assist.

• Anticipatory awakening. This entails alerting the person who has sleep terrors 15 minutes before they usually experience the event. The individual then stays awake for a few minutes before falling asleep again.

Medication/Treatment

Treatment for infrequent sleep terrors isn't usually necessary.

If the sleep terrors lead to the potential for injury, are disruptive to family members, or result in embarrassment or sleep disruption for the person who has sleep terrors, treatment may be needed. 

Treatment generally focuses on promoting safety and eliminating causes or triggers. Treatment options may include:

• They are treating any underlying condition. If the sleep terrors are associated with an underlying medical or mental health condition or another sleep disorder, such as obstructive sleep apnea, treatment is aimed at the underlying problem.

• They are addressing stress. If stress or anxiety contributes to sleep terrors, your doctor may suggest meeting with a therapist or counsellor. Cognitive-behavioural therapy, hypnosis, biofeedback or relaxation therapy may help.

• Anticipatory awakening. This involves waking the person who has sleep terrors about 15 minutes before they usually experience the event. Then the person stays awake for a few minutes before falling asleep again.

• Medication. Medication is rarely used to treat sleep terrors, particularly for children. However, if necessary, the use of benzodiazepines or certain antidepressants may be effective.

What happens when I'm having night terrors?

Night terrors are frightening because they can happen unexpectedly, even while you're soundly asleep. They also tend to occur more frequently than day terrors.

During a night terror episode, you may wake up with a start, feeling confused and disoriented. You may have trouble breathing or talking. You may feel afraid or anxious. You may not remember what happened during the dream.

You may find yourself trying to get out of bed, but you won't be able to move. Or you may try to open your eyes, but you can't. You may thrash around in bed, yelling or screaming.

You may think someone else is there. But no one is. It's just you — alone in the dark.

When you finally fall back asleep, you'll probably have nightmares. These dreams often involve scary things happening to you. Some people say their dreams are so vivid that they seem real. Others say they don't remember them.

The good news is that most people experience only one or two night terrors each month. And once you've had a night terror, you should never have another one.

Conclusion

Sleep terrors are very common among young children. Most kids grow out of them by age 5 or 6. However, if they continue into adulthood, they can cause problems.

Nightmares are also common in adults. They can be caused by many different factors, including depression, substance abuse, anxiety disorders, insomnia, post-traumatic stress disorder (PTSD), and other conditions.

Nightmares can be frightening and disturbing. 

They can disrupt sleep patterns and make it difficult to function properly.

If you have nightmares, kindly talk to your doctor.