Night terrors are intense episodes of fear or panic that occur during sleep. These events differ from nightmares, which are bad dreams that typically awaken an individual and are often remembered. In contrast, people experiencing night terrors usually remain asleep and have no memory of the event upon waking.
Understanding Night Terrors
Night terrors manifest with distinct characteristics, including screaming, thrashing, rapid breathing, and a fast heart rate. Individuals may also exhibit dilated pupils, sweating, and appear confused or dazed, sometimes even sitting up or moving violently.
These episodes occur during non-rapid eye movement (NREM) sleep, specifically the deep sleep phase, usually within the first third of the night. The brain is partially asleep and partially awake during a night terror, resulting in a state of panic or fear.
Night terrors are most common in children, affecting an estimated 1% to 6.5% of those between 1 and 12 years of age, with a peak incidence around ages 3 to 7. Most children outgrow them by adolescence.
While less common, night terrors can also affect adults, with approximately 2.2% experiencing them.
Several factors can contribute to the occurrence of night terrors. Sleep deprivation is a frequent trigger, as is an irregular sleep schedule. Stress, anxiety, and fever can also increase susceptibility. Underlying medical conditions, such as obstructive sleep apnea or restless legs syndrome, may also play a role by causing brief awakenings during sleep.
Immediate Steps During an Episode
When a night terror is actively occurring, the primary focus should be on ensuring the safety of the individual.
It is generally advised not to try and wake the person experiencing the terror, as this can increase their confusion and distress, potentially prolonging the episode. Instead, allow the episode to run its course.
Attempts to restrain or physically stop the person from moving can be dangerous for both the individual and the caregiver, as they are in a deep sleep state and may not respond predictably. Speaking to them slowly, quietly, and calmly can be helpful if they are out of bed, gently guiding them back.
It is important to create a safe environment around the person. This involves moving any potentially dangerous objects away from the bed and ensuring windows and doors are secured to prevent accidental injury.
Strategies for Prevention
Establishing a consistent sleep schedule is a foundational step in preventing night terrors. Going to bed and waking up at the same time each day, even on weekends, helps regulate the body’s natural sleep-wake cycle.
Creating a relaxing bedtime routine can prepare the body and mind for sleep. This might include quiet, calming activities such as reading, taking a warm bath, or solving puzzles. Avoiding screen time for at least an hour before bed can also contribute to better sleep hygiene.
Managing stress and anxiety is another important preventive measure. Identifying sources of stress and finding healthy coping mechanisms, such as relaxation exercises or talking about concerns, can reduce the likelihood of night terrors.
Addressing any underlying medical conditions, like sleep apnea, is also important.
For recurring night terrors that happen at a predictable time, a technique called scheduled awakenings can be effective. This involves gently waking the individual approximately 15 minutes before the expected onset of a night terror and keeping them awake for a few minutes before allowing them to fall back asleep. This brief interruption can reset the sleep cycle and prevent the terror.
When to Seek Professional Guidance
While occasional night terrors are generally not a cause for concern, there are specific situations where professional medical or psychological guidance is advisable.
If night terrors occur frequently, such as several times a week, or if they regularly disrupt the sleep of the affected individual or other family members, it may be time to consult a healthcare provider.
If the episodes cause excessive daytime sleepiness or significantly impact daily functioning, such as school or work performance, an evaluation is warranted.
Additionally, if night terrors continue beyond the teenage years or begin in adulthood, or if there are concerns about underlying medical or psychological conditions, a healthcare professional can provide a diagnosis and appropriate treatment.
Sleep specialists, pediatricians, or therapists are types of professionals who can offer support and intervention.