Night terror

Definition

Night terrors (sleep terrors) are a sleep disorder in which a person quickly wakes from sleep in a terrified state.

Alternative Names

Pavor nocturnus; Sleep terror disorder

Causes

The cause is unknown, but night terrors may be triggered by:

• Fever
• Lack of sleep
• Periods of emotional tension, stress, or conflict

Night terrors are most common in boys ages 5 - 7, although they also can occur in girls. They are fairly common in children ages 3 - 7, and much less common after that. Night terrors may run in families. They can occur in adults, especially when there is emotional tension or the use of alcohol.

Symptoms

Night terrors are most common during the first third of the night, often between midnight and 2 a.m.

• Children often scream and are very frightened and confused. They thrash around violently and are often not aware of their surroundings.
• You may be unable to talk to, comfort, or fully wake up a child who is having a night terror.
• The child may be sweating, breathing very fast (hyperventilating), have a fast heart rate, and widened (dilated) pupils.
• The spell may last 10 - 20 minutes, then the child goes back to sleep.

Most children are unable to explain what happened the next morning. They often have no memory of the event when they wake up the next day.

Children with night terrors may also sleep walk.

In contrast, nightmares are more common in the early morning. They may occur after someone watches frightening movies or TV shows, or has an emotional experience. A person may remember the details of a dream when he or she wakes up, and will not be disoriented after the episode.

Exams and Tests

In many cases, no further examination or testing is needed. If the night terror is severe or prolonged, the child may need a psychological evaluation.

Treatment

In many cases, a child who has a night terror only needs to be comforted.

Reducing stress or using coping mechanisms may reduce night terrors. Talk therapy or counseling may be needed in some cases.

Benzodiazepine medicines (such as diazepam) used at bedtime will often reduce night terrors, but are rarely used to treat this disorder.

Outlook (Prognosis)

Most children outgrow night terrors in a short period of time. The number of episodes usually decreases after age 10. Rarely, children will have problems falling asleep or staying asleep.

When to Contact a Medical Professional

Call for an appointment with your health care provider if:

• The night terrors occur often
• They disrupt sleep on a regular basis
• Other symptoms occur with the night terror
• The night terror causes, or almost causes, injuries

Prevention

Minimizing stress or using coping mechanisms may reduce night terrors. The number of episodes usually decreases after age 10.

References

Owens JA. Sleep medicine: In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 18.

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