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Night terror

Definition

Night terrors are a sleep disorder in which a person quickly awakens from sleep in a terrified state.

Alternative Names

Pavor nocturnus; Sleep terror disorder

Causes, incidence, and risk factors

Night terrors (sleep terrors) occur during deep sleep, usually during the first third of the night. The cause is unknown but night terrors may be triggered by fever, lack of sleep, or periods of emotional tension, stress, or conflict.

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

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 with emotional tension and/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 awaken a child who is having a night terror.
• The child may be sweating, breathing very fast (hyperventilating), have a fast heart rate, and dilated pupils.
• The spell may last 10 - 20 minutes, then normal sleep returns.

Most children are unable to explain what happened the next morning. There is often no memory of the event when they awaken the next day.

Children with night terrors may also sleep walk.

Signs 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 comfort and reassurance. Psychotherapy or counseling may be appropriate in some cases. Benzodiazepine medications (such as diazepam) used at bedtime will often reduce night terrors; however, medication is rarely recommended to treat this disorder.

Support Groups

Expectations (prognosis)

Most children outgrow night terrors in a short period of time. They don't usually remember the event. Stress reduction and/or psychotherapy may be helpful for night terror in adults.

Complications

• Insomnia (unusual)

Calling your health care provider

Call for an appointment with your health care provider if:

• The night terrors are persistent or frequent
• They occur often enough to regularly disrupt sleep
• 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.