Night terror symptoms typically include screaming or thrashing, often accompanied by sweating or heavy breathing. You may also feel confused as you wake up.

Night terrors, also known as sleep terrors, are intense episodes of fear and panic that occur during non-rapid eye movement (NREM) sleep, typically within the first few hours of falling asleep.

They’re classified as a type of ‘partial arousal parasomnia,’ where the person is partially awake and partially asleep. Other types of partial arousal parasomnias include sleepwalking and sleep paralysis.

Unlike nightmares, which occur during REM sleep and are often remembered, night terrors usually leave the person confused and agitated, often with no memory of the episode.

They’re more common in childhood, affecting approximately 17-21% of children, and tend to diminish with age. About 1-4% of adults experience them.

Let’s explore the symptoms, causes, and treatments for night terrors.

Night terrors are brief episodes lasting from 30 seconds to 5 minutes. They are characterized by the sleeper sitting up in bed, screaming, and showing signs of intense fear. These episodes often involve incoherent vocalizations and the sleeper may attempt to flee, leading to potential injury.

Symptoms of night terrors include:

  • screaming in terror
  • confusion and incoherent speech
  • sitting up in bed or thrashing around
  • no or little recollection of the event the next morning
  • sudden awakening from sleep with a sense of intense fear
  • difficulty waking or comforting the person experiencing the night terror
  • physical signs like fast heartbeat, rapid breathing, sweating, or dilated pupils

The exact cause of night terrors isn’t fully understood, but they’re believed to result from a mix of:

  • developmental
  • environmental
  • organic
  • psychological
  • genetic factors

Night terrors are linked to disruptions or abnormalities in the deepest stage of NREM sleep, known as slow-wave sleep. This stage is characterized by slow brain waves and is thought to be important for physical and mental restoration.

According to research from 2020, night terrors appear to occur more often with the following conditions:

Additionally, certain medications may increase the amount of stage three and four sleep, potentially leading to sleep terrors. These medications include:

  • neuroleptics
  • sedatives-hypnotics
  • stimulants
  • clonidine
  • opiates
  • antihistamines

Medical conditions like nocturnal asthma and gastroesophageal reflux may also contribute to the occurrence of sleep terrors.

In adults, psychological factors are more common, and there is an association between sleep terrors and psychiatric disorders such as depression and anxiety.

There is also a strong genetic predisposition to sleep terrors, with a high prevalence of certain genetic alleles found in individuals with the condition.

Night terrors typically don’t require specific treatment, as they often resolve on their own with age. However, if they’re frequent and severe or significantly disrupt sleep, several approaches may be considered:

  • Improving sleep habits: Ensuring a regular sleep schedule, adequate sleep duration, and a comfortable sleep environment can help reduce the frequency of night terrors.
  • Stress reduction: Techniques such as relaxation exercises, mindfulness, and stress management strategies can help reduce overall stress levels, which may contribute to night terrors.
  • Counseling or therapy: Cognitive behavioral therapy (CBT) or counseling may be beneficial, especially if stress or anxiety is a contributing factor.
  • Medication: In some cases, medications such as benzodiazepines or antidepressants may be prescribed to help manage symptoms, but these are typically used as a last resort due to the potential for side effects.
  • Treatment of underlying conditions: Addressing any underlying sleep disorders, such as sleep apnea, restless legs syndrome, or other medical conditions, may help reduce the frequency of night terrors.

In a 2014 case study, a 58-year-old man with night terrors showed improvement with a treatment plan that included sleep-education sessions and the use of paroxetine, a selective serotonin reuptake inhibitor (SSRI). This approach not only improved his sleep quality but also reduced his anxiety levels.

If you’re with someone experiencing a night terror, it’s important to stay calm and take steps to ensure their safety without trying to wake them abruptly, as this can lead to confusion and disorientation.

Here are some tips to help someone during a night terror:

Stay calm

Approach the situation calmly and reassuringly. Remember, the person experiencing the night terror is not in danger, even though they may seem distressed.

Ensure safety

Gently guide the person back to bed if they’re standing or moving around. Remove any potentially dangerous objects from the area to prevent injury.

Do not wake them

Unlike with nightmares, it’s generally not helpful to try to wake the person during a night terror.

Provide reassurance

If the person seems to respond to your voice, calmly reassure them that they’re safe and that the episode will pass. Avoid trying to reason with them or asking questions that require a complex response.

Scheduled awakenings

Track your child’s or partner’s sleep patterns to find the average time of their night terrors. Gently wake them 15 to 30 minutes before this time, let them fully wake up, and then allow them to go back to sleep.

Try to stay consistent with this routine every night for 2 to 4 weeks.

It’s important to note that this method is effective only if sleep terrors occur around the same time every night.

Helping children with night terrors involves creating a safe sleeping environment and establishing a calming bedtime routine. Here are some strategies:

  • Maintain a regular bedtime routine to promote relaxation before sleep.
  • Ensure the child gets enough sleep and follows a consistent sleep schedule.
  • Create a calm, quiet, and comfortable sleep environment.
  • Minimize stress and anxiety before bedtime.
  • Provide comfort and reassurance if the child experiences a night terror.
  • If the night terrors happen at approximately the same time each night, consider scheduled awakenings.
  • Consider discussing the issue with a pediatrician or sleep specialist for further guidance.

Night terrors are episodes of panic that occur during sleep, predominantly affecting children but also seen in adults, especially those with psychiatric conditions. Symptoms include:

  • abrupt awakening with a scream
  • overwhelming fear
  • confusion
  • difficulty returning to calmness

Unlike nightmares, night terrors occur during NREM sleep and are often not remembered afterward. They can be distressing for both the person experiencing them and their loved ones.

If night terrors are persistent and significantly impact your daily life, consider consulting a healthcare professional for an evaluation and management options.

If your child or loved one deals with night terrors, consider the following:

  • Ensure a quiet, comfortable sleeping environment.
  • Maintain a regular sleep schedule.
  • Reduce stress and anxiety through relaxation techniques.
  • Address underlying medical or mental health conditions.
  • Encourage refraining from alcohol, drugs, or caffeine before bed.