Night Terror (Sleep Terror)

Also members of the unpleasant menagerie of bad dreams and sleeping disorders, Night Terrors are known to be most frequent in children aged 3-13.

Some adults suffer from Night Terrors too.

Why do these disorders happen? What can one do to stop them? Can we prevent them? These are some of the issues I’ll address in this article.

What is the cause of night terrors in adults?

To call adulthood night terrors “undesired events” occurring during sleep, is a bit of an understatement, no matter how we look at it, yet that’s exactly how science defines them.

A parasomnia, a night terror will have one screaming and flailing during sleep, due to an intense bout of inexplicable fear which is not actually linked to a dream.

Sleep terrors in adults generally last a few seconds, though minute-long episodes have also been observed.

While night terrors can affect a whooping 40% of children, their occurrence in adults is much rarer.

From a medical point of view, night terrors are not considered dangerous in any shape or form, besides the obvious psychological impact that their repeated appearance causes. In certain cases, they may cause safety concerns, or may lead to a general lack of sleep. In such cases, specialized help should be sought.

Night Terrors Vs. Nightmares/Other Parasomnias

How do you know you’re dealing with a night terror and not some kind of other parasomnia?

In adults as well as children, night terrors usually begin with a frightening scream, after which the “victim” sits up in bed, or thrashes about, wide-eyed, face flushed, pupils dilated and a general expression of fright on his/her face.

Fast pulse, sweating and heavy breathing are also amongst the symptoms of this nasty disorder.

Night terror victims are often difficult to be awakened, and when they do wake up, they cannot be consoled.

In graver cases, night terror victims may react aggressively to being restrained, and they may run around the house. The disorder is in fact linked to sleepwalking.

Why do night terrors happen?

Exactly why night terrors come about is anyone’s guess at this point.

What I can tell you for certain though is that a lack of healthy sleeping habits obviously facilitates them.

I will also tell you that since they’re arousal-rooted disorders, night terrors happen during the non-REM (Rapid Eye Movement), N3 stage of sleep, which is indeed the deepest stage of NREM sleep, and which isn’t one of the dreaming stages.

That explains why night terrors are not associated by the vivid imagery of nightmares.

Sleepwalking occurs during this stage of sleep too, which explains why the two disorders are “related” to a certain degree.

Indeed, night terrors may in fact be peculiar reactions, triggered by the transition from one sleep stage to another.

With the above in mind, it makes perfect sense that night terrors should happen about 2-3 hours after the “victim” falls asleep. It is at this point that the above mentioned N3 stage of sleep is reached.

Some factors which can promote the occurrence of night terrors are: fever, stress, sleep deprivation, messed-up sleeping schedules, sleep apnea, restless leg syndrome, depression, as well as certain conditions triggered by chemicals, such as alcohol and certain medications.

What can stop night terrors?

The bad news is that there is nothing I can recommend that you do, when say your child is having a night terror episode.

Indeed, science hasn’t progressed as far in this matter as to be able to tell you how to actively intervene and stop such an episode.

All you can really do is take solace in the knowledge that night terror episodes are very brief, and that they do no actual damage to your loved one. In most cases, the “victim” of the night terror won’t even remember the unpleasant incident.

There are certain measures one can take though to limit the likelihood of a night terror, and – unsurprisingly – all these measures are aimed at improving the sleeping habits/conditions of the sufferer.

First of all, making sure the sufferer’s room/bed is free of objects that could cause the victim bodily harm during an episode, is the right thing to do.

A proper sleep schedule should be observed, and all factors liable to disturb sleep one way or another, should be eliminated. In this regard, you should get rid of all noise/light-related stimuli, in addition to all high-energy activities before bedtime, including cell-phone tinkering and the watching of television.

Chemical triggers, such as sugar and caffeine, should also be done away with.

Why do people suffer from sleep terror?

Given that I can definitively draw a link between night terrors and sleepwalking, or go even further and say that the two share the same root causes, I can also state that the triggers which bring about sleepwalking episodes are the same as the ones that result in night terrors.

In this regard, the repertoire is unfortunately rather vast: besides head injuries, we can include hyperthyroidism, stress and encephalitis.

Unfortunately, in the realm of sleep, the boundaries between various sleep disorders cannot be drawn up clearly and definitively. One such disorder can trigger another and so on. Therefore, other sleep problems like restless leg syndrome, and sleep apnea can also be jotted down among the multitude of causes that may lead to night terrors.

Now then, in a previous piece, I talked about how different sleep disorders can be traced back to genetic factors. Unfortunately, this holds true for one’s propensity to developing the problem of night terrors too.

Fever and various medications come into the equation as well, and of course: being a child.

As already stated above, children are by far more prone to having night terrors than adults. Sleep disorders in general, tend to be more frequent in children, a state of affairs possibly explained by the actively developing brains of the young ones.

Is it Normal for Night Terrors to Occur Early in the Sleep Cycle?

Night terrors typically occur during the first NREM cycle, often within the first few hours of sleep, particularly during stages 3 and 4 of NREM sleep, which are the deepest stages of sleep.

(It typically takes 60 to 90 minutes to reach the first NREM cycle after falling asleep.)

Night terrors are less likely to occur earlier than that because this period usually corresponds to lighter stages of NREM sleep (stages 1 and 2).

However, exceptions can occur based on individual sleep patterns and underlying conditions that may alter the sleep architecture.

For example, drugs that can decrease sleep latency lead to an earlier onset of NREM sleep, in which night terrors occur. Here are some of the drugs that can cause this:

• zolpidem (Ambien)
• olanzapine
• gaboxadol
• sodium oxybate (Xyrem)
• clonazepam

Also, there are drugs that reduce REM sleep and promote earlier NREM sleep onset, mostly antidepressants such as:

• amitriptyline
• nortriptyline
• clomipramine

Finally, some sleep disorders are also associated with going into the first NREM cycle earlier than the normal 60-90 minutes, such as epilepsy and sleep apnea.

How do you prevent night terrors?

Prevention is always better than treatment and this axiom holds doubly true for night terrors. While – as said above – stopping a night terror in its tracks is impossible, there’s a lot that can be done to prevent the problem.

First of all: if it is established with certainty that the main cause of the sleep disorder is an underlying health condition, that condition needs to be treated and eradicated. Once such underlying issue – which is rather frequent in adults too – is obstructive sleep apnea.

Another step which fits in nicely with this line of thought, is to deal with stress. Once anxiety and stress are eliminated, the sufferer might well find the night terrors gone as well.

One simple and perhaps a little contradictory measure is anticipatory awakening. This consists in the waking of the night terror sufferer around 15 minutes before the event occurs.

While this is relatively easy to accomplish timing-wise (we do know by-and-large when the problem is likely to strike), it might mess up the sufferer’s sleep schedule, and thus – while temporarily averting it – it may end up contributing to the problem in the long-run.

Medications, such as antidepressants, might be used in especially grave cases, to treat the problem too.

Do night terrors go away?

Yes and no.

Night terrors do tend to stick to a sort of periodic schedule: they may strike every night for say a whole week, after which they subside, and they leave the sufferer alone for a while, only to resurface again at an opportune time. A sickness, an overly stressed period in the life of the sufferer, or episodes of exhaustion may indeed bring it all back.

For children, the good news is that as they get older, night terrors will indeed become less and less frequent, to the point that they “go away” completely.

If a night terror does not go away within a week, consulting with a sleep specialist might be in order. This is especially true for adults, who should in theory be much less susceptible to developing the problem to begin with.

Do you wake someone having night terrors?

Generally, waking someone in the midst of a night terror is not a good idea.

As unnatural a course of action as it would seem when seeing another human being in panic, just let the terror run its course. The sufferer will soon just scream it out and go right back to sleep.

As I already said above, most night terror sufferers won’t even remember their scary run-in with this parasomnia.

The outside observer should not intervene by restraining the victim either, as that may result in added confusion and still more panic.

Even when awakened, a night terror sufferer will go back to sleep quickly an most likely forget about the ordeal right there and then.

If you do indeed feel an overwhelming need to help, just be gentle, and talk to the sufferer (most often a child) gently, letting him/her know that you are there. Loud noises and sudden movements will only add to the sufferer’s plight.

How long do night terrors last?

While most such terrors will only last a few seconds, maybe a minute from the point of view of an outside observer, the state of arousal that they generate can last for about 10 minutes, or, in some extreme cases, for an agonizing 40 minutes.

Are night terrors contagious?

Absolutely not. As discussed above, they are elicited by a set of factors which cannot in any shape or form be transmitted from one person to another.

Here’s a resource for those who would like to learn more about night terrors in toddlers.