Sleep Terrors (Night Terrors): Causes, Symptoms & More

Sleep terrors are moments of intense fear and screaming while you’re still sleeping. Sleep terrors, also known as night terrors, are frequently accompanied by sleepwalking. Similar to sleepwalking, sleep terrors are considered parasomnias, an undesirable occurrence while sleeping. Sleep terror episodes normally last from seconds to minutes, though they may last longer.

Approximately 40% of children experience sleep terrors, compared with an even smaller percentage of adults. While sleep terrors can be frightening, they’re usually nothing to worry about. Sleep terrors typically disappear by the time a child reaches their teen years.

It may be necessary to treat a sleep terror disorder if it causes difficulty getting enough sleep or it poses a safety risk.

The sleep cycle consists of two kinds of movements: rapid eye movement (REM) and non-rapid eye movement (non-REM). Usually, within 90 minutes of falling asleep, children experience night terrors during non-REM sleep.

Sleep terrors, or night terrors, affect up to 6 out of 100 children. Those affected can be boys or girls and of any race. Families are more likely to experience night terrors.

Read: Central Sleep Apnea

Night terrors vs. nightmares

Common nightmares occur during REM sleep, whereas night terrors occur during waking hours. Night terrors might make it difficult for you to wake your child. After the episode, your child will probably not remember what happened. 

Night terror symptoms

The morning after a child experiences sleep terrors, he or she usually does not remember anything about them. Many adults remember a dream fragment from their sleep terrors.

It is not uncommon for sleep terrors to occur during naps, but generally in the first third of the night. These can lead to sleepwalking.

Children who experience night terrors may also exhibit the following symptoms:

• Fast heart rate
• Fast breathing
• Sweating
• Dilated pupils

An episode of night terrors can cause a child to:

• Sit up in bed
• Flail around in bed
• Scream
• Seem to be awake, but look confused
• Seem to be unaware that their parents are nearby
• Not talk
• No response to comfort from their parents

Usually, episodes last less than a minute. However, the child may need as long as 30 minutes to relax and return to sleep.

Read: Psychophysiological Insomnia

Night terror causes and triggers

Parasomnias are undesirable behaviors or experiences that occur while sleeping. Sleep terror is an arousal disorder, which means it occurs during the third stage of the non-rapid eye movement (NREM) sleep cycle. It is also possible to experience sleepwalking in addition to sleep terrors.

Sleep terrors are caused by a variety of factors, including:

• Lack of sleep and extreme fatigue
• Stress
• Disruptions in sleep schedules or travel
• Fever

An underlying condition that interferes with sleep can sometimes trigger night terrors, such as:

• Sleep-disordered breathing. An abnormal breathing pattern is the common symptom of obstructive sleep apnea, a group of disorders
• Restless legs syndrome
• Some medications
• Mood disorders, such as depression and anxiety
• In adults, alcohol use

Risk factors

Families with a history of sleep terrors or sleepwalking are more likely to experience sleep terrors. Girls tend to experience sleep terrors more frequently than boys.

Read: Chronic Insomnia Disorder

Complications

Sleep terrors may result in the following complications:

• Excessive daytime sleepiness may be problematic at school, work, or in everyday life
• Disturbed sleep
• Relationship problems or night terrors causing embarrassment
• Self-inflicted injury or injury to someone close to you

Night terror diagnosis

An examination by a doctor is usually enough to diagnose night terrors in children.

If they suspect that they are suffering from other conditions, they might conduct the following tests:

• An EEG measures brain activity; it can be used to detect seizures
• A study polysomnography is used to check for breathing problems during sleep

Night terror treatment

Night terrors are not treatable, but they usually cease as a child grows older.

It is rare that your child’s doctor will prescribe low-dose benzodiazepines (such as imipramine) or tricyclic antidepressants (such as clonazepam) if the episodes interfere with their day-to-day activities.

Read: Dyssomnia

Home remedies for night terrors

Here are a few things parents can try:

• If your child suffers from an episode, you should make their room safe
• Discard any electronic screens or noises that could disturb their sleep
• Make sure your child is not stressed out
• Encourage your child to get enough sleep. If your child is too tired, tell them to go to bed
• Develop a bedtime routine that your child enjoys and stick to it
• Establish a routine for waking up every morning

Make sure your child does not wake up during an episode. If this happens, they might become more confused, and it might take longer for them to sleep again. Keep an eye on them and make sure they don’t hurt themselves thrashing around or tripping over something while they’re in their room.

Night terror prevention

You can try several things to help your child if they have frequent sleep terrors. A good example is to interrupt their sleep.

• First, note how much time has passed since bedtime when the night terrors began
• Your child should be awake and out of bed 15 minutes before they should have a night terror. Make sure they go to the bathroom first
• Repeat this once a week until the terror stops

Most episodes of night terror last for a few weeks. The majority of children grow out of them by the time they reach their teens.

Read: How Pandemic COVID-19 Affects Our Dreams

When you should call your doctor

It’s not dangerous for your child to have night terrors, but they can disrupt their sleep. More than half of children suffer from sleep disorders severe enough to require medical attention.

You may find that speaking with your child’s doctor eases your anxiety. Whenever your child experiences a night terror, let them know how frequent or long it lasts. A medical professional may be able to rule out other causes of night terrors.