You’re sleeping soundly in the middle of the night. Suddenly, you hear screams of intense fear. You rush over to a loved one flailing and thrashing from an invisible terror. You panic yourself because of the frightening ordeal, and you think:
What can I do?
Night terrors may seem a cause of great alarm, especially if it’s your first time seeing it happen. You’ll likely feel fear from seeing a family member be so terrified from something you can’t fight off. However, sleep terrors can be treated. Proper treatment can help your loved one get enough sleep, stop terrifying disruptions to healthy sleep habits, and assure his personal safety.
What Are Night Terrors?
Night terrors, also called sleep terrors, refer to a sleep disorder that makes a person suddenly wake up from sleep in a terrified manner. It’s one kind of parasomnia, which is an undesirable physical event or experience that interrupts sleep.
The sleep disorder commonly affects children, although adults may also suffer from it. You can recognize it by its clear symptoms. And causes of night terrors have been connected to underlying issues or mental conditions.
Night Terrors in Adults vs. Children
Very young children or preschoolers commonly suffer from night terrors. According to a Pediatrics sleep study, as much as 39.8% of children under six years of age experience night terrors. Specifically, around 35% of children at 1.5 years wake up from terror, although data also indicate that 56% of all children up to age 13 will go through a night terror at least once.
By the time children grow up and reach adolescence, most parasomnias, including night terrors, will disappear since the central nervous system matures. Another sleep study in Am Fam Physician quantified that only 4% of parasomnias like night terrors continue through adolescence.
As for adults, the American Academy of Sleep Medicine notes that 2.2% of adults still experience night terrors. The number isn’t that high, but if you do encounter it, understanding why it happens can help you know what to do, especially when it becomes a serious medical condition.
So, what’s different between night terrors in adults and in children? Children tend to outgrow the parasomnia when they reach adolescence. However, adults may not exactly move past night terror episodes, especially when the parasomnia stems from deep psychological trauma. This is where treatment comes in, but first, how do you recognize night terrors?
Usual Symptoms of Night Terrors
Symptoms of sleep terrors are visible and physical. A person excessively sweats and breathes laboriously. He looks pale, and his eyes open wide in extreme fear. Don’t be fooled by this since he won’t be aware of what he’s seeing. In fact, he’s actually half-asleep.
An adult may also exhibit memory loss, anxiety, and aggression which could result in self-injury. A grown person who shows the mentioned signs particularly needs appropriate treatment for his self-protection.
Differentiate Night Terrors from a Nightmare
But don’t get it wrong; nightmares are not the same as night terrors. When a person or a child sleeps, he undergoes the sleep cycle. During the Rapid Eye Movement (REM) sleep of this cycle, in the second half of the night, also called the Dream Stage, pleasant or scary dreams can occur randomly. So, nightmares happen when bad dreams haunt the sleeper, but it doesn’t involve physical or vocal behaviours.
As for night terrors, bad dreams aren’t involved because a different stage of sleep is disrupted. If nightmares happen during REM sleep, night terrors happen during slow-wave sleep or the non-rapid eye movement (Non-REM) stage of the sleep cycle. The Non-REM stage itself is divided into three parts, and night terrors specifically happen during the third part of Non-REM sleep or Stage N3.
When a person becomes mobile during a sleep terror, called a confusional arousal or sleepwalking, he also wakes up partially. His mind is asleep, but his eyes, facial expressions, and even the rest of the body will seem awake.
Recognize Triggers of Night Terrors
Now, what are the causes of night terrors? Adults usually suffer from deeper psychological issues or mental health conditions that result in sleep terrors. According to The Journal of Clinical Psychiatry, a history of psychopathology usually leads to night terrors. A history of bipolar disorder, depressive disorder, or anxiety disorder has been connected to sleep terrors as well. Even family history, as recorded in a published study in Pediatrics, indicates that night terrors can be inherited from close family members.
In addition, current factors such as the following have been known to trigger night terrors:
- Fever
- Sleep deprivation
- Separation anxiety in children
- Periods of emotional distress or conflict
- Disruption of sleep schedule
- Certain medications
- Alcohol use and abuse
- Headaches
- Head injury
- Post-traumatic stress disorder
- Sleep-disordered breathing — commonly obstructive sleep apnoea
- Restless leg syndrome
Managing the Scare and Aftermath of Night Terrors
When you encounter a family member going through a night terror, if there’s no sleepwalking, first and foremost, stand aside. Let the episode play out until it finishes. The risk of injury rises if you try to wake up someone going through a sleep terror. The episode may be prolonged if you make any attempt.
Only once the family member stops or wakes up himself can you move in and offer comfort. Encourage your loved one with kind words and remind him of your presence. Then, help him go back to sleep without fear.
However, if your loved one begins to walk or move about, you can just gently restrain him. Keep him away from risky or dangerous areas of the house. When he wakes or falls back to sleep, then can you bring him back to bed.
Build a Healthy Sleep Environment
Of course, you can already help immensely even before a night terror occurs. Create a healthy sleeping environment for your family member to induce healthy, uninterrupted sleep. Pair that with a solid bedtime routine, and sleep problems like sleep terrors can be prevented.
The ideal sleeping environment induces uninterrupted deep sleep from the Non-REM stage to REM sleep. To create that environment, you must keep the bedroom dark, cool, and quiet. Completely block all light, including blue lights from electronics. Maintain the temperature at a comfortable level. Soundproof the bedroom, as well as have a comfortable and supportive mattress and pillow. All of these will help your loved one wake up the next morning without any sleep disruptions.
A bedtime routine will also ensure high quality sleep, sleep that even bad dreams can’t disturb. A solid routine includes having your loved one avoid naps even if he feels daytime sleepiness and avoid electronics an hour before bed. Teach him to read or meditate before lying down to lower the heart rate and reach a calm, relaxed state. The goal is to be ready to doze off.
A relaxing sleep environment and a good sleep routine will both work to the benefit of your family member. The night terrors may be stopped. Even other sleep disorders may be addressed as well. However, when the parasomnia persists, it may be prudent to seek healthcare.
Seek Professional Help When Necessary
When sleep terrors end up causing lack of sleep or physical injury, it’s a sign that you have to consult with a sleep specialist. Professional help from a doctor or therapist can pinpoint the root cause and form an effective treatment for night terrors. In this process, a sleep diary may be recommended to give the sleep specialist a wider and more accurate picture of the situation.
Treatment options will then differ depending on the main cause of the night terrors. For example, anti-depressants may be recommended to treat underlying depressive disorders. Other drugs may be prescribed to strengthen the central nervous system. Relaxation techniques may also be taught to help your loved one get the necessary number of hours of sleep.
Night terrors may only seem scary when a family member experiences it, but professional treatment as well as home remedies such as a relaxing sleeping environment and good sleep routine will all fight the night terrors away.