Sleep Terrors

Night terrors, also called sleep terrors, are episodes of intense fear and distress during sleep. They can involve screaming, crying, thrashing about (like waving arms and legs), and sometimes sleepwalking. These are unusual behaviors that happen while someone is not fully awake. Sleep terrors, like sleepwalking, are types of parasomnias. Parasomnias are simply strange or disturbing actions or feelings that occur during sleep.

Night terrors typically last from a few seconds to a few minutes, but sometimes they can last longer. Children between the ages of one and twelve are most likely to experience them. They're much less common in adults. While they can be frightening for those witnessing them, night terrors are usually not a serious concern. Most children naturally grow out of them by their teenage years.

However, if sleep terrors are frequent or disruptive, causing problems with getting enough rest or creating safety hazards, then treatment might be needed.

Sleep terrors are different from nightmares. Nightmares are bad dreams that you wake up from, often remembering details. Sleep terrors, however, happen while you're still asleep. Kids usually don't remember anything about sleep terrors in the morning, but adults might recall some parts of the experience. Sleep terrors typically occur during the first part of the night's sleep, and rarely during naps. Sometimes, sleep terrors can lead to sleepwalking.

During a sleep terror, you might:

• Scream, shout, or cry: This is often a loud and sudden start to the episode.
• Sit up in bed and look scared: Your body language will show fear or distress.
• Have wide-open eyes: This is a clear sign of being in a state of intense fear or arousal.
• Sweat, breathe heavily, and have a fast heartbeat: Your body is reacting as if you're in danger, even though you're asleep. Your face might be flushed, and your pupils might get bigger.
• Kick and thrash: This is a physical expression of the fear and arousal associated with the sleep terror.
• Be hard to wake up and confused if you are woken: You'll likely be disoriented and may not respond to being talked to or comforted.
• Not be comforted: Trying to soothe a person having a sleep terror is often ineffective.
• Have little or no memory of the event: This is one of the key differences between sleep terrors and nightmares.

In severe cases, a person might get out of bed and run around the house, or even become aggressive if they are stopped.

Occasional sleep terrors aren't usually a problem. If your child has them, you can mention it during a regular checkup with their doctor. But it's important to talk to a doctor or other healthcare provider sooner if:

• Sleep terrors happen more often: Regular occurrences could signal an underlying issue.
• Sleep terrors regularly disturb your sleep or the sleep of others: This impacts the quality of everyone's sleep.
• Sleep terrors lead to safety concerns or injuries: This is a serious concern that needs immediate attention.
• You or your child experience daytime sleepiness or problems with daily activities: This could be a sign that the sleep terrors are having a negative impact on your daily life.
• Sleep terrors continue beyond the teen years or start in adulthood: This is also a sign that something might need further investigation.

Sleep terrors, occasional episodes of fear and distress during sleep, are typically nothing to worry about. If your child has these, you can bring it up during their regular check-up with their doctor. However, if you're concerned, or if your child is experiencing sleep terrors frequently or intensely, it's important to talk to a doctor or other healthcare provider right away. This is especially true if:

• Sleep terrors happen more often than not. This could mean they're happening more than a few times a month.
• They significantly disrupt sleep for the child or other family members. If sleep terrors are happening regularly and preventing everyone from getting enough rest, it's a sign something might need attention.
• There are safety concerns or injuries. If your child is hurting themselves or others during these episodes, or if there's a risk of harm, immediate medical attention is needed.
• Daytime symptoms appear, such as extreme tiredness or problems with daily tasks. If your child is unusually sleepy during the day or struggles with their schoolwork or other activities, it could be connected to the sleep terrors.
• Sleep terrors continue past the teen years or begin in adulthood. While sleep terrors are more common in childhood, if they persist into adolescence or start later in life, it's important to discuss it with a healthcare professional.

Sleep terrors are unusual sleep behaviors. They're a type of parasomnia, which means they're strange or disturbing things that happen during sleep. When someone has a sleep terror, they don't fully wake up. They might look like they're awake, but they're actually still partly asleep.

Several factors can make sleep terrors more likely. For example, not getting enough sleep and feeling really tired can contribute. Stress is another potential cause. Changes to your sleep schedule, like traveling across time zones or having trouble sleeping, can also trigger them. Even a fever can sometimes be a factor.

Sleep terrors can also be linked to conditions that disrupt sleep. These include sleep-disordered breathing. Sleep-disordered breathing involves unusual breathing patterns during sleep. One common type of sleep-disordered breathing is obstructive sleep apnea, where the airway gets blocked during sleep. Other conditions that can play a role include restless legs syndrome.

Certain medications can sometimes cause sleep terrors. And, mental health conditions like depression or anxiety, or alcohol use, can also be related.

If sleep terrors run in your family, you're more likely to experience them yourself. Having a family history of sleepwalking can also increase your chances of having sleep terrors. This suggests a possible genetic link, meaning that certain traits or tendencies related to these sleep disturbances can be passed down through generations. In simpler terms, if sleep problems like sleepwalking or sleep terrors are common in your family, you might be more prone to experiencing them too.

Sleep terrors can cause several problems. One common issue is feeling excessively tired during the day. This tiredness can make it hard to concentrate at school or work, and even affect everyday activities. Sleep terrors can also disrupt a person's sleep, making it hard to get a good night's rest. Someone experiencing sleep terrors might feel embarrassed about their episodes, which can sometimes impact relationships. In rare cases, sleep terrors can lead to injury, either to the person having the terror or to someone else nearby.

Doctors use several methods to diagnose sleep terrors.

1. Medical History and Physical Exam: The doctor will first ask about your overall health, including any other medical conditions you have. They might also want to know about your family's history of sleep problems. A physical exam can help identify any underlying conditions that could be contributing to the sleep terrors.

2. Symptom Description and Sleep Habits: Diagnosing sleep terrors often relies on your description of what happens during the episodes. The doctor will ask you (and perhaps your partner) questions about your sleep behaviors, like how often these episodes occur, what you do during them, and what you remember afterward. A video recording of a sleep terror episode can be very helpful in providing a clear picture of what's happening.

3. Overnight Sleep Study (Polysomnography): In some cases, a sleep study may be recommended. This study takes place in a sleep lab. Sensors are attached to your body to monitor different aspects of your sleep. These sensors measure your brain waves, oxygen levels in your blood, heart rate, breathing, eye movements, and leg movements throughout the night. Video recording may also be used to document your behavior during sleep. This helps the doctor determine if there's anything else going on during your sleep that might be connected to the sleep terrors.

Sleep terrors are often harmless and usually go away on their own as children get older. If they happen rarely, no treatment is typically needed. However, if sleep terrors are frequent, disruptive, cause safety concerns, or interfere with sleep, treatment might be necessary. Sometimes, people seek treatment if the terrors embarrass them or disturb others' sleep.

Treatment for sleep terrors focuses on making sure the person is safe and finding ways to reduce or eliminate the causes.

Possible Treatment Approaches:

• Addressing Underlying Conditions: If a medical condition, mental health issue, or other sleep disorder (like sleep apnea) is linked to the sleep terrors, treating that underlying problem is key.

• Managing Stress: If stress or anxiety seem to be contributing factors, a healthcare professional might recommend a sleep specialist. This could involve therapy like cognitive behavioral therapy (CBT), hypnosis, or relaxation techniques to help manage stress and anxiety.

• Anticipatory Awakening: Sometimes, waking the person 15 minutes before the usual terror time and keeping them awake for a short while before letting them go back to sleep can help. This is called anticipatory awakening.

• Medication: Medicine is rarely used, especially for children. If needed, a doctor might prescribe sleep aids like benzodiazepines or certain antidepressants. They will carefully consider the benefits and risks of any medication.

Important Considerations:

If you or a loved one is experiencing sleep terrors, it's crucial to talk to a healthcare provider. They can evaluate the situation, rule out any underlying medical problems, and recommend the most appropriate course of action. Additional information on various treatment options, like biofeedback and cognitive behavioral therapy, is available.