About Sleep Terrors (Night Terrors)
The exact causes of sleep terrors are not fully understood. However, there are several factors that may contribute to their occurrence.
Non-modifiable risk factors of sleep terrors are factors that cannot be changed or controlled. These include:
- Family history: There seems to be a genetic component to sleep terrors, so having a family history of this condition may increase the likelihood of experiencing them.
Modifiable risk factors of sleep terrors are factors that can be influenced or changed. These include:
- Disrupted sleep: Poor sleep quality, such as from jet lag, changes in sleep schedule, alcohol or drug use, certain medications, or an uncomfortable sleeping environment, can increase the likelihood of sleep terrors.
- Other sleep disorders: Having other disruptive sleep disorders like restless leg syndrome, sleepwalking, periodic limb movement disorder, sleep apnea, or insomnia can also contribute to the occurrence of sleep terrors.
- Mental health conditions: Certain mental health conditions like depression, anxiety, bipolar disorder, and post-traumatic stress disorder (PTSD) may increase the chances of experiencing sleep terrors.
- Medications: Some medications can contribute to other parasomnias and may also increase the likelihood of sleep terrors in some individuals.
It's important to note that these risk factors may vary from person to person. If you experience sleep terrors or have concerns about your risk factors, it's best to consult with your healthcare professional for personalized advice.
The most common early symptoms of sleep terrors include:
- Intense feelings of panic or fear during the first third of the night
- Screaming or thrashing around
- Rapid heartbeat
- Abnormally fast breathing
- Dilated pupils
- Sweating
As Sleep Terrors progress or become more severe, other common symptoms may occur, such as:
- Sitting up in bed and crying out
- Episodes lasting from 45 to 90 minutes
- Staring blankly
- Feeling flushed or sweaty
- Appearing confused or disoriented
- Jumping or running around
- Becoming aggressive, especially if someone tries to stop them
It's important to note that most children who experience Sleep Terrors return to sleep afterward and do not remember having an episode. However, adults are more likely to remember what happened during the episode. If an adult thrashes during a Sleep Terror, they may also injure themselves or anyone nearby.
To diagnose sleep terrors, doctors may perform the following examinations, tests, and procedures:
- Physical exam: Your doctor will conduct a physical examination to assess any signs of underlying physical or mental causes.
- Sleep history: Your doctor will ask detailed questions about your sleep quality, patterns, quantity, and routine to gather information about your symptoms.
- Sleep study (polysomnography): This test involves spending a night in a sleep laboratory where various measurements are taken while you sleep. It helps evaluate brain waves, blood oxygen levels, heart rate, breathing, and leg movements to assess sleep behavior.
Additional examinations, tests, and procedures to determine the stage or severity of sleep terrors may include:
- Electroencephalogram (EEG): This test assesses electrical activity in the brain and can detect any abnormal patterns associated with sleep terrors.
- Multiple sleep latency test (MSLT): This daytime napping study is used in conjunction with a polysomnography at night to help diagnose narcolepsy.
These examinations and tests are crucial in determining the appropriate treatment for sleep terrors.
The goals of treatment for sleep terrors include reducing the frequency and severity of episodes, improving sleep quality, and addressing any underlying causes or contributing factors. Here are the recommended treatments and how they work to achieve these goals:
Medication:
- Benzodiazepines and serotonin re-uptake inhibitors (SSRIs) may be prescribed in some cases to help reduce sleep terrors.
- These medications can help regulate brain chemicals and improve sleep patterns.
Therapies:
- Image rehearsal therapy: This therapy involves recalling the storyline of recurring nightmares and creating a happier ending, which can make dreams more pleasant or less traumatic.
- Cognitive-behavioral therapy (CBT): CBT can help identify and change negative thought patterns and behaviors associated with sleep terrors, leading to improved sleep quality.
- Psychotherapy: This therapy aims to address any underlying emotional or psychological issues that may contribute to sleep terrors.
Therapeutic procedures:
- Scheduled awakening: This treatment interrupts the brain waves by briefly waking up the person before the expected time of a night terror, preventing its occurrence.
- Anticipatory awakening therapy: Involves waking up around 15 minutes before night terror episodes typically occur, staying awake for several minutes, then falling back asleep. This can disrupt the sleep pattern associated with night terrors.
Health behavior changes:
- Improving sleep hygiene: Creating a relaxing sleep environment, maintaining a consistent sleep schedule, and avoiding stimulants like caffeine before bedtime can promote better sleep quality.
- Stress management: Identifying sources of stress and finding ways to relieve them can help reduce the occurrence of night terrors.
It's important to note that medication dosing may be affected by individual factors, so it's best to consult with a healthcare professional for personalized advice. Additionally, other side effects may occur with medication use, so it's important to discuss potential risks with your healthcare provider.