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Nightmares vs. Night Terrors

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Chances are good you’ve had a nightmare or two, and you may have even experienced a night terror or sleep terror episode, which is like a bad nightmare on steroids. Researchers say that as much as 5% of the general adult population has weekly nightmares, and psychiatric patients experience them even more frequently. Night terrors are more than standard nightmares, and they’re not as uncommon as you might think. Let’s take a look at both and discuss some ways that may help you avoid night terrors altogether.

What Are Night Terrors and Nightmares?

A nightmare is an unpleasant or scary dream; it may involve being chased by someone wishing to do you harm, driving your car off a cliff or witnessing an injury to someone you love. Nightmares can be filled with scary things that seem nonsensical or unreal. A nightmare is generally remembered, at least partially, upon awakening. Sleep terrors, on the other hand, involve intense fear and may be accompanied by thrashing around and screaming while you sleep.

Other things differentiate the standard nightmare from its much-worse cousin, the sleep terror or night terror. For instance, you usually remember at least some of your nightmares, but if you have night terrors, you may awaken and have no clue that it even happened. Typically, those suffering night terrors only realize it when told by the sleeping partner or someone within earshot.

Further, nightmares typically get scarier as the dream progresses, not intensely frightening right away, almost like watching a scary TV show or movie in your sleep. Sleep terrors aren’t that predictable. You may be experiencing calm sleep at one moment and then begin screaming in terror the next.

The dreamer’s sleep stage can determine whether a dream turns into a nightmare or a night terror. Nightmares are associated more with the vivid dreaming stage of REM sleep, while sleep or night terrors usually happen during periods of non-REM sleep, specifically in stage three — deep sleep.

What Causes Night Terrors and Nightmares?

No one knows for sure what causes dreaming, nightmares or night terrors, although an over-aroused central nervous system is thought to play a part.

Nightmares can be brought on by:

  • Eating right before bedtime since this can kick up the person’s metabolism and make the brain stay active.
  • Certain types of medications
  • Lack of sleep and sleep disorders, including sleep apnea
  • Stress
  • Pregnancy

Factors that may contribute to night terrors include:

  • Depressive, anxiety and bipolar disorders (in adults)
  • Migraine headaches
  • Traveling and sleeping in unfamiliar surroundings
  • Obstructive sleep apnea
  • Genetic links

Both sleep disorders occur more frequently in children and are usually outgrown by the teen years.

The U.S. Department of Veterans Affairs says that trauma survivors and individuals experiencing post-traumatic stress disorder may have recurring nightmares and dreams where the same circumstances play out each time.

Remedies for Night Terrors

Most researchers feel it’s usually unnecessary to treat sleep terrors unless they are frequent and causing issues for the individual experiencing them or their family members. Maintaining safety and eliminating triggers and causes is the primary focus of treatment. Some treatment options include:

  • Reducing stress if it appears to be a factor in the night terror episodes
  • Treating associated medical or mental health conditions, including PTSD
  • Using a CPAP device to treat sleep apnea
  • Waking the person regularly, based on the general timing of previous night terror episodes
  • Prescription medications

Lifestyle changes can be helpful during treatment, including establishing a regular bedtime routine, getting sufficient sleep, meditating before bed and ensuring that the sleeping environment appears safe to the sleeper.

Warning Signs to Worry About

Generally, sleep terrors shouldn’t be overly concerning for parents. Children usually grow out of them on their own. If sleep terrors become more frequent and disrupt the person’s sleep or the sleep of other household members, then it may be time to see a doctor.

Also, if terrors are leading to concerns about safety and injury to the sleeper or others, or if the sleeper starts to have excessive daytime sleepiness or experience problems functioning, seek professional help. Reoccurring terrors that begin suddenly in adulthood should be evaluated by a medical doctor to find the underlying cause.

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