Sleep Terrors

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Sleep terrors, or night terrors, are a parasomnia condition in which the subject reacts to a foreboding sense of fear or terror by screaming, thrashing around or crying. They may also get out of bed and walk or run around, and adults are at a risk of performing violent acts during this time. The subject is still in a sleep like state during this outburst and cannot be awoken without some difficulty. The episode can last as long as 20 minutes, after which the subject will either go directly back to REM or deep sleep without ever leaving their sleeping state, or may wake up to extreme confusion. People waking up from a sleep terror may experience amnesia for a short duration following the episode, in which they cannot recall their name, location, or any other distinguishing features of themselves. This usually passes within a couple of minutes.

Sleep terrors (night terrors) are often associated with, or definitively considered a nightmare, though they are in fact quite different. Nightmares occur in the REM stage of sleep, and are traditional dreams from which the person experiencing them may recall imagery, sound and/or feelings. Typical nightmares include being chased by someone or something, falling for an inordinate amount of time, or things that the person finds particularly disturbing or frightful that are often rooted in their sub conscious.

Sleep terrors / night terrors, on the other hand occur before the dream state of REM sleep, in the phase just before deep sleep called the slow-wave sleep phase. The person is not incited to the outburst through any form of imagery or sound that a nightmare would include, but simply a deep sense of terror and fear that they cannot shake.

Sleep terrors are most common in children, especially very young children under the age of 7. Children with sleep terrors are also likely to talk in their sleep and sleepwalk, or develop these parasomnias later after they stop having sleep terrors. As many as 15% of children experience sleep terrors. Adults can also develop sleep terrors, though this is uncommon and is usually brought upon by a deeply traumatic or emotional event, or is developed in adults with a long history of depression, anxiety or bipolar disorders. Adults with sleep terrors should consult a psychiatrist, who should be able to help them deal with the issues that are plaguing them and causing the terrors. As few as 2% of adults experience sleep terrors. There is no link between sleep terrors in children and emotional disorders, or disorders that will be developed later in life.

Sleep terrors, like many other parasomnias are deeply linked to genetics, and those with a family history of sleep terrors are more likely to have them as well. Sleep terrors share the same root causes as sleepwalking, as these can include head injuries, hyperthyroidism, encephalitis, stress, other sleep disorders such as obstructive sleep apnea, fevers and medications.

Sleep terrors are easily detectable in most cases, as the person experience them will often let out loud screams or wails that will likely wake up most people in the household. It can be a scary and traumatic experience for parents or loved ones to see their children or partners in such distress, as the look of fear and terror is often easily visible on the person’s face. It should be remembered that sleep terrors are not dangerous, and many times the victim will not fully recall the experience, but go through feelings of disorientation and embarrassment more than anything else. It is important not to try and wake the victim from their state, but to remain by them until it passes. This gives them comfort when they snap out of it, and assures you that they are not getting up and moving about while still in the state, potentially harming themselves or others in the process.

Sleep terrors do not often require any treatment or tests, and in most children they pass before their teen years. If the problem persists, or in the case of sleep terrors in adults, it may be helpful to talk to your doctor or consult a sleep specialist. An overnight sleep study, called a polysomnogram will be advised, which will help determine any other sleep related factors that may be contributing to the sleep terrors, and how they can be limited. The polysomnogram monitors brain wave activity, and can chart the areas of the brain that are being actively used prior to an episode.

The majority of parasomnias , including night terrors, occur in the stage before deep sleep, and taking measures to achieve deep sleep faster, and remain in it once there can limit the number of parasomnia occurrences. Having proper sleeping conditions, limiting any caffeine intake or the intake of any other stimulants, and having routine bed times can all lead to quicker and better quality deep sleep.

 

Reviewed September, 2007

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