Night Terrors

What are night terrors?

Night terrors (sleep terrors) happen when your brain is partially asleep and partially awake. It causes a state of panic or fear. You or your child may sit up or jump out of bed, cry, scream, start sweating and feel your heart beat fast. Night terrors usually last between one and 30 minutes, and you’ll fall back to sleep when they’re over.

It can be difficult for parents, caregivers or sleeping partners to calm you down during a night terror. In the morning, you won’t remember what happened.

Night terrors are a type of parasomnia. These are a group of sleep disorders that affect sleep movements and behavior. They happen during the non-rapid eye movement (NREM) stage of sleep, usually in the first part of the night.

Night terrors in children

Children are more at risk of night terrors, especially between ages 3 through 7. Most often, children grow out of night terrors when they reach adolescence or adulthood. Children may look dazed with their eyes open or sometimes closed. Children aren’t easily consoled or responsive to simple conversations during an episode and may become more upset if you try to calm them down. They may have partial awake behaviors such as kicking, mumbling or unclear speech. Kids who have sleep terrors are more likely to sleepwalk later in life, wet the bed and they likely won’t remember what happened in the morning.

Night terrors in adults

Night terrors are less common among adults. Adults may be more injury-prone than children, as many people suddenly get out of bed when one happens. Night terrors in adults usually point to an underlying mental health condition, like post-traumatic stress disorder or anxiety disorder.

What’s the difference between night terrors and nightmares?

It can be easy to confuse night terrors and nightmares, but there are differences.

How common are night terrors?

One study estimated that sleep terrors affect 1% to 6.5% of children between 1 through 12 years of age. They’re less common among adults.

What are the signs and symptoms of night terrors?

Signs of night terrors include:

• Sweating.
• Screaming or crying.
• Quick breathing (hyperventilating).
• Fast heart rate.
• Dilated pupils.
• Fast, violent movements (thrashing).
• Sleepwalking.

Symptoms of night terrors include:

• Fear.
• Panic.
• Confusion.
• No awareness of surroundings.
• Not able to be comforted or respond to someone else talking.
• Difficulty waking up.
• No memory of the night terror in the morning.

What causes night terrors?

The cause of night terrors is unknown. Research suggests night terrors happen when your consciousness is stuck between deep stages of sleep and wakefulness. You’re not fully awake as a night terror happens. That’s why it’s hard for someone else to comfort or wake you up.

What triggers night terrors?

Night terrors may trigger (happen) after or because of the following:

• Having a fever.
• Sleep deprivation.
• Obstructive sleep apnea.
• Feeling stress or anxiety.
• Emotional tension.
• Drinking alcohol.

What are the risk factors for night terrors?

Night terrors can affect anyone at any age. Studies show that night terrors may run in your biological family history.

You may also be more at risk of night terrors if you have another underlying sleep disorder, like obstructive sleep apnea or periodic limb movement disorder.

What are the complications of night terrors?

Night terrors may or may not interrupt your child’s sleep and affect the quality of sleep you get each night.

Night terrors could also lead to physical injury. They usually involve thrashing (moving around violently). Children and adults may fall out of bed or smack their arms and legs on nearby bedroom furniture. It’s common to wake up with bruises after a night terror. Some injuries are more serious and require immediate medical attention.

How are night terrors diagnosed?

A healthcare provider will diagnose night terrors after a detailed history and a physical exam to learn more about you or your symptoms or gather observations from a parent or sleeping partner. Treatment isn’t necessary if you only have infrequent episodes, like a few night terrors a year. But you should see a healthcare provider if they happen frequently, like a few times each week.

You won’t usually need additional testing. But your provider may offer tests like an electroencephalogram (EEG) or overnight sleep study (polysomnography) to rule out conditions with similar symptoms or triggers like obstructive sleep apnea.

How do I stop night terrors?

There isn’t a specific treatment that stops night terrors for everyone.

The first line of treatment is to ensure the safety of someone who has a night terror and then let the episode run its course. The person experiencing the night terror might not remember what happened. Offering support the next day can help someone better understand what’s going on. It’s also important to address common triggers such as a lack of sleep, obstructive sleep apnea or fever, as that can reduce the frequency of episodes.

A healthcare provider may recommend strategies to reduce stress, like talking to a mental health professional. Your emotional health can impact how well you sleep at night.

Medications for night terrors

Healthcare providers don’t recommend medications as a treatment for night terrors. If you need medications, your provider will offer them only in very frequent injury prone episodes after treating triggers. Medications treat underlying conditions, especially anxiety disorders, for example.

How can I prevent night terrors?

A healthcare provider may recommend strategies to improve your sleep hygiene. This will help you get the amount and quality of sleep you need. It may reduce how often night terrors affect you. These include:

• Keep a regular sleep schedule and get an age-appropriate amount of sleep.
• Avoid drinking alcohol or caffeine before bedtime.
• Eliminate sleep disruptions like bright lights or loud noises.
• Manage any underlying sleep disorders like sleep apnea, for example.
• Move furniture (like nightstands) or potentially dangerous objects away from your bed to improve nighttime safety.

What can I expect if I have night terrors?

Night terrors are disruptive, not only to you but also to others within your household. They’re alarming for parents, caregivers and sleeping partners, as it can be difficult to comfort someone who’s experiencing one.

Night terrors usually don’t last forever. Many children may outgrow night terrors before they reach high school. Some night terrors happen with underlying conditions, so managing those can reduce how often night terrors happen.

If night terrors are frequent and you’re not getting quality sleep each night, let a healthcare provider know.

Should I try to wake someone up if they have night terrors?

Experts don’t recommend waking up someone who’s having a night terror. Your first reaction might be to hold down or stop someone from thrashing or moving during an episode. This can be dangerous for both you and the person experiencing a night terror, as their brain is in deep sleep and may not wake up easily. In fact, attempting to wake up someone may prolong a sleep terror episode.

You can help someone during a night terror by gently guiding them back to bed (if they’re out of bed) and speaking to them slowly, quietly and calmly. This will help them get back to sleep when the episode is over. You should also stay with the person experiencing an episode to make sure they’re safe until they fall back to sleep.

When should I see a healthcare provider?

Talk to a healthcare provider about night terrors if:

• They happen often (a few times per week).
• You or your child aren’t getting quality sleep.
• You or your child experience injuries after a night terror.
• If episodes happen frequently each night, particularly in the second half of the night.
• Episodes are shorter than one minute.
• Symptoms of other conditions, such as snoring, mouth breathing and excessive daytime sleepiness.

What questions should I ask my healthcare provider?

• What caused night terrors?
• Do I need to participate in a sleep study?
• How do I improve my sleep hygiene?
• How do I stay safe during a night terror?