Overview

Sleep terrors, also known as night terrors, are episodes of screaming, intense fear, and flailing while still asleep. They are considered a parasomnia, an undesired occurrence during sleep, and are often associated with sleepwalking. While these episodes typically last from seconds to a few minutes, they may occasionally extend longer.

Sleep terrors primarily affect children, with nearly 40 percent experiencing them, while they occur in a much smaller percentage of adults. Although frightening, sleep terrors are usually not a cause for concern, as most children outgrow them during their teenage years.

However, when sleep terrors lead to sleep disturbances or pose safety risks, they may require treatment.

Symptoms and Differentiation from Nightmares

Sleep terrors differ from nightmares in that the person experiencing a sleep terror episode remains asleep and often has no recollection of the event upon waking. Children, in particular, rarely remember anything about their sleep terrors in the morning, while adults may have fragmented dream memories.

Sleep terrors typically occur in the first third to first half of the night and rarely during daytime naps. In some cases, sleep terrors may be accompanied by sleepwalking.

During a sleep terror episode, a person may exhibit the following symptoms:

• Start with a frightening scream or shout
• Sit up in bed and appear frightened
• Stare wide-eyed
• Sweat, breathe heavily, and have a racing pulse, flushed face, and dilated pupils
• Kick and thrash
• Be hard to awaken, and be confused if awakened
• Be inconsolable
• Have no or little memory of the event the next morning
• Possibly, get out of bed and run around the house or have aggressive behavior if blocked or restrained

When to Seek Medical Attention

Occasional sleep terrors are generally not a cause for concern. However, it's essential to consult a doctor if sleep terrors:

• Become more frequent
• Routinely disrupt the sleep of the person with sleep terrors or other family members
• Lead to safety concerns or injury
• Result in daytime symptoms of excessive sleepiness or problems functioning
• Continue beyond the teen years or start in adulthood

Causes and Risk Factors

Sleep terrors are classified as a parasomnia and occur during N3 sleep, the deepest stage of non-rapid eye movement (NREM) sleep. They can be triggered by various factors, including sleep deprivation, stress, sleep schedule disruptions, and fever. Underlying conditions such as sleep-disordered breathing, restless legs syndrome, certain medications, mood disorders, and alcohol use may also contribute to sleep terrors.

Individuals with a family history of sleep terrors or sleepwalking have a higher risk of experiencing sleep terrors. Additionally, sleep terrors are more common in female children.

Complications

Experiencing sleep terrors may lead to some complications, including:

• Excessive daytime sleepiness, affecting school or work performance and everyday tasks
• Disturbed sleep
• Embarrassment or relationship problems due to sleep terrors
• Injury to oneself or, rarely, to someone nearby