What are night terrors?
Night terrors, also known as sleep terrors, are a disorder that causes someone to partially wake up confused and terrified during non-REM sleep. They most often occur in children between the ages of 3 and 12 years old, but can affect adults as well. During a night terror episode, the person may:
– Sit up in bed looking terrified and confused
– Scream or shout
– Thrash around violently
– Sweat, breathe heavily, and have a racing pulse
– Be inconsolable or not respond to comfort
– Have eyes open but be unresponsive
– Not remember the episode the next morning
Night terrors typically happen during the first few hours of sleep at night. An episode usually lasts between 1 to 20 minutes, after which the person lays back down and continues sleeping. When they wake in the morning, they usually have no memory of the event.
Why you shouldn’t wake someone during a night terror
While night terrors can be frightening to witness, it is not recommended to wake the person. Here’s why:
They are still asleep
Even though the person’s eyes may be open and they may seem awake, they are actually still asleep during a night terror. The part of the brain that controls movement and emotions is active, but the parts that control logic, reason, and memory are still dormant. If you wake them, they will be confused and disoriented and may lash out or be combative due to their confused state.
It can prolong the episode
Night terrors tend to be self-limiting and only last for several minutes before the person settles back into normal sleep. Waking them during an episode may actually prolong the event as they struggle to wake up fully. Letting the night terror run its course allows them to finish the disturbed sleep cycle and return to normal sleep more quickly.
They won’t remember it anyway
Because night terrors occur during non-REM sleep, the person experiencing them will have no memory of the event the next day. Even if they seem distressed in the moment, they will not recall the details or remember being woken up. There’s no benefit to waking them since they won’t have any recollection of the night terror or your intervention.
You may get an aggressive response
Since they are confused and only partially awake, someone in the midst of a night terror may lash out or act aggressively if woken up. They may swing their arms, kick, or even scream or shout angrily when startled awake. This aggressive reaction is not intentional, but simply a result of their disturbed sleep state. However, you do risk getting hurt if you attempt to restrain or wake them.
It can disrupt their sleep cycle
Waking someone up during a night terror interrupts their normal sleep stages, which could make it difficult for them to fall back asleep. The confusion caused by being woken up may also lead to issues returning to sleep. It’s best to let the night terror run its course so they can complete that sleep cycle and continue sleeping normally.
What to do during a night terror episode
While you should avoid restraining or waking someone during a night terror, there are some things you can do to help:
– Make sure they are safe – Protect them from injury by moving dangerous objects like lamps or glass away from the bed. Push furniture against walls and pad hard edges if needed.
– Allow the episode to pass – Don’t try to wake or restrain them, just gently guide them back to bed if needed. Speak softly and turn on a light to illuminate the room when it seems to be ending.
– Comfort afterward – When they lay back down, comfort them by softly speaking their name or rubbing their back. This may help ease the transition back to normal sleep.
– Consult a doctor – If night terrors become frequent or disruptive, talk to a doctor who may refer you to a sleep specialist for further evaluation.
Safety tips for night terrors
Here are some additional tips for protecting a night terror sufferer:
– Use padded bed railings to prevent falls
– Clear the bedroom floor of objects
– Use a low bed or mattress on the floor
– Tuck in sheets tightly or use a sleep sack to restrict thrashing
– Don’t try to restrain their arms or legs
– Move breakables like lamps and glasses out of reach
When are night terrors a concern?
Infrequent night terrors are not necessarily a cause for concern. However, talk to your doctor if:
– Episodes occur several times per week
– The person screams, acts out violently, or hurts themselves during an episode
– Night terrors begin happening in adulthood for the first time
– Other sleep problems or daytime fatigue develop
Frequent or severe night terrors may require medical evaluation. A sleep study may be recommended to rule out underlying sleep disorders like sleep apnea.
In rare cases, night terrors combined with other sleep or psychological problems could be a sign of a mental health condition. A doctor can help determine if anxiety, depression, post-traumatic stress disorder (PTSD), or other disorders may be contributing to night terrors.
What causes night terrors?
Doctors aren’t entirely sure what causes night terrors, but here are some possible contributing factors:
– Genetics – A family history of night terrors may increase risk.
– Sleep deprivation – Fatigue may make them more likely to occur.
– Fever or illness – Sickness can trigger night terrors.
– Medications – Some prescription drugs are associated with night terrors.
– Stress or anxiety – Emotional distress may increase their frequency.
– Sleep apnea – Interrupted breathing during sleep can lead to them.
– REM sleep behavior disorder – This sleep disorder involves acting out dreams.
– PTSD – Post-traumatic stress disorder has been linked to night terrors.
– Bruxism – Grinding teeth during sleep may contribute to them.
– Hyperthyroidism – An overactive thyroid gland is associated with night terrors.
The exact cause often remains unknown. Doctors may run tests to identify any underlying physical or mental health issues that could be contributing factors.
Are night terrors dangerous?
Night terrors are not inherently dangerous and many children outgrow them over time. However, the associated behaviors do pose some risks:
– Falling out of bed and getting injured while thrashing around
– Unintentionally harming bed partners or others in close proximity
– Causing bodily harm like cuts or bruises from frantic movements
– Exhaustion and daytime sleepiness from frequent disrupted sleep
– Dangerous behaviors if night terrors occur while sleepwalking
While not directly life-threatening, frequent night terrors can impact quality of life. Seeking treatment is advised if they become excessive or hazardous.
Safety precautions for night terrors
Some steps that can be taken to prevent injury during night terror episodes include:
– Padding sharp corners of furniture
– Using bed railings or moving mattress to floor
– Removing objects that could be potential weapons
– Having bed partners sleep separately
– Keeping lighting low if the person gets up
– Securing windows and doors if sleepwalking also occurs
Taking safety precautions allows the night terror to run its course without the person harming themselves or others.
Treatments for night terrors
While many kids eventually outgrow night terrors on their own, there are some treatment options available in more persistent or severe cases:
Sleep hygiene
Ensuring good sleep hygiene practices may help reduce their frequency, such as:
– Consistent bedtime routine
– No screen time before bed
– Comfortable sleep environment
– Avoiding caffeine, large meals, and strenuous activity before bedtime
Stress management
Learning to manage stress and anxiety through counseling, meditation, exercise, or relaxation techniques may help lower occurrence.
Medications
Medications that treat underlying issues contributing to night terrors may be prescribed, like:
– Antidepressants for anxiety or depression
– Blood pressure drugs for PTSD symptoms
– Thyroid medications for hyperthyroidism
– Dopamine blockers for REM behavior disorder
Cognitive behavioral therapy (CBT)
CBT provides tools to help identify and modify thoughts and behaviors that worsen night terrors.
Hypnosis
Hypnosis training teaches self-hypnosis methods to use at bedtime to reduce episodes.
Sleep studies
An overnight sleep study can diagnose issues like sleep apnea that may be interrupting normal sleep cycles and triggering night terrors.
While not always preventable, various relaxation and lifestyle changes may help reduce night terror frequency, severity, and associated risks. Medical advice should be sought if they become a safety issue or severely affect sleep quality on an ongoing basis.
Conclusion
Night terrors can be alarming for parents or bed partners witnessing an episode. The sight of a loved one shouting, thrashing, and appearing terrified is understandably disconcerting. However, waking someone up during a night terror is inadvisable and unlikely to provide any comfort since they will remain confused and disoriented.
It’s best to allow night terrors to run their course and then comfort the person afterward. With age, most children outgrow them on their own. If they persist or result in injury or sleep deprivation, a doctor can evaluate any underlying medical or mental health conditions contributing to their occurrence. While not medically dangerous in most cases, taking safety precautions allows the night terror sufferer to get through each episode with minimal risks. With proper treatment, most people find relief from frequent night terrors and their disrupted sleep patterns.