Sometimes, you are woken up at night panting and without breath feeling as if you have just completed a marathon but with no account of what happened. That is what sleep terrors do to us. The feeling of great apprehensive fear sometimes while screaming, crying, thrashing around and flailing while asleep is the definition of sleep terrors. The night terrors as they are also referred to often occur in a combination with sleepwalking.
These forms of parasomnia are quite disturbing. I remember an episode where my mom had to scream at my dad while he was having such an episode. My dad was sleep walking while threatening everyone while screaming that thieves had visited our home. The adrenaline rush could not let him see us as his kids but adversaries.
Almost 40 percent of children experience sleep terrors but in less adults do. In children these terrors are very frightening but should not concern you. This is because they always end by teenage years in most of the people. In adults however, most at time they may cause a safety concern for the individual or the family. In this case or in cases where the child or adult does not get enough sleep due to the sleep terrors then treatment will be required. Sleep terrors are a form of parasomnia (Experiences or behaviors that are not desirable during sleep).
Sleep terrors are common in people where a family member has had a history of sleep terrors or sleepwalking. It is also more common in female children as compared and males.
What are the symptoms of night terrors?
What is the difference between night terrors and nightmares? Most at times people confuse sleep terrors with nightmares. The nightmares are just mere bad dreams where most at times we can vividly remember the details. The nightmares occur during the dream stage of sleeping also called the REM sleep. This is mostly from 2.00am to 6.00am. The child after a nightmare is comforted by your presence when they wake up. Night terrors on the other hand, happen while we are still asleep and does not wake up. In the morning after the night terror, children have no account at all of the happenings while adults recall a very small percentage of the terror.
The terrors which in most times happen in the first half of our sleeping mostly taking place in the first third of our sleep. At times the sleep terror makes the individual to sleepwalk. The symptoms below occur during a night terror:
- Start with a shout or loud scream.
- Stare at an individual or space with wide open eyes mostly with dilated pupils.
- Sit while looking frightened or extreme fear.
- Breathe more heavily than normal while having a racing pulse or sweating.
- Having an elevated blood pressure.
- Kick or throw the hands rapidly.
- Become deep asleep such that it would be very hard to wake them up but if woken up the person will look confused and inconsolable.
- Can’t remember anything about the sleep terror even if they were walking or talking during the time.
- Be more aggressive especially if they start sleepwalking and someone tries to impede their movement.
Do we need to see a doctor for sleep terrors?
Like it was mentioned above, sleep terrors are common in children with a little cause for concern. However, if either of the following occurs then we should see a doctor:
- The episodes increase in frequency.
- The sleep terrors wake up the individual or other members of the family.
- Where the condition becomes a safety problem to themselves or other family members or in case of injury.
- When an individual cannot concentrate during the day or is excessively sleepy.
- If the issues do not cease at teenage years and continue during adulthood.
What causes sleep terrors?
Sleep terrors occur during the N3 sleep stage. This stage is the deepest non-rapid eye movement (NREM) sleep period mostly taking place at the transition between stage 3 and stage 4 of sleep. Because of this the condition is an arousal disorder. Another NREM sleep disorder is sleepwalking which happens mostly together with night terrors. The night terrors are thus a result of so many factors including:
- Fatigue when going to sleep.
- Having moments of sleep deprivation
- A person being stressed
- Jet lag and other forms of sleep schedule changes. This might be due to travel or work schedules interruption the regular sleeping patterns.
- Fever and other diseases like malaria.
Other sleep and behaviors that alter sleeping can also result to sleep terrors including:
- Sleep apneas and other abnormal breathing patterns during sleep.
- Medications that affect the brain including some sleeping pills
- Restless leg syndrome.
- Depression and anxiety
- Excessive use of alcohol commonly in adults.
What are the complications of night terrors?
- Being so sleepy during the day. This is a major complication which may be caused by sleep terrors. The daytime sleepiness affects concentration at school or at work. This leads to poor performance at our daily tasks.
- Having a disturbed sleep. Most at times, most people experience a disturbed sleep as a result of night terrors. People are always scared to sleep if the night will produce the sleep terrors.
- Being the laughing stock from family and friends. Most at times, when we experience sleep terrors people talk about them. This is quite embarrassing for us in the midst of our loved ones like spouses, family or friends. I remember us talking about the things our dad experienced.
- Injury to ourselves or a neighbor. When one experiences night terrors, it is sometimes accompanied by sleepwalking. Because the walking takes place sub-consciously, it may lead to accidents. Also one can injure a nearby person if they try to restrain the sleepwalking person.
How can we diagnose sleep terrors?
In diagnosing sleep terrors the doctor reviews the patient’s medical history and symptoms by asking the noting the following before making any diagnosis:
- The period that the sleep terrors have been happening.
- Frequency of the sleep terrors.
- If the person has had a sleeping problem in the past.
- If there is a family history of members suffering from sleep disorders including sleep terrors.
Armed with the explanations above the doctor might use any or a combination of the following methods to evaluate the sleep terrors:
A physical exam is a good way to examine your body for any conditions that might be the cause of sleep terrors. The examination checks the body to check the following things that affect our sleeping:
- Breathing problems. Breathing problems is one of the causes of sleep terrors. If there is a problem with our breathing pathways then that is very important in the diagnosis.
- Being overweight is a major contributor to obstructive sleep apnea which can lead to night terrors. The weigh is thus checked to rule out its effects on the individual.
- Heart problems. Heart conditions affect the flow of oxygen to the brain sometimes leading to night terrors. The heart is therefore examined to rule out its contribution to the sleep terrors.
- Other body systems and parts are also examined.
Polysomnography is a nocturnal sleep study tests that examine how the person sleeps at night while at a sleep clinic. The sleep study analyses the following functions as we sleep:
- Brain activity
- Heart function
- Breathing rates and volume
- Eye movement
- Snoring sounds
- Muscles/ skeletal movement.
The two while combined with the discussion of symptoms with you or your dependent is very useful in diagnosing sleep terrors.
What is the treatment for sleep terrors?
In children or if the sleep terrors happens once in a while, treatment is not necessary. However, treatment should be sought for the following instances:
- For people who injure themselves or other family members during the sleep terror or also where observations show a potential to injure oneself or others.
- In instances where sleep terror causes disruption of the lives and sleeping of other people who sleep near or with the individual. These may include immediate family, friends or spouses.
- When sleep terrors frequently disrupts the sleeping of the individual experiencing the night terrors. This is because such disruptions causes an individual to suffer loss of attention during the day or is very sleepy.
- If the sleep terrors causes the individual or family member to be embarrassed in one way or another.
- If the frequency of the sleep terrors has increased or persists after teenage years.
The treatment options available work to improve safety and take care of the triggers/ causes. They include:
- Treating the causative underlying condition. In some cases the sleep terrors are caused by conditions like obstructive sleep apnea. This sleep disorder and other medical and mental conditions can be treated to reduce instances of sleep terrors.
- Managing stress. As we discussed above, stress or anxiety may be the cause of sleep terrors. When this problem is addressed then the sleep terrors reduce or are cured altogether. Stress management also helps in treating insomnia and other sleeping disorders.
- Use of medication. In young ones, medications are rarely used to manage night terrors. It is also not recommended in most of the cases. If absolutely necessary, some antidepressants or benzodiazepines are used effectively for the condition.
- Getting and anticipatory awakening. This works well to make sure that he individual does not go into N3 sleep where sleep terrors occur. The individual is awakened 15 minutes before the sleep terrors start and then stay awake for a few minutes before sleeping again.
What are the Simple night terror solutions that can be used at home?
In instances where a member of our family experiences sleep terrors, there are several ways that we can manage it. These ways are simple and effective in most cases for children and adults. They include:
- Getting enough sleep every night. In most cases, fatigue is a major cause of sleep terrors. To get enough sleep regularly will work in managing sleep terrors.
- Regular and relaxing bedtime routine. Having a relaxing routine such as listening to insomnia music, reading books, yoga, meditation or taking a warm bath goes a long way to get a relaxed sleep. This prevents episodes of sleep terrors.
- Making the bedroom comfortable for sleeping. This is possible by making the bedroom clean from allergens, making it cool and quiet for a good night sleep.
- Handling stress. Sometimes anxiety and stress may be the cause of sleep terrors. Managing stress by the several recommended methods helps. These methods include handling the urgent and important tasks first, making a to-do list, regular exercise, meditation and others.
- Make a recording of the night terror patterns. This can be done by a parent to a child having frequent night terrors. The timings the child experiences the night terrors can be recorded relative to the sleeping time. If a pattern is established, then anticipatory awakening might be used to help the child.
- Comforting the person experiencing night terrors. Trying to awaken a person experiencing a sleep terror impeding them causes the individual to be more aggressive. However, the individual can be comforted using cuddles or soft massage while letting the episode to pass.
- Removing anything that can cause injury to a person. The main problem with a person who experiences sleep terrors is injury to themselves or to people sleeping near them. To prevent these people from injury one might try to avowing bunk beds, ensure all doors and windows are locked, blocking any stairways in the house when sleeping and making sure all electrical cords are kept in safe place.