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Sleep Terrors

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What is it?

Sleep terrors is also called “night terrors.” It is a parasomnia. A parasomnia involves undesired events that come along with sleep.

In a typical episode, you will sit up in bed and pierce the night with a "blood-curdling" scream or shout. This scream can include kicking and thrashing. You may say or shout things that others are unable to understand. You will also have a look of intense fear with eyes wide open and heart racing. You may also sweat, breathe heavily and be very tense. At times, you may even bolt out of bed and run around the house. This response is more common in adults. It may also lead to violent actions.

Individuals having an episode of sleep terrors will not respond to voices and can be hard to wake up. Once they do wake up, they will be very confused. They may not know where they are or what is going on. Most often, they will not have any memory of what took place. At times, they may recall brief bits of a dream. This dream will likely involve great danger or fright. It can take a long time to comfort the patient once the episode is over.

It most often occurs in the first third of the time that you are asleep. This is during the slow-wave cycle of sleep. Episodes in adults can occur at any time in the sleep cycle. Adults are also more likely to recall a dream that was a part of the event.

Serious and even deadly injury can occur. Attempts to escape from bed or to fight can result in harm to the patient or others. Individuals may be embarrassed by the sleep terrors. This can greatly affect their relationships with others.

Who gets it?

It is more common in children and affects males and females equally. It may affect as many as 6.5% of all children. It tends to begin when a child is four to 12 years old. Children with sleep terrors will often talk in their sleep and sleepwalk.

In rare cases, it can begin in adulthood. Overall, only about 2.2% of adults have it. Very few people over the age of 65 have sleep terrors.

There is a strong genetic and family link. It can occur in several members of the same family.

Many adults who have sleep terrors are also likely to have a history of one of the following:

  • Bipolar disorder
  • Some depressive disorders
  • Anxiety disorders

It is unclear how closely it may be linked to these mental disorders in adults. In children, there does not seem to be any connection between mental disorders and sleep terrors.

Episodes of sleep terrors and sleepwalking share many of the same causes. These include the following:

  • Sleep deprivation
  • Hyperthyroidism (overproduction of thyroid hormones)
  • Migraine headaches
  • Head injury
  • Encephalitis (brain swelling)
  • Stroke
  • The premenstrual period
  • Bloated stomach
  • Physical or emotional stress
  • Obstructive sleep apnea (OSA)
  • Other sleep-related disorders or events
  • Travel
  • Sleeping in unfamiliar surroundings
  • Some medications
  • Alcohol use and abuse
  • Noise or light
  • Fevers in children

How do I know if I have it?

1. Do you get up in the night with a loud cry or scream of intense fear?

2. Do you perform any actions that could put you or another person in danger?

3. Is it hard for someone else to wake you up?

4. Are you very confused when you do wake up?

5. Is it hard for you to remember what took place?

If your answer to the first question and at least one of the others is yes, then you might have sleep terrors.

It is also important to know if there is something else that is causing your sleep problems. They may be a result of one of the following:

  • Another sleep disorder
  • A medical condition
  • Medication use
  • A mental health disorder
  • Substance abuse

Do I need to see a sleep specialist?

It is fairly normal for a child to have sleep terrors. It does not normally need medical treatment. Parents should simply keep a close watch on their child. An adult who continues or begins to have sleep terrors is at a greater risk of injury. In this case, it would be a good idea to seek a doctor’s advice.

What will the doctor need to know?

You should complete a sleep diary for two weeks. This will give the doctor clues as to what might be causing your problems. You can also rate your sleep with the Epworth Sleepiness Scale. This will help show how your sleep is affecting your daily life. The doctor will need to know your complete medical history. Be sure to inform him or her of any past or present drug and medication use. Also tell the doctor if you or a relative have ever had a sleep disorder.

Will I need to take any tests?

Your doctor will likely have you do an overnight sleep study if you are an adult. This is called a polysomnogram. The polysomnogram charts your brain waves, heart beat, and breathing as you sleep. It also records how your arms and legs move. This shows if there are other disorders, such as sleep apnea, that are causing your sleep problems.

The best sleep study will also record your sleep on video. This will help show if you get up and do anything unusual during the study.

How is it treated?

For children, it tends to go away on its own as they enter the teen years.

Sleep terrors can occur when sleep is fragmented by other sleeping problems. Obstructive sleep apnea (OSA) is a common medical problem that can lead to frequent arousals from sleep. This may increase the risk of parasomnias such as sleep terrors. Symptoms of OSA include snoring, waking up gasping for air, and daytime sleepiness. Treatment of OSA may improve sleep terrors.

Reviewed by David Kuhlmann, MD
Updated August 31, 2007


More Information

Preventing Parasomnias

Comparing Parasomnias

Comparing Child Parasomnias

Tips for Parents

Sleep terrors can be very disturbing to parents. Most of the time a child has no memory of the event. These tips will help you respond well when your child has this parasomnia:

  • Remain calm so that you do not frighten your child with a panic-stricken response.
  • Do not try to wake your child.
  • Watch your child to make sure that he or she remains safe.
  • Wait near your child until he or she returns to normal sleep.

Ask a Specialist


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