Most sleep disorders share certain common consequences, the most notable being fragmented sleep – a disrupted sleep architecture (the natural progression through different sleep stages) that leads to daytime fatigue and similar problems. The main reason to be afraid of a sleep disorder boils down to being unable to get good rest consistently, which makes the person in question susceptible to other illnesses and accidents at work, on the road, etc.
Night terrors (also known as sleep terrors or pavor nocturnus) are different. This sleep disorder occurs in episodes somewhere around 3-4 hours after the person has fallen asleep, and it’s characterized by extreme fear, flailing limbs and screaming. One of the main risks to worry about here is potential injury, not just to the person experiencing sleep terrors, but anyone in their vicinity. This sleep disorder can hurt a person’s feeling of self-worth and impact their relationships with those around them.
The purpose of this article is to provide enough information on night terrors that anyone dealing with them (whether through first-hand or second-hand experience) can take proper steps to ensure the safety of everyone involved. We will be covering potential causes, how it’s diagnosed, as well as what you can do to make your life easier while fighting off night terrors.
An Overview of Night Terrors
Night terrors are a sleep disorder that is primarily seen in children, usually before or during early teenage years. After that, most people grow out of this condition – the percentage of affected people drops from 7-20% (in children) to only around 2-4% post-adulthood. Most of the time, night terrors are outgrown after roughly eight years of age. The most common issue with night terrors can be the fact that it’s often misinterpreted as regular nightmares, which is barely similar in any way. These are two separate problems, and treating them as one thing can lead to complications for the patient in question, even if those complications don’t directly impact their health.
One of the biggest and most reliable ways to separate night terrors from nightmares is based around how much the person remembers their episode. Nightmares stick out in our mind because we can often recall the details, and they can also wake us up frequently. On the other hand, the person dealing with night terrors often has no recollection of what happened the previous night (even if they went through an episode). This isn’t the only way to differentiate between nightmares and night terrors – the other major difference is that nightmares very rarely involve any kind of motor activity, especially thrashing. We advise seeking medical help if the problem keeps repeating.
Recognizing night terrors is easy if someone in your household is experiencing them. The symptoms are very obvious and include screaming, intense fear, limb flailing, and similar actions, usually while the person in question is sitting up. Often, they will wake up anyone else that is in their home when they go through an episode of night terrors. If you talk to this person about their problem, be sure to comfort them to avoid any unnecessary embarrassment that can have a negative impact on some people.
In terms of frequency, night terror episodes can vary heavily and differ between person to person. You can expect to face night terror episodes anywhere from weekly to multiple times per night, with varying levels of severity depending on your biological quirks and medical history. The higher the frequency, the more disruption night terrors will cause to your circadian rhythm through fragmented sleep. Because your circadian rhythm (a biological rhythm regulated by a “clock” in your brain stem using photoreceptors to determine the time of day) affects such a large number of processes in your body, this can be catastrophic for your health.
Night terrors typically occur within the first 3-4 hours after falling asleep. A connection has been made by researchers between night terrors and slow-wave sleep (otherwise known as deep sleep or delta sleep). Because slow wave sleep is more common in the early hours of a person’s rest, it makes sense that night terrors wouldn’t take very long to trigger during the arousal periods. In the past, it was hard to differentiate night terrors and nightmares, but that problem was solved since the discovery of rapid eye movement.
Causes, Symptoms, and Diagnosis Methods
In order to start dealing with night terrors and confirm that the patient is facing them, you have to know how to identify the symptoms. Sleep disorders tend to make their symptoms obvious, fortunately, so this is not difficult to do. In most cases, you want to look for the following telltale signs of night terrors:
- A look of intense fear is one of the main ways to tell if night terrors are occurring. While this can happen when someone wakes up from a nightmare, the person dealing with night terrors often isn’t very responsive to their surroundings.
- Screaming is not uncommon during night terror episodes. This is probably the easiest symptom to spot, so identifying an episode should be straightforward.
- Arm and leg flailing is another telltale sign of night terror episodes and the most dangerous one at that. Depending on the person’s surroundings, this flailing can result in injuries.
- Much like with panic attacks, you can expect to notice intense, fast breathing and a rapid heart rate. Their eyes may zoom from side to side, searching for threats. It’s incredibly hard to console a person experiencing a night terror episode.
- Sweating is a common symptom, and it isn’t exactly hidden from observers. When combined with any of the above symptoms, it is almost impossible to mistake night terrors for anything else.
If you’re concerned about night terrors and consult your doctor about them, you can expect to participate in polysomnography. Commonly called a “full sleep study,” polysomnography is a thorough and effective method of diagnosing every single sleep disorder out there, night terrors not being an exception. This process takes a full night to perform, and a follow-up test can take up the entire following day if you want to be thorough. Organize your schedule around this.
Most sleep disorders have unclear causes, and night terrors are more sensible than average in that regard. Night terrors are directly caused by the extreme arousal of the central nervous system somewhere between late NREM sleep and REM sleep. Several factors contribute to the likelihood of night terrors occurring. Sleep deprivation is a common one, and unfortunately, it also results from night terrors, due to how fragmented sleep reduces the amount of effective rest you get (even if you get the “right” amount of sleep on paper). Other important contributing factors include heavy caffeine intake (this one tends to contribute to most other sleep disorders, too), illness and sleeping in an uncomfortable location, one that the sleeper hasn’t adjusted to efficiently.
Dealing With Night Terrors
Fortunately, night terrors don’t require any real treatment, as they’re outgrown by the vast majority of children that experience them. Unfortunately, if you’re one of those people that still have this issue well into adulthood, the bad news is that night terrors have no real cure. The best you can do is minimize the impact they have on your life by reducing the risk of injury. Much like with sleepwalkers, this is done by moving sharp corners and other obstacles away from the bed and common movement paths through the house. In rare cases, someone dealing with night terrors might get up and move around in a state of panic, and you don’t want them tripping on anything, falling down a flight of stairs or hitting themselves on any edges.
Parents are advised to improve their children’s sleeping environment and train them to practice better sleep habits. You may hear the term “sleep hygiene” tossed around, but in basic terms, you want to establish a strict and healthy sleep schedule for kids dealing with night terrors. Prevent them from consuming foods with high sugar content or caffeine (in case they get their hands on something like coffee). If the problem persists, gently wake them up around the time you expect night terrors to occur, since that can completely stop an episode from happening. Don’t go overboard, as interrupting someone’s sleep too often is never good for their health.