After a stressful, exhausting day, there is nothing better than sinking into a deep, restful sleep. Sleep means sweet dreams and peaceful rest to most people, but it’s a different story for those suffering from night terrors.
Night terrors are not always nightmares. During a night scare, you may suddenly sit up in bed, scream or gasp for air, and act anxiously. It may seem like you are awake, but most people don’t wake up and fall asleep right back after an episode.
You’d think night horrors only happen to children. However, around 2% of adults also suffer from these worrying events. Many people do not remember having had night terrors and do not report it to their doctor, so the number is likely higher in reality.
With Dr. Raheel Karim, Pall Mall Medical Specialist in Psychiatry, spoke to learn more about night terrors, what causes these episodes, and how to stop them:
What are night terrors?
Night terrors, like sleepwalking, are a form of parasomnia, a category of sleep disorders. These disorders include abnormal movements, emotions, and behaviors that occur while sleeping.
“Unlike nightmares that occur during REM sleep, night terrors are brief episodes of screaming, hitting, or extreme panic,” says Dr. Karim. “They occur during the transition from one sleep phase to the other, for example from deep sleep to REM sleep.” During these sleep transitions, you are not fully awake and you are not fully sleeping.
What triggers night terrors?
If the central nervous system (CNS) is overactive during sleep, it can trigger night terrors. Dr. Karim explains: “Children are often affected by night terrors because their central nervous system is still developing and as they age they tend to overcome the problem.”
Sleep disorders such as night terrors and sleepwalking often run in families. “Genetics is an important trigger for night terrors,” explains Dr. Karim. Having another family member who has had or has night terrors increases the chances of having night terrors of their own.
Even if you don’t have someone in the family who is terrified at night, other factors can trigger an episode. Other night terror triggers can be:
- Alcohol Use and Abuse
- Certain medications
- Emotional distress
- Head injury
- Migraine headache
- Separation anxiety
- Lack of sleep, stress or illness
- Sleep in a new environment
Experts still do not understand the exact cause of night anxiety, although it has been linked to trauma and chronic stress, such as post-traumatic stress disorder.
According to the Sleep Foundation, you’re more likely to have night terrors if you have a sleep disorder like nighttime asthma, obstructive sleep apnea (OSA), or restless legs syndrome. In children with night terrors, more than half of the OSA respiratory disorder is present.
What happens with night terrors?
Night terrors usually occur during the first third of the night when you are in a deeper or non-REM sleep. “You can suddenly sit up in fear, scream, or sound desperate,” explains Dr. Karim. “If someone tries to comfort you while you are having a sleep scare, you may not recognize them.”
Someone who has a night terrors can also:
- Be aggressive
- Breathe heavily and have a racing pulse
- Kick and beat up their limbs
- scream and shout
- Stare with open eyes but no reaction
- Sweating profusely
Usually people are difficult to wake up during a night horror and when they do they may not remember what happened.
What is the difference between a nightmare and a night terrors?
While you sleep, you alternate between two different sleep modes: non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. Your brain and body behave differently during these two states and during the transition.
Dr. Karim explains, “The main difference between a nightmare and a night terrors is that night terrors occur during NREM sleep and nightmares occur during REM sleep.” The usual window for night terrors to appear is when the sleep cycle transitions from the deepest stage of NREM to lighter REM sleep.
The main difference is that night terrors occur during NREM sleep while nightmares occur during REM sleep.
NREM sleep occurs first and is divided into three phases. The last two are if you are sound asleep. After the NREM phases, you move into a short phase of REM sleep.
During REM sleep or quick eye movement sleep, your eyes are closed but moving quickly. You can have vivid dreams or nightmares, but not night terrors.
“Everyone has nightmares from time to time, but night terrors tend to affect those with a history of parasomnia or only a few,” explains Dr. Karim. “Night terrors can be pretty scary, but when you wake up in the morning they usually only remember the nightmare and not the night terrors.”
What causes night terrors in children?
Waking up to the sounds of a child screaming is a disturbing experience. Although children often experience nighttime anxiety, as Dr. Karim explains, “Fortunately, their CNS is still developing, and by the time children reach puberty, most of them grow out of them.”
He added that “night terrors in children may be genetic or related to trauma or psychiatric disorder”.
Is Night Terrors a Sign of Mental Illness?
Night terrors can occur because you are stressed or anxious. Doctors agree that there is a strong link between emotional stress and night terrors.
Dr. However, Karim says: “In many circumstances night anxiety is not a sign of mental illness. There tends to be no significant association between mental disorders and night terrors. ‘
Even if you fear the worst because night terrors are so excruciating, it does not mean that you have any mental illness.
How do you stop night terrors?
“When you hit puberty, you grow out of fear of night,” says Dr. Karim. So most children with night terrors do not need treatment. It’s just a case of waiting.
For adults, night terrors can negatively impact their lives and relationships. It can be difficult to perform well at work or go about your usual daily activities when your sleep is disturbed. Stopping night terrors may not be easy, but there are a few things you can do to help alleviate the situation.
Establishing a good sleep routine and practicing ways to improve your sleep will help stop nighttime anxiety.
“Establishing a good sleep routine and practicing ways to improve your sleep will help stop night terrors,” advises Dr. Karim. Night terrors or not, getting enough sleep is important. Often times, when they commit to a healthy sleep schedule, people find that nighttime anxiety diminishes or disappears altogether.
There are many ways to improve your sleep, such as meditating, taking a relaxing bath, and avoiding caffeine and alcohol. You may want to try different approaches and record the results in a journal. Over time, you can create a sleep routine that works best for you and that keeps the nighttime horrors away.
“If you feel that night anxiety is caused by a specific event or health condition, your GP or sleep specialist can point you in the right direction,” says Dr. Karim.
What to do if your child is scared of night
It is important to stay calm when your child is terrified at night and remember that you may find it more frightening than the child.
“When a child is terrified at night, they usually do not respond, although their eyes may be wide open. As a parent, it is important to comfort your child but not to wake them up, as they will usually go back to sleep after a few minutes, ”says Dr. Karim.
A night terrors may seem very scary, but in general the child won’t remember it and there won’t be any long-lasting effects.
Does melatonin help with night anxiety?
Melatonin is the sleep hormone. Your body produces melatonin in response to darkness and prepares you for sleep. If you have trouble sleeping you may be naturally low.
So does it help with night terrors? Dr. Karim says, “5 mg of melatonin has been shown to prevent nighttime anxiety as it causes more REM sleep.” However, some doctors have advised against melatonin, so it is best to seek medical advice before starting any treatment.
Last updated: 19-02-2021
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