Night terrors

A night terror is a brief disruption of normal sleep in which the sleeper becomes terrified. 

If you have a night terror you may call out, scream, thrash your arms and legs, or try to get out of bed while still asleep.

Afterwards you probably won’t remember the experience, and will fall back to sleep. 

Night terrors tend to last between one and six minutes and they are more common in toddlers and children than adults.

Although they can be disturbing to witness, the attacks are mostly harmless and most children grow out of them. 

Adults may develop night terrors due to underlying mental health conditions, such as post traumatic stress disorder (PTSD), or because of interrupted sleep due to medications or disorders like sleep apnoea.

If you or a family member are having a night terror you will show certain symptoms and behaviours including: 

• Amnesia – you probably won’t remember your night terror
• Confusion – you may wake from a night terror feeling disorientated
• Difficult to wake – it may be difficult to wake you up
• Distress – though you may not remember your night terror to an observer you will appear quite distressed and fearful while asleep
• Vocalisation – you may scream or sleep-talk
• Agitated – you may thrash your legs and arms or sleepwalk away from the bed to escape, and if your child is having a night terror initially it may be difficult to comfort them
• Physical symptoms of anxiety – your heart rate may increase even double, you may sweat, have rapid breathing and dilated pupils
• Timing – night terrors tend to happen within the first three hours of sleep

How are nightmares different from night terrors?

When we go to sleep we enter into a sleep cycle which has two main phases: 

• Non-rapid eye movement (NREM) phase
• Rapid eye movement (REM) phase

Each sleep cycle lasts between 90 to 100 minutes and has a longer NREM phase followed by an REM phase. Most people have four to six sleep cycles in one night.

Nightmares usually happen during the rapid eye movement (REM) phase at the end of the sleep cycle, whereas night terrors tend to happen during the non-rapid eye movement sleep (NREM) at the beginning of the sleep cycle. 

If you have a night terror it will normally happen when you first go to sleep during your first sleep cycle when you’re in deep (NREM) sleep. 

It is rare to have more than one night terror episode in the night. 

Around a third of people will experience a night terror at some time in their life.

Children between the ages of three and seven are the most likely age group to have night terrors with a small percentage (2%) experiencing frequent episodes.

Night terrors tend to happen less the older we get. 

You may experience night terrors as a teenager but by adulthood you’ll have grown out of them. 

It’s quite rare to develop night terrors later in life unless you have post traumatic stress disorder or are on certain mediation. 

If you sleepwalk or sleep-talk you are more likely to have a night terror.

There are several factors associated with night terrors including

• Brain development – night terrors may be a normal part of growing up. Children tend to have more night terrors than adults because their brains are growing and their sleep patterns are developing
• Genetics – night terrors can run in families
• Sleep deprivation e.g obstructive sleep apnea (difficulty breathing while you sleep)
• Erratic sleeping habits e.g. restless legs syndrome
• Medications (antihistamines and antidepressants)
• Alcohol (in adults)

Emotional disturbance can trigger night terrors, including:

• Post traumatic stress disorder (PTSD)
• Depression and anxiety
• Low self esteem
• Phobias
• Unexpressed emotion such as aggression

There are different techniques for managing night terrors in children and adults.

Children with night terrors:

• If your child is having a night terror don’t try to wake your child
• Provide comfort and reassurance until they wake
• If they are sleepwalking, walk them gently back to their room
• Remove any hard objects from your child’s room so they can’t injure themselves
• If your child has attacks at a certain time each night, wake them just before the attack is due then ease your child back to sleep
• Speak to your doctor or specialist if you are concerned

Adults with night terrors:

• Speak to your doctor or specialist to get confirmation that you are having night terrors
• Your doctor or specialist may refer you to a sleep clinic where they can identify the cause of your sleep disorder
• Treatment involves a combination of cognitive behavioural therapy (CBT) and medication

Can night terrors be mistaken for something else?

Night terrors can be mistaken for other conditions including: 

• Epilepsy
• Nocturnal panic attacks
• Dementia (sundowning syndrome)

At The London Clinic we have a dedicated sleep clinic with different treatment options for night terrors and other sleep disorders.

Private patients can choose from three study packages which are run in collaboration with Sleep & Health Clinic Ltd:

• Sleep study with real-time attendance and an overnight multiple sleep latency test (MSLT)
• Sleep study with subsequent reporting and analysis
• Home outpatient sleep study

All of our packages include the Sleep & Health Clinic study fees.

One of our renowned sleep specialists will treat you for your night terrors and any underlying issues that may be contributing to episodes of disrupted sleep.