What Causes Night Terrors?

Night terrors, also called sleep terrors, are often confused with nightmares. However, they are very different from each other.

Night terrors are present as episodes of intense fear, screaming and flailing (moving without control) while still being asleep, and are often associated with sleepwalking. They are considered a form of parasomnia (a sleep disorder that involves unusual and unwanted physical events or experiences that can disrupt sleep). Episodes of night terrors usually last a few seconds to minutes, though they sometimes may last longer.

Sleep terrors are more common in children (affecting almost 40 percent of children) and occasionally can affect adults as well. Most children outgrow them by the time they become a teenager. Furthermore, they may not be able to recall their night terrors when they are fully awake.

Night terrors require treatment if they are affecting the person’s quality of sleep or pose a safety risk.

Nightmares are vividly realistic, disturbing dreams that can disturb sleep, create fear and even cause palpitations and rapid breathing. Nightmares tend to occur most often during rapid eye movement sleep or REM sleep, which most dreams occur during this stage. Because periods of REM sleep become progressively longer as the night progresses, nightmares are more common in the early morning hours.

The subjects of nightmares can vary with people. However, there are some common themes that many people experience. For example, not being able to run fast enough to escape danger, falling off a cliff, teeth falling out, etc. Recurrent nightmares may occur following a traumatic event, such as an attack or accident.

Nightmares and night terrors both cause disturbed sleep and awaken people in fear. However, they are different. Night terrors usually occur in the first few hours after falling asleep. They are experienced as feelings and not dreams. Generally, people do not recall their night terror and why they are terrified on awakening, but people may be able to recall nightmares.

Nightmares and night terrors can occur in adults and children, with night terrors more common in the latter. Chronic, recurrent nightmares can result in poor quality sleep and affect mental and overall health.

Nightmares and night terrors caused by other medical conditions or medications usually stop when the condition is treated or the medications are discontinued. Psychological conditions may require treatment with medication and psychotherapy. They are effective in most cases, including those who have depression, anxiety or post-traumatic stress disorder (PTSD). Lifestyle changes, such as keeping a regular sleep-wake schedule, regular exercise, practicing yoga and meditation and stress management can help reduce and prevent night terrors.

The following ways may help reduce the frequency or stop night terrors and nightmares in children:

• Making sure the child gets enough sleep
• Keeping the bedtime routine light and happy
• Talking about the nightmare during the day
• Comforting and reassuring the child
• Encouraging the child to go back to sleep in their own bed
• Avoiding keeping bright lights on in the bedroom, but a night light may be used to give the child comfort
• Leaving the bedroom door open, so they feel safe and close to the parents
• Seeking the help of a doctor or child counselor to help address the underlying cause and help the child overcome nightmares and the associated distress