Imagine waking up next to someone screaming, flailing, and showing intense fear while asleep. Not knowing what to do, you panic and try to calm them down. But does it work?
If it’s your first time to witness any of your family members having night terrors or any of these sleep habits, it has most likely been a cause of great alarm. And as frightening as it can be, these sleep terrors will require treatment if they cause problems getting enough sleep or pose a safety risk.
So, what are the symptoms and causes of night terrors? And how does the experience of adults differ from children? Are there effective treatment and prevention steps that address this? Let’s find out.
Night Terrors in Adults vs. Children
Night terrors usually happen in children between 4 and 12 years of age and 3-6% of children go through it. Even one sleep study found that up to 40% of children under age five experience night terrors.
On the other hand, according to the American Academy of Sleep Medicine, only 2.2% of adults experience night terrors. Although this is not a significant number, it is still essential to understand this phenomenon among adults and address it if it turns out to be a medical condition.
So what’s the difference in experience between adults and children? Adults might recall fragments of the dream they had during their sleep cycle. On the other hand, children usually don’t remember anything about their sleep terrors in the morning.
According to pediatrics, most children will outgrow night terror episodes without treatment. However, this may not always be the case for adults. It will always depend on their mental and emotional condition. The best way to end it is through treatment, which will be discussed later.
Night terrors are distinguished by extreme fear, excessive sweating, labored breathing, confusing behaviors, paling of the skin, and screaming.
Those experiencing night terrors have the impaired ability to return to full consciousness. Their eyes are wide open, yet they are seemingly unaware of their surroundings.
Don’t be confused, though. A night terror is different from a nightmare, as a night terror rarely involves a dream at all.
Taking the stages of sleep into consideration, a night terror occurs during the first third of the night or during deeper sleep. It is also called the slow-wave sleep or the non-rapid eye movement (NREM) part of the sleep cycle.
People think sleep terrors are synonymous with nightmares. But a nightmare usually happens at random and takes place during the rapid eye movement (REM) cycle. On the other hand, night terrors tend to be more routine, usually appearing somewhere between nightly and monthly.
Frequently, it can be difficult to rouse someone experiencing a night terror. Since night terrors include motor activity, adults may jump out of bed and run, attempting to leave through doors or windows. The person tends to be unresponsive while sleepwalking and will be confused and disoriented if awakened. They usually end up going back to normal sleep patterns without fully waking up.
Adults experiencing night terrors also tend to suffer from other sleep disorders such as nocturnal asthma, obstructive sleep apnea, restless leg syndrome, confusional arousals, or gastroesophageal reflux.
In adults, night terrors are often a symptom of a deeper issue or a mental health condition, closely associated with life trauma and psychological disorders.
According to a published study, night terrors happen in adults with histories of psychopathology. During the polysomnography, disorders of arousals were documented from slow-wave sleep in 9 of 10 patients. And in this case report, all of the original patients reported psychiatric symptoms.
There are also a handful of adults experiencing sleep terrors who are likely to have a history of bipolar disorder, depressive disorder, or anxiety disorder.
These cases entail signs of aggression, anxiety, memory loss, and inward pain that are often expressed in the form of self-harm, as the unconscious mind is unable to overcome the disconnect between reality and illusion.
Additionally, several factors have been shown to trigger night terrors:
- Sleep deprivation
- Separation anxiety in children
- Periods of emotional distress or conflict
- Disruption of sleep schedule
- Certain medications
- Alcohol use and abuse
- Migraine, headaches
- Head injury
- Post-traumatic stress disorder
- Sleep-disordered breathing — commonly obstructive sleep apnea
- Restless legs syndrome
There is also evidence that night terrors have a genetic component, as there are some cases of individuals who have a family history of parasomnia, specifically their close relatives, that experience night terror.
This is almost the same case with children as 80% of children who have night terrors have a family member who also has it or sleepwalking.
Treatment and Prevention
It is essential to seek medical advice upon encountering the following scenarios involving night terrors:
- Episodes occur two or more times per week
- Episodes result in injury or near injury
- Night terrors are accompanied by sleepwalking or sleep talking
- A person has disrupted sleep and/or daytime sleepiness or problems functioning
- Sleep terrors begin in adolescence or adulthood
If there is also an underlying medical problem or any psychiatric condition, which is usually the case for adults experiencing night terrors, treating that condition with the help of a doctor plays an integral role in reducing the symptoms.
It is also advisable to work with a sleep specialist who can help identify, and address, underlying causes. They may also prescribe therapy to manage the symptoms of night terrors.
Typical medication given by doctors falls under anti-depressants and pain relievers, namely Klonopin, Tofranil, and Valium. With these medications, it could take up to two weeks to experience optimal results while dosage is adjusted until the perfect balance is found.
In case you are not comfortable ingesting psychotropic medications, an all-natural herbal remedy has been shown to reduce the telltale symptoms of depression and anxiety. It’s called St. John’s Wort.
General prevention tips revolve around creating a healthy sleep routine. This includes banning blue light at night, relaxing and meditating, limiting caffeine and alcohol, and making your bedroom a safe space for sleep while limiting work activities.
If you have loved ones or family members who experience night terrors, it will also be helpful to heed advice against rousing someone mid-episode since there’s always the possibility that the person experiencing the night terror could react violently. It will be great to show support and alleviate stress together only as soon as your loved one wakes up from the night terror.