Also called night terrors, sleep terrors are a parasomnia-related
disorder. Parasomnias are a class of sleep disorders characterized by abnormal
movements, behaviors, emotions, perceptions, and dreams. In contrast to
nightmares, which are very vivid, highly frightening dreams occurring during
REM, sleep terrors occur during non-REM sleep, usually in the first part of the
night. This is obviously a very frightening experience for the person and
anyone who witnesses the event. Here is all you need to know about sleep
terrors, their cause, symptoms, and how they can be managed.
What are Sleep Terrors?
Sleep terror is a sudden state in which one gets up suddenly
and screams with flailing about of the body, yet still asleep. This is opposite
to nightmares whereby one wakes up and often recounts details of the
frightening dream. A person under sleep terror remains mostly asleep and
usually remembers nothing by morning. Sleep terrors are most common in
children, although they also happen to adults.
During a sleep terror attack, a person will sit up in bed,
scream or shout, exhibit tachycardia, and generally appear to be in a state of
panic. The movements may also include thrashing or even an attempt to get out
of bed. The outward signs are those of a person who is awake; however, in
reality, this person is not conscious and oftentimes cannot be easily comforted
or awakened.
Causes of Sleep Terrors
Although the true cause of sleep terrors remains unknown,
there are several predisposing factors that may be involved in it:
Genetics:
A little evidence suggests that sleep terror can be
transmitted in families. If there is a family history of sleep terrors or other
kinds of parasomnias, such as sleepwalking, there could then be likelihood for
having sleep terrors.
Sleep Deprivation:
Moreover, the cases of sleep terrors in children can appear
if the child does not get enough sleep or is not provided with a regular
pattern of sleep. A too overtired body may break the normal sleep cycle because
of which sleep terrors may strike.
Stress and Anxiety:
High levels of stress and anxiety may disrupt sleep,
including inducing sleep terror attacks. If the brain is stressed, this would
indeed well be responded to when one is asleep, thus leading to the attacks.
Fever and Minor Illness:
In children, sleep terror attacks are triggered by fever or
minor illness. The physiological stress of the body when ill will cause
discomfort to the body, affecting the ease of falling asleep and thus resulting
in parasomnias.
Environmental Factors:
The sleep environment may also trigger one's sleep terror
episodes. A change in the sleep environment, entry into a new home, or even
sleeping in a different place or environment may trigger the episodes. Other
than this, very loud noises or sudden lights while a person is asleep may
result in a sleep terror episode.
Medications:
Certain medications, mainly those that act on the central
nervous system, increase the propensity for sleep terrors. Some medications,
especially those that disrupt normal sleep architecture or produce vivid
dreams, are associated with an increased incidence of parasomnias.
Mental Health Conditions:
Some mental health conditions in patients, such as
depression, anxiety, and even post-traumatic stress disorder, may be triggers
in the attacks of sleep terror.
Symptoms of Sleep Terrors
Sleep terrors can be quite frightening in a person
experiencing such an attack. For the most part, though, the key symptoms
related to the incidence of such attacks are as follows:
- Sudden Waking: The person will suddenly get up and sit in bed; he or she may appear to be very frightened or terrified.
- Screaming or Crying: The attack may be marked by loud screams, cries, or shouts.
- Rapid Breathing and Heart Rate: This is the period of strong physical arousal whereby the individual starts breathing fast, sweats, and experiences a racing heart.
- Thrashing or Flailing: Physical movements can be dramatic during a sleep terror and include thrashing, kicking, or even trying to get out of bed.
- Incoherent Speech: The person speaks or shouts incomprehensible words or phrases.
- Unresponsiveness: With all this intense behavior, the person is very hard to wake up and usually is not responsive to attempts at comfort.
- No Memory of the Event: On awakening in the morning, there is amnesia for the sleep
terror event and any sleep content accompanying it.
How Are Sleep Terrors Diagnosed?
Sleeping terrors are mostly diagnosed by describing one's
symptoms or by the people who get to see them, like family members. One may
need to provide a health professional with information on how often, how long,
or how intense the recurring episodes have been and any related sleep disorders
or other general medical conditions.
In some patients, a sleep study may be required to rule out
other sleeping disorders, such as sleep apnea, that could be the cause of sleep
disruption and thus the parasomnias. The sleep study will monitor the brain
activity, heart rate, breathing, and movements of the patient while asleep.
Sleep Terrors: Management and Treatment
Most sleep terrors do not require any kind of treatment and
usually correct themselves, especially in children. However, if they recur too
frequently and become too much to handle with respect to disturbance or
disruption, then the following steps can help manage and minimize sleep terror
attacks:
- Improving Sleep Hygiene: The child will often be less likely to encounter sleep terror attacks if he or she maintains a regular sleep pattern and obtains adequate amounts of rest at night. Establishing a calm and soothing bedtime routine can be important as well.
- Management of Stress: As it is very known that stress is a common trigger for sleep terror attacks, managing and reducing the amount of stress during the day can help in reducing the possibility of sleep terror attacks. These practices include mind relaxation, meditation, and other relaxation techniques.
- Treatment of Underlying Disorders: In cases where the sleep terrors relate to an underlying health disorder, treatment for the primary disorder, such as sleep apnea or mental health disorders, will help in the reduction of sleep terrors.
- Pharmaceuticals: If the sleep terrors are too disruptive or recur frequently, a health professional may prescribe medications. Some medications, mostly those that alter the sleep cycle, are useful in reducing sleep terrors.
Sleep Terrors vs. Nightmares
It needs to be underlined that sometimes people mistakenly
confuse sleep terrors with nightmares:
- A nightmare is a more vivid, unpleasant dream during REM sleep—generally
later in the night estimating the sleeper. Often, these are recalled by the
waking person and may make it difficult to go back to sleep.
- Sleep terrors occur in non-REM sleep, typically in the first
one-third of the night. The symptoms include feelings of fear and
physical-sympathetic-type symptoms. There is usually no memory of such episodes
on waking up in the morning.
Seeking Help
Although sleep terrors are harmless and non-troubling and
may altogether cease on their own, there is a necessity to consult a doctor if:
- The episodes are frequent and troublesome.
- The violence of the physical movements might cause the
individual to hurt himself in the process.
- Other sleep disorders like sleep apnea are likely to be present.
- The sleep terrors are causing much distress to the
individual or their family.
Conclusion
Although sleep terrors are a very distressing experience for
the person going through them and others around him or her, greater
understanding of their cause and means of management enables its frequency and
impact to be reduced. Professional help can underline relief if the sleep
terrors are too frequent or very strong and make sure that the underlying cause
is treated.
Please book an appointment with the best Psychologist in Lahore, Karachi, Islamabad, and all major cities of Pakistan through InstaCare, or call our helpline at 03171777509 to find the verified doctor for your disease.
