Get Some Sleep: Night terrors explained
February 1st, 2011
01:11 PM ET

Get Some Sleep: Night terrors explained

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

Emily is an 8-year old girl with no past medical problems who was brought to my sleep center by her mother because of “terrible nightmares.” Her mother reports that at least three times a week, Emily “wakes up with a blood-curdling scream.”

Her parents usually find her sitting up in her bed, with her eyes wide open; she appears terrified and acts agitated and confused. When this first started, they would try to hold her and comfort her, but she would push them away and appeared even more upset, so now they just watch her until she goes back to sleep which is usually within a few minutes. Emily has no memory of these episodes.

They seemed to start a few months ago and were becoming more frequent. Her parents can almost set their clock by these episodes because they occur two hours after she falls asleep ,which these days is around 9:30 pm. Mom is worried that Emily might have “psychological problems.” She does well in school and appears to be a happy child. She does appear tired lately, her mother reports, but never naps. She has had strep throat in the past six months and in general she gets frequent sore throats.

This is a classic presentation of night terrors, a common parasomnia that occurs in 1%-6% of children. They are very unsettling to witness, because an episode begins with a piercing scream and children appear terrified. They are found to have rapid breathing, racing heart and sweatiness. However, it is rare for children to report a nightmare associated with the night terror and typically they do not remember the night terror episode. And night terrors almost never represent a psychological or psychiatric problem in children.

We don’t know what causes night terrors but they are classified among the arousal disorders, or  conditions in which someone seems half-awake and half asleep, partially aroused from a deep sleep. Actually, the children are only partially awake even though their eyes are open. They do not respond to their environment and, as Emily’s parents discovered, they seem more upset if someone attempts to comfort them or wake them. Sometimes, they can fall out of bed or have a sleepwalking episode associated with the night terror so it is good that Emily’s parents stay with her until the episode is over.

These and other parasomnias such as sleepwalking do tend to run in families. Causes can include include sleep deprivation and obstructive sleep apnea. In this case, partial sleep deprivation was determined to be a contributing factor. Emily had been accustomed to going to bed at 8 p.m., but a few months before the night terrors began her family started eating dinner later because her father was coming home late. Therefore, her bedtime was pushed later by one to two hours.

When she returned to her 8 p.m. bedtime, the night terrors decreased to once a week. I was still concerned that her large tonsils and rough breathing at night meant that she might be at risk for obstructive sleep apnea.

Sure enough, Emily was found to have moderate obstructive sleep apnea that resolved after a tonsillectomy with adenoidectomy. The night terrors decreased to one episode every two or three months. The chances are that she will outgrow the night terrors completely when she enters her teen years.

soundoff (311 Responses)
  1. JJ

    I had night terrors for years and then found out that I was hypothyroid. Once I started taking synthroid, the night terrors stopped. A cure?

    April 28, 2012 at 09:51 | Report abuse | Reply
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  3. billguillen6

    Yes but there is another dimension to night terrors that remains unmentioned. In fact it is unmentioned because it is unmentionable. It is the experience of the abyss.

    July 25, 2013 at 16:17 | Report abuse | Reply
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  17. Timothy

    I am 43 and have had night terrors since I was a young boy. Mostly voices when I was young. In college it got bad, really bad images. After college I had to ask my girlfriend to please WAKE ME UP when I started to scream, but she didn't think it necessary. Now, my wife has grown to learn when she should wake me up. I am not violent, Just screaming out of breath. I cannot go to sleep without the TV on, because I have taught my brain that Reality is a TV and no TV is a Terror. When I am actually awake, I see a TV. This is a very bad condition, and I feel for anyone who has any form of it..... People don't understand how it effects us.

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  23. Monica

    My son is only 15 months old but has been getting night terrors since before he was 1. They are very scary and one thing he does during these episode is have his arms pinned to his side. He is lying face up and it looks as if someone is pinning him down. When I try to soothe him, he scratches at me and attempts to get away from me as if I'm hurting him. I've done a lot of research and found commonalities in the age range night terrors will occur. No where did I find night terrors occurring in children less than 18 months. He has been getting them since he was around 8 months old and is 15 months old now. Is this normal and should I be worried? Also, I was diagnosed with Hypersomnia, can that be a factor of why he is have bought terrors? Thank you for your time and I hope you can help.

    July 15, 2014 at 23:58 | Report abuse | Reply
  24. Monica

    Sorry there was and error in the second to last sentence.
    *Also, I was diagnosed with Hypersomnia, can that be a factor of why he is having night terrors?

    July 16, 2014 at 00:01 | Report abuse | Reply
  25. Hannah

    I've been sufferig from severe night terrors since I was 20. Last year I started a gluten free diet and after about two weeks the terrors were gone! I can recommend anyone suffering from night terrors to start eating gluten free. I know it takes a lot of commitment but not having the terrors anymore is an incredible relieve!

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  28. Jenna

    Norm and Jim

    I have "the gift" but I never thought my girls would. Our youngest started havin night terrors at 2 and had them until 8 years old. We spent several stays in hospitals. Went through 3 psychiatrist. And psychologist. Several specialist and even have a seizure dog. Hers were so severe that they were classified as seizures. I can tell you we went throug the gambit.

    Around 8 years old we went to a Native American festival. A very old medicine man walked over to us. He kneeled to our daughter and they exchanged glances but no words. They smiled at each other as if they were old friends.
    The old man came to me. He said. "When I look into your little ones eyes. I see the tribe. She has a tribe with her always. She is Navajo and she is a powerful medicine man and the wolf protects her"
    We really didn't know what to say. But we looked into this as a possibility. ( if you have ever had a child with night terrors you get desperate and we were at that time so we were investigating all possibilities and the wierd part was our daughter has had a fascination with wolves all her life. Her room was filled with them. Stuffed. Pictures. Calanders etc)
    We found a way of making her a medicine bag. And we looked into learning all we could about the Navajo people and eventually he came to terms with her gift and is currently terror free. Sure she sees things and knows things and still gets scared sometimes but now we know how to handle it. Without medications or surgeries.
    I am not saying it will work for everyone but always listen and pay attention to your children. Explore all options. Don't discount any possibility. Like Jim and Norm said. Believe your kids. You can keep the spirits out and protect your children. If you listen.

    June 6, 2015 at 23:56 | Report abuse | Reply
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