Medical App & Medical Advice with Hello Doctor

Are night terrors the same as nightmares?

It’s the middle of the night. Your child is screaming and shouting out in intense fear. It’s a terrifying experience for you to watch and it feels as if there’s nothing you can do to console him. He’s probably having a night terror… fortunately, these are rarely harmful and most children outgrow them by adolescence. Fewer than 2% of adults experience them.

What is a night terror and how does it differ from a nightmare?

A night terror:

  • Is an episode of intense fear.
  • It takes place whilst the person remains asleep.
  • It’s associated with crying, shouting, screaming, kicking or thrashing, fast breathing and a rapid pulse.
  • It can last from 1-45 minutes.
  • It occurs during non-REM sleep (non-dream sleep), about 90 minutes after falling asleep, the person will usually not be able to remember the incident the following morning.
  • It can occur in conjunction with sleep –walking during a night terror, the person will be unaware of your presence, be inconsolable and difficult to awaken.

A nightmare:

  • the person wakes up from their dream.
  • the person can remember aspects of their dream.
  • it occurs during REM sleep (dream sleep), often during the second half of the night.
  • your presence will be a source of comfort to the person.

What causes night terrors?

  • the cause is not fully known, although night terrors tend to run in families.
  • night terrors can be associated with the following medical conditions:
    • Obstructive sleep apnoea
    • Medications affecting the central nervous system
    • Restless leg syndrome
    • An overactive thyroid gland
    • Neurological conditions such as: migraines, stroke, encephalitis, head injuries
  • Factors that can contribute to night terrors include:
    • Fever (especially in children)
    • Sleep deprivation
    • Sleep disturbance from noise or light
    • Stress
    • Sleeping in an unfamiliar place
    • A full bladder

What can be done about night terrors?

  • Educate the family/people sharing the home, that night terrors are generally not dangerous.
  • Keep to a regular bedtime routine (going to bed and getting up at the same times each night and morning).
  • Avoid caffeine and stimulants.
  • Consider an ENT opinion where enlarged tonsils or adenoids could be causing sleep apnoea/obstruction during breathing at night .
  • Make the bedroom and surrounding area safe by:
    • keep windows and outside doors locked and install a gate at the top of stairs
  • In the event of a night terror:
    • Stay with the person during the episode
    • Do not try to wake the person up
    • Do not restrain or hold onto the person, unless you can see he/she is in direct danger of hurting
      him/herself
    • Be calm, talk quietly if necessary
    • Block the person from coming in contact with any potentially harmful objects by placing yourself
      between the person and the specific object

When is it necessary to see a doctor about night terrors?

  • When night terrors start in adulthood
  • When night terrors persist beyond early teen years
  • When they pose a safety risk or cause injury
  • When they lead to sleep deprivation
  • If they become more frequent