Theory and Treatment of Night Terrors

Night terrors are a sleep disorder which is relatively common in children from the ages of six months to three years old, affecting roughly five percent of the population. It can potentially occur in people of any age, but is far less common at one percent.

Also known as sleep terror disorder, and Pavor Nocturnus; the typical night terror episode starts with the child awakening during the fourth stage in the sleep cycle in a state of absolute terror. They will scream, shout, and run around as if in a living nightmare. For this reason many people suffering from this disorder are often mis-diagnosed with Post-Traumatic Stress Disorder.

Though their eyes are open and they are technically awake, they cannot communicate and often do not acknowledge the presence of other people. Physical symptoms include tachycardia averaging 120-150 beats per minute, pupils dilated to pinpricks, uncontrollable shivering, and high blood pressure. The episodes last up to thirty minutes, and while apparently conscious, they cannot be reasoned with and appear to not recognize other people and their surroundings.

It is nearly impossible to wake a person during a night terror, but when they finally do snap out of it they will have little memory of what happened and the faint suggestion that, up until that point, their surroundings were in some way horrific and terrible that they needed to flee from immediately.

These episodes are not in and of themselves dangerous, but because of their frantic behavior they run the risk of tripping, falling, crashing into things, and even hurting themselves while operating household appliances. Paradoxically there are some people that seem to gain near superhuman traits while under the influence of a night terror. My own brother has suffered from them for many years and still does, which, at the age of eighteen, is extremely rare. When experiencing a night terror he is able to run through a pitch black room at top-speed without breaking step. He becomes incredibly agile, able to leap over most anything in the house, and is incredibly strong to the point that he once picked up and threw a large sofa half-way across the room. In spite of this, he moves as if he is light as a feather, once scrambling halfway up the tiled wall of a bathroom before falling.

It is unclear as to what causes such episodes. They can occur within infants as young as six months, it is not likely they are trauma induced. They do often to run in the family, however, suggesting a genetic tendency. During such an episode the person should not be held or touched as it will trigger an immediate attempt to flee. Several drugs have proven marginally effective; imipramine and several benzodiazepines have had the best result. It has been suggested that by changing the mood of surroundings the person in a sleep terror may be slowly calmed. Specifically, turning on lights and electrical appliances that are commonly heard throughout the house. Also talking to the person in a quiet, soothing manner and playing comforting music can help.

In most cases the episodes are just a phase which the child will grow out of, but in adults there is little that can be done. It is unfortunate that at this point medicine has little knowledge about what can trigger sleep terrors, as well as effective treatments.

References:
Berkeley Parents Network. http://parents.berkeley.edu/advice/sleep/terrors.html
March 21st, 2005.

Richards, David W. Night Terror Research Center. http://www.nightterrors.org/ 2003.