Night terrors affect millions of people worldwide. Research estimates that up to 40% of children will have one episode at least once during early childhood. Night terrors can be overwhelming nighttime experiences that can happen to people both adult and children, but often happen to children.
Night terrors can affect an adult, usually when they’re very stressed, or in a state of sleep deprivation. Night terrors can be a frightening experience and cause the sleeper distress but can also affect the peace and calm for the entire household as well. You can limit night terrors with an awareness of the causes, signs and symptoms, frequency and duration.
What are Night Terrors?
Night terrors are most common in children aged 3 to 12, with some studies showing that up to 40% of children may experience them occasionally. They tend to decrease with age and usually resolve by adolescence. However, adults can also experience night terrors, particularly those with high stress levels, trauma history, or co-existing sleep disorders like sleep apnea or restless leg syndrome.
Night terrors in toddlers are most common between 3 and 12 years old, with epidemiological studies suggesting that approximately 40% of children may experience occasional night terrors. Night terrors decrease with age and are typically resolved by adolescence.
Night terrors in adults are typically in the presence of other conditions or increased stress, or trauma, or in conjunction with other sleep disorders such as sleep apnea or restless leg syndrome.
Typical episodes of night terrors last anywhere from 30 seconds to a few minutes. However, these episodes can last longer in rare instances of a long episode lasting 15–20 minutes. The frequency of episodes can vary considerably. Some people have one isolated episode, while other patients have episodes nearly every night, or multiple times per week.
Symptoms of Night Terrors
Although individuals who have night terrors tend not to recall the episode, the disruption in sleep may lead to irritability, fatigue, and cognitive impairment. In adults, the effects of night terrors can be especially detrimental to overall health and well-being when they occur with frequency and/or intensity.
- Sudden awakening with intense fear or panic
- Screaming, shouting, or crying in sleep
- Rapid heartbeat and breathing
- Sweating or flushed skin
- Dilated pupils
- Kicking, thrashing, or sitting upright
- Unresponsive to comfort or attempts to wake
- Confusion or disorientation upon waking (if awake at all)
- No memory of the episode the next morning
- Episodes usually occur in the first half of the night (non-REM sleep)
Causes of Night Terrors
1. Sleep Deprivation: When one does not get enough sleep, normal sleep patterns can be interrupted, as well as increasing the chances of experiencing night terrors to children.
2. Stress & Anxiety: Excessive levels of emotional or psychological stress can lead to night terrors, particularly if there is excess stress due to some changes or traumatic events.
3. Fever or illness: Increased body temperature, as well infections in children, can change brain activity while in deep sleep, which can lead to night terrors.
4. Sleep Disorders: Obstructive sleep apnea, restless leg syndrome, chronic insomnia are important sleep disorders that can affect the sleep framework can in turn lead to night terrors.
5. Medications or Stimulants: Certain drugs (especially for the central nervous system) and ingestion of caffeine or energy drinks before sleep can lead to night terrors.
6. Genetics: Genetic components may also play a role, as those with a family history of parasomnias such as sleepwalking & night terrors increase the chance of experiencing night terrors.
7. Irregular Sleep Schedule: Having an irregular sleep schedule or frequently waking up at different times and sleeping much later may affect deep sleep and increase episodes.
8. Emotional Trauma: Night terrors may also occur with post-traumatic stress disorder or unresolved emotional conflict will manifest during sleep. This is especially true with adults.
How Common Night Terrors Are?
Night terrors are fairly frequently seen in children, especially in the 3 to 12-year-old age range. Research estimates show night terrors affect approximately 1% to 6.5% of children, with episodes peaking around ages 4 to 7. Children typically outgrow night terrors by adolescence and do not require treatment in the majority of cases.
In contrast, adults experience night terrors very infrequently, affecting less than 1% of the adult population. When adults do experience night terrors, they often relate to more chronic stresses, trauma, and other sleep disorders.
Nightmares Vs. Night Terrors
| Feature | Nightmares | Night Terrors |
|---|---|---|
| Sleep Stage | REM sleep | Non-REM (deep) sleep |
| Time of Occurrence | Often in the second half of the night | Usually in the first few hours of sleep |
| Awareness | Person often wakes up fully | Person may appear awake but is unresponsive |
| Memory of Episode | Usually remembered vividly | Rarely remembered |
| Behavior During Episode | May cry or wake up scared, but is easily comforted | May scream, thrash, and appear terrified |
| Duration | A few minutes | Several minutes; can last longer |
| Emotional Impact | Can cause lingering fear or anxiety | Confusion and fatigue afterward |
| Age Group | All ages, more common in adults | Mostly children aged 3–12 |
| Cause | Often linked to stress, trauma, or fear | Triggered by stress, fever, sleep disruption |
| Need for Treatment | Rarely needed unless frequent or intense | May require help if frequent or harmful |
What Triggers Night Terrors?
Triggers are immediate factors that provoke an episode. Here's a list of night terror triggers specifically:
- Sudden loud noise during deep sleep
- Sleep apnea
- Sleep deprivation
- Overheating during sleep
- Irregular routines
- High fever
- Overtired-ness
- Smoking
- Stress and anxiety
- Late-night screen time
- Consuming alcohol
Severe Risk Factors of Night Terrors
While night terrors are typically harmless and temporary, certain severe risk factors can lead to more frequent or intense episodes. Recognizing these high-risk conditions is important for early intervention and proper treatment:
Post-Traumatic Stress Disorder (PTSD) – strongly associated with frequent and intense episodes, especially in adults.
Neurological Issues – disorders such as epilepsy or traumatic brain injury can interfere with normal sleep processes.
Chronic Sleep Disorders – untreated sleep apnea or insomnia can amplify night terrors and increase frequency.
Substance Abuse – alcohol, recreational drugs, or sedatives can alter brain functioning during sleep.
Serious Mental Illness – depression, bipolar disorder, and anxiety disorders can increase nervous system arousal.
Traumatic Brain Injury (TBI) – may create abnormal brain signals during deep sleep.
Chronic Sleep Deprivation – causes prolonged non-REM sleep, increasing the risk for intensification.
Use of certain psychotropic medications – antidepressants or stimulants may alter sleep architecture.
How to Diagnose Night Terrors?
The diagnostic process for night terrors generally begins with a detailed medical and sleep history that sometimes incorporates information from bed partners or caregivers. To evaluate night terrors, a doctor may recommend a sleep study (polysomnography).
A polysomnography test tracks brain activity, heart rate, breathing, and movement while sleeping, especially when episodes are occurring more than occasionally; with violent behavior; and/or if they are associated with other sleep disorders. In addition, on occasion, a psychological evaluation to assess underlying stress, trauma, or mental health issues may be recommended.
Recommended Medications for Night Terror Treatment
Medication is usually a last resort and only prescribed when night terrors are frequent, severe, or disruptive to safety and quality of life. Common options include:
Benzodiazepines (e.g., clonazepam) – Helps reduce deep sleep arousals
Tricyclic antidepressants (e.g., imipramine) – Used in persistent cases, especially in children
Selective serotonin reuptake inhibitors (SSRIs) – Prescribed if night terrors are linked to anxiety or PTSD
Melatonin supplements – Sometimes used to regulate sleep patterns
Short-term sedative use – In specific adult cases under medical supervision
Note: The aforementioned information is not a medical advice, just informative data inspired from credible sources. Always consult a healthcare provider before starting any medication, as treatment depends on age, underlying cause, and severity.
How to Stop Night Terrors (Treatment)?
Treatment for night terrors often starts with better sleep hygiene and a regular sleep schedule. Practicing a relaxing bedtime routine, limiting screen time before bed, and avoiding caffeine and heavy meals in the evenings, may reduce nighttime disturbances significantly. Reducing stress and anxiety, through relaxation training, therapy, etc. is also very helpful, particularly in adults.
In some cases, scheduled awakenings, gently waking the person 15–30 minutes before the normal timing of the episode, may help break the cycle and prevent the episode from happening that night.
Treating any potential underlying sleep disorder, for instance sleep apnea or restless leg syndrome, will also improve longer-term management of night terrors. If a person suffers from regular and or severe and potentially dangerous night terrors, the health care provider may recommend cognitive behavioral therapy (CBT) or short term medication, with either benzodiazepines or tricyclic antidepressants.
Medication is generally a last solution, and should only be tried under the supervision of a health care professional.
How to Sleep with Night Terrors?
Managing night terrors when sleeping begins with a calming and predictable bedtime routine:
- Keep the same sleep schedule every day, including weekends, to reduce the variability in your sleep cycles.
- Ensure that the bedroom is quiet, dark, and at a comfortable temperature to minimize interruptions to deep sleep.
- Avoid using caffeine, alcohol, or heavy meals before your sleep schedule, as these can disturb the quality of sleep.
- Practicing relaxation techniques, such as deep breathing, meditation, or gentle stretching, even a short session of 5–15 minutes of practice before bed, may help you let go of some anxiety that has built up during the day.
- If episodes are frequent, consider safety measures, such as removing items that could be used as a weapon to harm themselves or others, or using bed rails.
- For adults, it is important to address the underlying issues, which could be stress or sleep disorders.
Working with a therapist or other professional can help you develop a plan to improve your sleep and potentially mitigate night terrors over time.
Prevention of Night Terrors
A healthcare practitioner can propose strategies to enhance your sleep hygiene. Your sleep hygiene will help get the amount of sleep and the right quality of sleep needed. It may lessen the frequency of your night terrors. Recommended changes will include:
- Establishing a regular sleep pattern and getting an appropriate amount of sleep for your age.
- Avoid drinking alcohol or caffeine shortly before going to bed.
- Eliminate sleeping disruptions such as bright lights or loud noises.
- Manage any underlying sleep disorders, for example, sleep apnea.
- Relocate furniture (such as night stands) or any potentially dangerous objects from around your bed to improve safety if you do encounter any episodes during the night.
When to Consult With a Medical Professional?
If night terrors occur consistently, increase in intensity over time, or the individual risks harm during episodes, you should mark it on your calendar to see your healthcare provider. You may also want to seek help if the episode leads to:
- severe fatigue in the day, affecting family or personal life;
- if it develops suddenly and unexpectedly, especially in an adult; or
- if there is strong concern about the possibility of other comorbidities, such as:
- obstructive sleep apnea
- anxiety, or
- past trauma
A healthcare provider can evaluate the situation, and may suggest treatment or recommendation including, but not limited to, therapy, sleep study or medication.
Final Thoughts
Although night terrors can be very disturbing to the person experiencing them and to anyone who witnesses the event, they are, for the most part, temporary and manageable if addressed in the correct manner.
Many people can limit the severity and frequency of happening by keeping a regular sleep schedule, reducing stress, and addressing contributing factors. If night terrors continue or impact daily life, getting professional support will guarantee a proper diagnosis and treatment.
