Night terrors
| Night terror | |
|---|---|
| Synonyms | pavor nocturnus |
| Classification and external resources | |
| Specialty | Psychiatry |
| ICD-10 | F51.4 |
| ICD-9-CM | 307.46 |
| MedlinePlus | 000809 |
| MeSH | D020184 |
Night terror, also known as sleep terror, is a sleep disorder, causing feelings of terror or dread, and typically occurs during the first hours of stage 3-4 non-rapid eye movement (NREM) sleep. Night terrors tend to happen during periods of arousal from delta sleep, also known as slow-wave sleep. Delta sleep occurs most often during the first half of a sleep cycle, which indicates that people with more delta sleep activity are more prone to night terrors. However, they can also occur during daytime naps.
Night terrors have been known since ancient times, although it was impossible to differentiate them from nightmares until rapid eye movement was discovered. While nightmares (bad dreams that cause feelings of horror or fear) are relatively common during childhood, night terrors occur less frequently according to the American Academy of Child and Adolescent Psychiatry. The prevalence of sleep terror episodes has been estimated at 1–6% among children, and at less than 1% of adults. Night terrors can often be mistaken for confusional arousal. Sleep terrors begin in children between the ages of 3 and 12, and usually dissipate during adolescence. In adults, they most commonly occur between the ages of 20 to 30. Though the frequency and severity vary between individuals, the episodes can occur in intervals of days or weeks, but can also occur over consecutive nights or multiple times in one night.
Night terrors are a largely unknown phenomenon. This has created a situation in which any type of nocturnal attack or nightmare may be confused with and reported as a night terror.
The universal feature of night terrors is inconsolability, very similar to that of a panic attack. During night terror bouts, people are usually described as "bolting upright" with their eyes wide open and a look of fear and panic on their faces. They will often scream. Furthermore, they will usually sweat, exhibit rapid breathing, and have a rapid heart rate (autonomic signs). In some cases, individuals are likely to have even more elaborate motor activity, such as a thrashing of limbs—which may include punching, swinging, or fleeing motions. There is a sense that the individuals are trying to protect themselves and/or escape from a possible threat of bodily injury. Although people may seem to be awake during a night terror, they will appear confused, be inconsolable and/or unresponsive to attempts to communicate with them, and may not recognize others familiar to them. Occasionally, when a person with a night terror is awakened, they will lash out at the one awakening them, which can be dangerous to that individual. Most people who experience this do not remember the incident the next day. Sleepwalking is also common during night terror bouts, as sleepwalking and night terrors are different manifestations of the same parasomnia.
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