Night Terrors


Night Terrors

Description, Causes and Risk Factors:

ICD-10: F51.4

Alternative Name: Sleep terrors, pavor nocturnus.

Night terrors are sleep disturbances in which a child may suddenly bolt upright in bed, cry, scream, moan, mumble, and thrash about with his eyes wide open, but without being truly awake. Because he's caught in a sort of a twilight zone between being asleep and being awake, he's unaware of your presence and isn't likely to respond to anything you say or do.

A night terror is a sleep disruption that seems similar to a nightmare, but with a far more dramatic presentation. Though night terrors can be alarming for parents who witness them, they are not usually cause for concern or a sign of a deeper medical issue. Night terrors are most common in boys ages 5 - 7, although they also can occur in girls.

During a typical night, sleep occurs in several stages. Each is associated with particular brain activity, and it's during the REM (rapid eye movement) stage that most dreaming occurs.

Night terrors happen during deep non-REM sleep. Unlike nightmares, which occur during REM sleep, a night terror is not technically a dream, but more like a sudden reaction of fear that happens during the transition from one sleep phase to another.

Night terrors usually occurs about 2 or 3 hours after a child falls asleep, when sleep transitions from the deepest stage of non-REM sleep to lighter REM sleep, a stage where dreams occur. Usually this transition is a smooth one. But rarely, a child becomes agitated and frightened — and that fear reaction is a night terror.

Night terrors are caused by over-arousal of the CNS (central nervous system) during sleep. This may happen because the CNS is still maturing. Some kids may inherit a tendency for this over-arousal — about 80% who have night terrors have a family member who also experienced them.

The prevalence rate of night terrors is 18 % and 4 % of the children experience night terrors once or more a week. The researchers say that parasomnias such as nightmares, night terrors and sleepwalking often occur together. In contrast to nightmare frequency, no substantial correlation between personality and night terror frequency emerged. As expected, the occurrence of stressors (hospitalization, school problems, parental divorce and amount of TV consumption) are associated with night terrors. Longitudinal studies should be carried out in order to investigate whether stress is also responsible for intra-individual fluctuations. Such investigations may prove fruitful for developing and evaluating effective treatment strategies for night terrors in children.

Symptoms:

During a night terror, a child might suddenly sit upright in bed and shout out or scream in distress. The child's breathing and heartbeat might be faster. He or she might sweat, thrash around, and act upset and scared. After a few minutes, or sometimes longer, a child simply calms down and returns to sleep.

Diagnosis:

Diagnosis for night terror is achieved by monitoring a patient's symptoms and sleep diary kept by their family/partner. The symptoms for night terrors are so clear and unique, that no special tests are required. If the night terror is severe or prolonged, the child may need a psychological evaluation.

The easiest way to tell the difference between a night terror and a nightmareis to ask yourself who's more upset about it the next morning. "If your child is more agitated, he had a nightmare. If you're the one who's disturbed, he probably had a night terror."

Treatment:

Night terrors can be very upsetting for parents, who might feel helpless at not being able to comfort or soothe their child. The best way to handle a night terror is to wait it out patiently and make sure the child does not get hurt by thrashing around. Kids usually will settle down and return to sleep on their own in a few minutes.

It is best not to try to wake kids during a night terror. Attempts usually do not work, and kids who do wake are likely to be disoriented and confused, and may take longer to settle down and go back to sleep.

Benzodiazepine medicines (such as diazepam) used at bedtime will often reduce night terrors, but are rarely used to treat this disorder.

Preventive Measures:

    Reduce your child's stress.

  • Establish and stick to a bedtime routine that's simple and relaxing.

  • Make sure your child gets enough rest.

  • Prevent your child from becoming overtired by staying up too late.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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