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Insomnia
Night sweats
Sweating in sleep
Unable to sleep
Waking up drenched in sweat
Sudden fear
Crying in sleep
Fast heartbeat at night
Not seeing your symptoms? No worries!
What is Night Terrors?
Night terrors are episodes of fear that involve screaming, flailing, or thrashing while the person is asleep and has no memory of it upon waking. They are common in children, who usually outgrow them with age. It is generally not a concern unless sleep is significantly disrupted and insufficient.
Typical Symptoms of Night Terrors
- Unable to recall abnormal behaviors or actions that I did while asleep
- When sleeping, I sometimes scream loudly and wake up
- Child cries at night
- Uncontrollable movements that usually happen at night
- Punch or strike out with fists while asleep
- Uncontrollable movements that make me subconsciously walk or wander around
- Have slept so deeply that others were unable to awaken me
- Patient unable to recall or speak his/her name and birthday
Diagnostic Questions for Night Terrors
Your doctor may ask these questions to check for this disease:
- Are you unable to remember abnormal behaviors or actions while asleep?
- Do you scream loudly and wake up while sleeping?
- Does your child cry at night without a reason?
- Do your uncontrollable movements happen at night?
- Do you punch or strike while asleep?
Treatment of Night Terrors
Medical treatment is typically not required. Treatment may be helpful for particularly disruptive night terrors or those that may compromise safety. Options include treating underlying causes (sleep apnea, stress, or anxiety), or waking the person in anticipation of an episode before a night terror begins.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Yu Shirai, MD (Psychiatry)
Dr. Shirai works at the Yotsuya Yui Clinic for mental health treatment for English and Portuguese-speaking patients. He treats a wide range of patients from neurodevelopmental disorders to dementia in children and participates in knowledge sharing through the Diversity Clinic.
Content updated on Jul 19, 2024
Following the Medical Content Editorial Policy
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Diseases Related to Night Terrors
FAQs
Q.
Adult Night Terrors: Causes, Symptoms, and How to Stop Them
A.
Adult night terrors are sudden episodes of intense fear during deep non-REM sleep, often with screaming, rapid heartbeat, sweating, confusion, and little or no recall; common triggers include sleep deprivation, high stress or PTSD, alcohol or certain drugs, medications, and sleep disorders such as sleep apnea. They can often be reduced with consistent sleep routines, stress management, limiting alcohol, treating underlying sleep or mental health issues, and sometimes scheduled awakenings or short-term medication, but there are several factors to consider and important safety signs for when to seek care, so see the complete details below.
References:
* Pagel GP. Sleep Terrors in Adults: An Overview. Sleep Med Clin. 2017 Mar;12(1):15-22. doi: 10.1016/j.jsmc.2016.10.007. PMID: 28164893.
* Scullin SC, Bliwise AE. NREM Parasomnias. Semin Neurol. 2015 Oct;35(5):486-93. doi: 10.1055/s-0035-1563721. Epub 2015 Oct 19. PMID: 26485078.
* Iannella G, Polimeni A, Iannella F, Di Maio P, Ciofalo A, D'Ecclesia A, Magliulo G. Treatment of adult NREM parasomnias: an update. Sleep Med Rev. 2021 Apr;56:101402. doi: 10.1016/j.smrv.2020.101402. Epub 2020 Dec 20. PMID: 33497914.
* Singh AR, Scullin SC. Sleep Terrors: Epidemiology, Pathophysiology, Diagnosis, and Management. Curr Treat Options Neurol. 2019 Jul 24;21(9):44. doi: 10.1007/s11940-019-0588-y. PMID: 31342137.
* Bassetti RMM, Siclari F. Sleepwalking and Sleep Terrors in Adults. Handb Clin Neurol. 2021;179:305-316. doi: 10.1016/B978-0-12-819410-2.00019-2. PMID: 33838977.
Q.
Adult Night Terrors: Why Your Bad Dreams Feel So Real Lately
A.
Bad dreams feeling more real can come from vivid REM nightmares or from adult night terrors during deep non-REM sleep, which cause intense fear with little recall; recent spikes are often linked to stress, sleep loss, mental health issues, alcohol or medication changes, and sleep disorders like sleep apnea. There are several factors to consider. See below for key differences, practical steps, and treatments that can change your next steps; seek medical care if episodes are frequent, lead to injury, severe daytime fatigue or confusion, or you have symptoms of sleep apnea.
References:
* Siclari F, Bassetti CL. Non-REM sleep parasomnias: an update. Curr Opin Neurol. 2017 Aug;30(4):427-434. doi: 10.1097/WCO.0000000000000455. PMID: 28816823.
* Lu M, Schenck CH, Li SX, Wing YK. NREM parasomnias: an update on treatment. Curr Neurol Neurosci Rep. 2018 Apr 11;18(6):31. doi: 10.1007/s11910-018-0842-z. PMID: 29594459.
* Palagini L, Bazzano E, Manconi M. Nightmares, Night Terrors, and Nightmare Disorder. Curr Sleep Med Rep. 2021 Jun;7(2):49-56. doi: 10.1007/s40675-021-00192-z. PMID: 34177708.
* Bassetti CL. Sleep terrors and other NREM parasomnias. Handb Clin Neurol. 2011;99:763-78. doi: 10.1016/B978-0-444-52903-9.00057-3. PMID: 21096113.
* Pressman MR. Night Terrors in Adults: An Overview. J Clin Sleep Med. 2007 Oct 15;3(6):570-5. PMID: 17958172.
Q.
Confused in the Dark? Understanding Adult Night Terrors After 65
A.
Night terrors after 65 are uncommon but real, typically involving abrupt arousal from deep non-REM sleep with intense fear, confusion, and little or no recall. There are several factors to consider, including triggers like sleep loss, stress, alcohol, medications, sleep apnea, and, less commonly, neurological disease, as well as red flags such as injuries, breathing pauses, daytime confusion, or new neurological symptoms that require prompt medical evaluation. See below for how to tell night terrors from nightmares, what workup to expect, safety steps at home, and treatments from sleep hygiene to addressing underlying conditions and when to seek urgent or emergency care, which could change your next steps.
References:
* Guenaga, L., De La Fuente, L. B., & Monti, J. (2011). Night terrors, parasomnias and the elderly. *Journal of Clinical Sleep Medicine, 7*(5), 555-557.
* Chen, W., Li, H., Liu, G., & Hu, M. (2019). Late-onset night terrors: A case report and review of the literature. *Sleep Medicine, 55*, 30-34.
* Scammell, T. E., & Lu, J. (2017). NREM Parasomnias in Adults. *Current Treatment Options in Neurology, 19*(7), 29.
* Sateia, M. J., & Ravese, K. G. (2021). Parasomnias: An Update on the Pathophysiology and Treatment. *Current Neurology and Neuroscience Reports, 21*(6), 28.
* Bubu, O. M., Olvera, C., & Yaffe, K. (2020). Sleep and Sleep Disorders in Older Adults. *Mayo Clinic Proceedings, 95*(5), 1040-1052.
Q.
Night terrors are very different from bad dreams. Learn how to distinguish between the two and what triggers these intense nighttime episodes.
A.
Nightmares are vivid REM dreams that occur later in the night, wake you fully, and are usually remembered; night terrors happen in deep non-REM sleep early in the night, involve intense fear with screaming or thrashing, are hard to interrupt, and leave little to no memory. Triggers differ: nightmares commonly follow stress, trauma, certain medications, or sleep loss, while night terrors are linked to sleep deprivation, irregular schedules, alcohol, illness or fever, sleep apnea, restless legs, some medicines, and family history. There are several factors to consider, including safety risks, red flags that warrant medical care, and effective treatments; see below for important details that could guide your next steps.
References:
* Olmos de la Iglesia O, de la Casa-Fages B. Sleep terrors and sleepwalking: a review of clinical presentation, pathophysiology, and management. Rev Neurol. 2022 Feb 16;74(4):145-156. Spanish. doi: 10.33588/rn.7404.2021271. PMID: 35140683.
* Li SX, Wing YK. Night Terrors: A Review of Etiology, Diagnosis, and Treatment. Curr Treat Options Neurol. 2019 Mar 15;21(4):17. doi: 10.1007/s11940-019-0558-8. PMID: 30877568.
* Pressman MR. Sleep terrors and nightmares: a comparative review. Rev Neurol (Paris). 2017 Oct;173(10):686-692. doi: 10.1016/j.neurol.2017.07.009. Epub 2017 Aug 2. PMID: 29019688.
* Dhondt K, Van Rysselberghe E, Vlaminck S, Van Someren EJW, De Groef B, Derijck H, Vandekerckhove M, Hoedt V, Verbraecken J. NREM parasomnias: clinical spectrum and approach to diagnosis and treatment. Eur J Paediatr Neurol. 2020 Jan;24:1-12. doi: 10.1016/j.ejpn.2019.11.002. Epub 2019 Nov 22. PMID: 31792348.
* Toussaint M, Brandewinder M, Sforza E. Night terrors, sleepwalking, and confusional arousals: a review of the NREM parasomnias. Sleep Med. 2015 Oct;16(10):1193-200. doi: 10.1016/j.sleep.2015.06.004. Epub 2015 Jul 2. PMID: 26058942.
Q.
Waking Up in a Fright? How to Stop Nighttime Panic for Good
A.
Nighttime panic attacks are common and treatable; evidence-based steps like CBT, controlled breathing, solid sleep habits, lowering daytime stress, treating contributing conditions, and medication when appropriate can stop them for good. There are several factors to consider, including how to tell panic from night terrors or medical mimics such as sleep apnea, GERD, asthma, thyroid or heart rhythm problems, and when to seek urgent care for severe chest pain, fainting, irregular heartbeat, or persistent breathing trouble; see the complete guidance below to choose the right next steps.
References:
* Craske, M. G., Tsao, J. C. I., & Mystkowski, J. L. (2001). Cognitive behavioral therapy for nocturnal panic attacks. *Journal of Behavior Therapy and Experimental Psychiatry*, *32*(2), 117–129.
* Tseng, C. H., Tseng, P. T., Chen, H. C., Fan, S. C., Lin, Y. S., Yang, Y. K., & Chen, S. L. (2017). Sleep and panic disorder: A systematic review. *Comprehensive Psychiatry*, *72*, 132–140.
* Roy-Byrne, P. P. (2005). Pharmacotherapy of panic disorder with nocturnal attacks. *The Journal of Clinical Psychiatry*, *66*(Suppl 4), 28–33.
* Katerberg, H., Broersma, M. E., & de Jong, F. A. (2005). Nocturnal panic attacks: prevalence, clinical features, and comorbidity. *The Journal of Clinical Psychiatry*, *66*(Suppl 4), 13–17.
* Rappaport, L. M., & Kripke, D. F. (2012). Panic disorder and sleep: A bidirectional relationship. *Current Psychiatry Reports*, *14*(4), 371–377.
Q.
Scary Dreams Every Nap? Causes & Relief Steps for Women 30-45
A.
There are several factors to consider: many women 30 to 45 slip into REM quickly during naps, making dreams vivid, and this is often amplified by stress, hormonal shifts, sleep deprivation, anxiety or depression, certain medications, irregular schedules, and less commonly night terrors. Shorten and time naps to 20 to 30 minutes early afternoon, improve nighttime sleep, calm stress, track patterns, and review medications, and seek medical care for acting out dreams, severe disruption, mood or trauma symptoms, neurological changes, or persistent daytime sleepiness; see complete guidance and important nuances below.
References:
* Schredl, M., & Alm, B. (2020). Nightmare disorder in adults: Diagnosis, epidemiology, pathophysiology, and treatment. *Journal of Sleep Research*, *29*(1), e12933.
* Spira, A. P., & Stone, K. L. (2022). Stress, sleep and health in women: A narrative review. *Sleep Medicine Reviews*, *63*, 101625.
* Ameratunga, D., & Nadkarni, G. (2020). Sleep and Health in Midlife Women. *Current Sleep Medicine Reports*, *6*(4), 312-321.
* St-Onge, M., & Pilon, M. (2021). Cognitive behavioral therapy for insomnia (CBT-I) and its relevance for nightmares. *Sleep Science*, *14*(3), 241-248.
* Schredl, M., & Reinhard, I. (2011). Prevalence and risk factors of chronic nightmares in adult women: a population-based study. *European Journal of Neurology*, *18*(10), e120-e121.
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Van Horn NL, Street M. Night Terrors. 2021 Jul 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29630274.
https://www.ncbi.nlm.nih.gov/books/NBK493222/Snyder DM, Goodlin-Jones BL, Pionk MJ, Stein MT. Inconsolable night-time awakening: beyond night terrors. J Dev Behav Pediatr. 2008 Aug;29(4):311-4. doi: 10.1097/DBP.0b013e3181829f4c. PMID: 18698194.
https://journals.lww.com/jrnldbp/Abstract/2008/08000/Inconsolable_Night_Time_Awakening__Beyond_Night.10.aspxBoyden SD, Pott M, Starks PT. An evolutionary perspective on night terrors. Evol Med Public Health. 2018 Apr 14;2018(1):100-105. doi: 10.1093/emph/eoy010. PMID: 29765596; PMCID: PMC5941156.
https://academic.oup.com/emph/article/2018/1/100/4971513