Understanding Night Terrors – Causes, Symptoms, and Prevention
Hearing terrified screams in the middle of the night or watching a child shoot up in bed, sweaty and disoriented, is a deeply disturbing experience for any parent. These episodes are called night terrors, a sleep disorder that is often misunderstood. Unlike nightmares, they can be accompanied by physical activity — such as flailing, shouting or even sleepwalking — and the person going through it is generally unaware it’s taking place.
Night terrors in children are not uncommon — especially in toddlers and preschoolers — while night terrors in adults do happen, indicating underlying stress or sleep issues. These episodes can be dramatic, but they are mostly harmless and can often be prevented with proper care and routine.
In this blog, Chase Lodge Hospital discusses night terrors in detail — what they are, their symptoms, what the causes are, and how they can be treated or prevented when required.
What Are Night Terrors?
Night terrors, or sleep terrors, are a form of parasomnia — a category of sleep disorders characterised by abnormal movements or behaviours while dreaming. Nightmares, unlike the other, occur during REM sleep (Rapid Eye Movement); night terrors happen during non-REM deep sleep, generally during the first two to three hours of sleep.
A typical episode may include the person abruptly sitting up in bed, screaming, kicking or thrashing. They might seem confused, have big eyes and even get out of bed. Crucially, they are non-responsive to comfort and do not remember the episode once awake.
Episodes typically last from a few seconds to a couple of minutes, though they can seem much longer to those experiencing them. Scary to watch, most night terrors don’t do lasting damage.
Night Terrors in Different Age Groups
Night terrors in young children are actually pretty common and usually start between ages 1 and 4. At this time, a child’s sleep patterns are still maturing, and their brain has difficulty with the transitions between sleep stages. These episodes can happen multiple times a month and typically resolve on their own as the child gets older.
In preschoolers, nighttime terrors can be triggered by developmental leaps, stress or overtiredness. (Changes such as attending nursery for the first time, or adapting to the arrival of a new sibling may make anxiety worse and interfere with sleep patterns.)
Though night terrors in adults are uncommon, they do occur when underlying problems such as chronic stress, anxiety disorders, PTSD, or conditions such as sleep apnoea are present. In adults, night terrors can continue or get worse without treatment, and they can require medical treatment or therapy.
Knowing when night terrors begin and how they evolve is important. Most children eventually outgrow night terrors by early adolescence, but if night stresses continue or arise in adulthood, it may be prudent to seek professional advice.
What Causes Night Terrors?
There are many possible causes of night terrors — usually several triggers, rather than just one. Here are some of the most common culprits:
- Genetics: If you have a family history of sleep disturbances such as sleepwalking or night terrors, there is a much higher chance you could experience them.
- Sleep deprivation: Not getting enough sleep might cause disruption of sleep cycles.
- Stress and anxiety: Emotional stress — whether related to life changes, school challenges or pre-existing mental health conditions — can be a potent trigger.
- Fever or illness: In children particularly, high temperatures can affect sleep architecture and lead to terrors.
- Disrupted sleep routine: When bedtimes are irregular during holidays, or you are in an unusual environment or travel (jet lag), sleep can be disrupted.
With young children, overtiredness and a lack of naps around bedtime can easily rock their developing sleep cycles. In adults, the episodes may be caused by stimulant use, certain medications, or mental health disorders. For many, sleep issues like night terrors can become chronic unless the underlying cause is effectively addressed.
Signs and Symptoms of Night Terrors
The behaviours linked to night terrors tend to be obvious. Common symptoms include:
- Sudden screaming or shouting
- Fast breathing, fast heartbeat
- Sweating and flushed skin
- Thrashing or kicking
- Sleepwalking or running
- Open eyes and confused expression
In toddlers, signs can include crying that cannot be soothed, shaking or clinging to a parent without waking up completely. The episode’s end is also vital: The child will tend to fall back asleep quickly after the episode ends, and have no memory of the episode come morning.
Night terrors happen outside of REM sleep and usually do not involve dreams, unlike nightmares. That’s why the afflicted may look awake but are, in fact, in a deep state of unconsciousness.
How to Stop and Prevent Night Terrors
Though there’s no surefire cure, night terrors can often be diminished, or even eliminated, with careful lifestyle changes. Here’s how to manage or prevent them:
- Avoid irregular sleeping patterns: Going to bed and waking up at the same time every day helps maintain a healthy circadian rhythm.
- Avoid being overtired: Ensure children are getting adequate sleep for their age. Adults need 7–9 hours a night.
- Establish a calming bedtime routine: Engage in relaxing activities such as reading or taking a warm bath to get the body ready for slumber.
- Cut back on screen time and caffeine: Steer clear of stimulation — whether in the form of screens or drinks — two hours before bed.
- Treat underlying conditions: Successfully treating conditions like sleep apnoea or anxiety may lead to drastic improvements in sleep quality.
- Make the sleep space safe: If the child is prone to sleepwalking, the room should be cleared of any dangerous items.
For parents, the key is not to wake the child up during a night terror, as that can lead to greater confusion and distress. Instead, focus on ensuring their safety and allow the episode to pass.
When to Seek Medical Help
Most of the time, night terrors don’t need any medical treatment. But it’s time to talk to a doctor or sleep specialist if:
- Episodes happen often (a few times per week)
- The individual risks injury (e.g., falls, hitting furniture)
- Night terrors persist into teenage years or adulthood
- Daytime sleepiness or behaviour problems caused by inadequate sleep
Treatment can include cognitive behavioural therapy (CBT), stress management techniques, or, in some instances, medication if the episodes are connected to a mental health or neurological condition.
Our specialists at Chase Lodge Hospital, including sleep expert Dr Ibrahim Yahli, also provide tailored assessments and support if night terrors are persistent or problematic.
Conclusion
Night terrors, while unsettling to witness, are typically non-threatening and often a transient stage in childhood. Knowing the triggers and symptoms can help you identify them calmly and address the episodes efficiently.
Coupled with sound sleep practices, stress management and, when needed, medical attention, most people can reduce or put a stop to night terrors. If you’re worried about how often these events occur, or how severe they are, seek professional help.
Contact the team at Chase Lodge Hospital for further advice, assessments, or referrals.
