Night Terrors: Diagnosis, Treatment, and Resources

Night Terrors is emotional sleep disorder characterized by episodes of fear, flailing, and screaming while asleep, and is often paired with sleepwalking. And although this sleep disorder affects the whole family, it usually goes away on its own in time.
 

Typical diagnosis:

Night terrors, also referred to as Sleep Terrors Disorder or Pavor nocturnus, is an emotional sleep disorder characterized by episodes of fear, flailing, and screaming while asleep, and is often paired with sleepwalking. Although not proven, it is believed night terrors are caused by fever, lack of sleep, lights or noise, and/or emotional stress, tension, or conflict. They have also been commonly misdiagnosed as nightmares; despite both being categorized as a parasomnia (disorders characterized by undesirable motor, verbal, or experiential phenomenon occurring in association with sleep, specific stages of sleep, or sleep-awake transition phases), the two are in fact very different. Nightmares occur during deep sleep (REM sleep) and can occur at any point during the night. Night terrors, on the other hand, usually occur within an hour after a child has fallen asleep, during the transition into the REM stage of the sleep cycle. An episode can last 5 to 20 minutes, and the child’s eyes may be open the entire time. 

Symptoms include:

  • sitting up in bed
  • screaming
  • sweating and breathing heavily
  • rapid heart rate (160-170 BPM)
  • unable to fully wake
  • sleepwalking
  • staring wide-eyed
  • difficult to comfort
  • inability to explain what happened
  • vague sense of frightening images
  • no memory of the episode or “bad dreams” the next morning

Night terrors affect six percent of kids ages 3-12, and a smaller percentage of adults. They also tend to run in families, though there is no conclusive evidence. If episodes occur once a week or more, seek professional help. This sleep disorder is not permanent, and generally as a child gets older, night terrors occur less frequently until they stop completely.
 

What it means for your child:

Night terrors directly disrupt a child’s sleep cycle. If they occur consistently, his daily functions—in school, with friends, etc.—will also be affected. Any sleep disorder not only results in a tired, cranky, child, and often a poor-performing student at school, but also an irritable, unhappy child or teenager at home. Additionally, there is a possibility of injury if an episode is severe or if no one is around when the episode occurs. In some cases, the child may experience other sleep disorders, such as sleepwalking, in addition to the night terrors.
 

What it means for you:

While an episode is actually occurring, parents can do little more than ensure their child’s safety. To accomplish this, parents are encouraged to safety-proof the whole house—especially the child’s bedroom—to prevent injury. Parents should remain nearby and be ready to comfort, speaking softly and calmly when the episode ends. The child may also be gently restrained. Shaking the child or shouting may make things worse.

During a night terror, the sufferer may look awake (with their eyes wide open or moving around the room), but parents should keep in mind that he is asleep and will not react to any stimuli. Any sleep disturbances (like light or noise) should be eliminated, and parents should maintain a consistent bedtime routine and wake-up time. Keeping a diary is also useful; if there is a pattern to the child’s night terrors, parents might be able to wake the child up before an episode actually occurs.
 

What it means for your family:

If there are other kids in the house, family discussions about the sleep disorder are encouraged. Discussions ensure everyone in the family understands the situation and no one is frightened. Families should also try to keep the time before bed stress-free so that the sufferer of night terrors does not go to sleep feeling anxious. Siblings can also help keep the house safety-proofed as well. A doctor should be consulted if a child’s sleep terrors routinely disrupt the sleep of other family members.
 

Treatment:

There is no real treatment for night terrors, as this disorder usually goes away on its own with time.
 

Alternative treatments:

Medication is rarely recommended, especially for a child. Certain types of antidepressants or benzodiazepines (such as Valium), or sleep medications (like Lunesta and Ambien) used at bedtime can reduce night terrors. Medications should only be used under a doctor’s recommendation and supervision. Psychotherapy and counseling may be suggested if stress or anxiety is thought to be contributing to the night terrors. Cognitive behavioral therapy, hypnosis, biofeedback, and relaxation therapy are other alternatives. If the terrors are associated with an underlying medical or mental health condition or another sleep disorder, treatment is aimed at the underlying problem.
 

Get support:

The National Sleep Foundation is a charitable, educational, and scientific not-for-profit organization dedicated to improving sleep health and safety through education, public awareness, and advocacy.

Pillow TalkTM is a National Sleep Foundation online community where parents/sleep-disorder sufferers can share experiences.

Child Uplift, Inc. is devoted to helping identify sleep disorders in children at an early age. This site provides the Sleep Disorders Inventory for Students (SDIS), a sleep screening that is used by pediatric professionals worldwide, and other tools for parents as well as professionals.


Bronx

The Sleep Disorders Center at The Children’s Hospital at Montefiore is the only full-service sleep laboratory and evaluation center dedicated exclusively to children in the New York Metropolitan area.

The Bronx Medical Center for Pulmonary, Asthma and Sleep Disorders evaluates and treats all sleep disorders.

The Sleep-Wake Disorders Center of the Department of Neurology at Montefiore Medical Center is certified by the American Board of Sleep Medicine.


Manhattan

The New York Sleep Institute offers a complete evaluation and treatment of various sleep disturbances; accredited by the American Academy of Sleep Medicine.

Sleep Medicine Associates, located in Manhattan, provides a multidisciplinary approach to sleep disorders, including sleep evaluations, testings, and treatment for all ages; accredited by the American Academy of Sleep Medicine.

The Sleep Disorders Institute (SDI) is a diagnostic and treatment center with a separate pediatric clinic; identified as a “Center of Excellence” by New York Magazine‘s best hospitals in New York; accredited by the American Academy of Sleep Medicine.

The Pediatric Sleep Disorders Center at New York-Presbyterian Morgan Stanley Children’s Hospital, accredited by the American Academy of Sleep Medicine, provides the diagnosis, management, and treatment of sleep disorders in newborns, children, and adolescents. It is the only NY metro-area hospital on the U.S. News Best Children’s Hospital Honor Roll.

Columbia University Cardiopulmonary Sleep and Ventilatory Disorders Center provides both in-patient and outpatient comprehensive consultative and diagnostic services; accredited by the American Academy of Sleep Medicine.
 

Brooklyn

The Sleep Disorder Center at New York Methodist is the only hospital-based sleep center in Brooklyn to receive accreditation from the American Academy of Sleep Medicine.

The Comprehensive Sleep Disorders Institute is one of only two sleep centers in Brooklyn to be accredited by the American Academy of Sleep Medicine.
 

Staten Island

Institute for Sleep Medicine at Staten Island University Hospital is directed by the Pulmonary division and accredited by the American Academy of Sleep Medicine.

Northeast Insomnia & Sleep Medicine in Staten Island is under the direction of Dr. Ahmed Fadil, Board Certified in Internal Medicine, Pulmonary, Critical Care, and Sleep Medicine.
 

Long Island

The Center for Sleep Medicine at St. Joseph Hospital in Bethpage diagnoses and treats all symptoms of sleep disorders; accredited by the American Academy of Sleep Medicine.

North Shore Long Island Jewish Health System Sleep Disorders Center, located in Great Neck, is one of the largest sleep disorder facilities in the northeast; accredited by the American Academy of Sleep Medicine.

Ultimate Health Sleep Disorders Center (UHSDC) utlizes a team approach for the diagnosis and treatment of sleep disorders; located in New Hyde Park and and in Hauppage and accredited by the American Academy of Sleep Medicine. Website provides thorough information and sleep quiz.

Huntington Medical Group Sleep Disorders Center is a full service facility staffed by specialists in Pulmonary Medicine and Sleep Medicine; accredited by the American Academy of Sleep Medicine.

The North Shore Sleep Medicine facility in Great Neck diagnoses and treats a wide variety of sleep disorders; accredited by the American Society of Sleep Medicine.

St. Charles Sleep Disorders Center is located in Port Jefferson; accredited by the American Academy of Sleep Medicine.

Stony Brook University Medical Center Sleep Disorders Center, located in Smithtown, is the oldest sleep center on Long Island and hosted the first national Sleep Technician Registry Exam; accredited by the American Academy of Sleep Medicine.
 

Westchester

The Center for Sleep Medicine at Lawrence Hospital in Bronxville opened in 2010 and is under the medical direction of Dr. Rochelle Waldman, who is boarded by The American Board of Sleep Medicine.

White Plains Hospital’s Sleep Center offers advanced sleep diagnostic services and is accredited by the American Sleep Association.

The Center for Sleep Medicine at Northern Westchester Hospital in Mount Kisco received an American Academy of Sleep Medicine accreditation.

Sleep Disorders Center at Sound Shore Medical Center in New Rochelle is accredited by the American Academy of Sleep Medicine.
 

Rockland

Bon Secours Sleep Disorder Institute at Good Samaritan Hospital in Suffern is the only sleep center in the lower Hudson Valley accredited by the American Academy of Sleep Medicine.
 

Fairfield

Fairfield County Sleep Center is an independent sleep center that is fully accredited by the American Academy of Sleep Medicine.

The Center for Sleep Medicine at Bridgeport Hospital is accredited by the American Academy of Sleep Medicine

Danbury Hospital Sleep Disorders Center was among the first accredited centers in the state of Connecticut devoted to the practice of clinical sleep medicine; accredited by the American Academy of Sleep Medicine.

The Sleep Disorders Center at Norwalk Hospital offers complete evaluation, diagnosis, and treatment; accredited by the American Academy of Sleep Medicine.

The Sleep Center at Greenwich Hospital offers complete evaluation, diagnosis, and treatment; accredited by the American Academy of Sleep Medicine.
 

Give support: 

The Infant & Children Sleep Apnea Awareness Foundation, Inc. is a non-profit organization, dedicated to bringing national awareness to infant and children sleep apnea, SIDS and pediatric pulmonary issues. To donate: www.kidssleepdisorders.org/help.html

To donate to the National Sleep Foundation: www.sleepfoundation.org/donations/make-donation

Learn more:

For more information on night terrors and other sleep disorders:

· www.emedicinehealth.com

· www.mayoclinic.com/health-information

· “Solve Your Child’s Sleep Problems“, writtten by Richard Ferber, M.D.