Night Terror

Crescent moon high in the sky, surrounded by mistA night terror, sometimes called a sleep terror, is a sleep disorder that causes people to wake with overwhelming feelings of fear and dread. While night terrors typically do not cause long-term harm and go away on their own, they can sometimes occur as a symptom of a mental health condition.

What Are Night Terrors?

Night terrors are sometimes characterized as occurring in between sleep and wakefulness. More specifically, they are thought to occur during stage three of non-REM sleep, also known as slow wave sleep. Night terrors are related to sleepwalking, and people who sleepwalk may be more likely to have night terrors.

People who experience night terrors are not dreaming, nor are they fully conscious. They may be confused and and do not typically respond to verbal reassurances or questions. It’s not uncommon for someone experiencing a night terror to thrash, scream, or act aggressively. When someone is experiencing a night terror, their pulse may nearly double, their pupils often dilate, and they may also sweat or have increased body temperature.

Because people do not often remember night terrors the next day, it is difficult to know what people experiencing night terrors see or feel. They may be frightened by a dream they just had or by the fact that they do not know where they are. They may also be imagining frightening images or thoughts and be in a dreamlike state.

How Long Do Night Terrors Last?

Night terrors usually last between 10 and 20 minutes. In adults, night terrors may be shorter, lasting anywhere from 30 seconds to 5 minutes.

Night Terrors vs. Nightmares

People often mistake night terrors for nightmares, but they are two different things. Nightmares are dreams that cause fear or anxiety, but they occur more often during stage four, or REM sleep, while night terrors most often occur during stage three sleep. Additionally, night terrors are more likely to occur early in the evening, while nightmares are more common during early morning. Night terrors are much more likely than nightmares to involve movement during the episode, with children being more mobile than adults. Screaming and other vocalizations are also much more common in night terrors than nightmares.

Another difference between night terrors and nightmares is that when someone wakes up from a nightmare, they can often remember the distressing dream. When an individual wakes from a night terror, they are typically confused and disoriented with little to no recollection of what they experienced.

Night Terrors in Toddlers and Infants

While night terrors most often begin around age 4, babies and toddlers can also experience night terrors. Night terrors may occur in babies from 18 months of age, and they may most often occur in toddlers and young children ages 1 to 5.

In one study, 18 months was found to be the peak age for night terrors, during which nearly 35% of children were said to have experienced a night terror.

When a toddler experiences a night terror, they often scream and cry, and it can be difficult for a parent to comfort or wake them. There is no “cure” or treatment for night terrors, and many experts suggest allowing the night terror to run its course. However, there are some approaches that may help reduce the occurrence of night terrors in infants and toddlers if they happen frequently. Scheduled awakenings, which require a parent to wake the child around the time they usually experience the night terror, are sometimes used. A 2018 study proposes cosleeping as a potential way to mitigate night terrors and suggests that sleeping separately may actually trigger night terrors in some instances.

Night Terrors in Children and Teenagers

Night terrors are common in children between ages 3 and 7, and they typically begin to decrease during the early teen years. While they are benign and most often go away by themselves, they can be very distressing to both the child experiencing them and parents in the moment.

One study found that children between the ages of 8 and 10 who had been bullied were two times more likely to have a night terror than those who were not bullied. In children, night terrors may also be caused by stress or anxiety, sickness or fever, or problems sleeping.

While night terrors typically dissipate by adolescence, they can occur in teenagers. Teens who experience night terrors may also be more likely to experience other sleep disorders. They may also have higher chances of having a mental health condition and have more trouble with emotional regulation.

Night Terrors in Adults

Up to about 5% of adults may experience a night terror at some point in their life. Men are two times as likely to experience a night terror compared to women. Adults in the midst of a night terror may be a danger to themselves or others, as they may lash out without being aware of their surroundings. In one study, adults who experienced night terrors were over four times more likely to have been in a car accident within the previous year.

Adults who are under immense stress or who have posttraumatic stress disorder (PTSD) are more likely to experience night terrors.

What Causes Night Terrors?

The exact cause of night terrors is not well understood, but illness, stress, and sleep deprivation can make an individual more prone to night terrors.

Genetics are also thought to play a role in who experiences night terrors. Multiple studies have found that someone with family members who have experienced a night terror are much more likely to experience one themselves at some point.

Certain mental health issues are also implicated in the development of night terrors, especially when the night terrors occur in teenagers or adults.

Night Terrors and Mental Health

Night terrors are associated with some mental health conditions, including:

  • Posttraumatic stress: Many studies have found night terrors to be a result of trauma and PTSD. Treatment for sleep issues may help individuals who experience night terrors as a result of PTSD to gain relief.
  • Depression: Having a history of depression may make it more likely that an individual will experience night terrors. More research is needed to explore the link between night terrors and depression.
  • Anxiety: While anxiety has been found to potentially increase an individual’s chances of experiencing a night terror, it may also cause other sleep issues that are different from night terrors. Those with panic disorders may experience nocturnal panic, for example, which generally takes place during an earlier stage of sleep than night terrors.

Life changes that cause significant amounts of stress or grief have also been connected to night terrors in adults. If you experience sudden onset night terrors, it’s important to consult your doctor. If you think a mental health issue or increased stress may be causing night terrors, reach out to a licensed mental health professional.

Night Terrors Treatment: How to Stop Night Terrors

Children who have night terrors typically grow out of them, and some mental health professionals view them as a normal part of development. When a child experiences a night terror, there’s not typically a way to make it stop right away. Often, the best thing a parent can do is to be there with their child during the experience and speak to them in a soothing voice until it has run its course. Trying to shake the child awake may make the night terror worse.
Stress management techniques can help minimize the risk of night terrors, and some adults who have night terrors seek out counseling to address any mental health related causes of their night terrors.

In some cases, adequate sleep is all that’s needed to get rid of night terrors. Adults who experience continued instances of night terrors may be referred to a specialist who will conduct a nocturnal sleep study to monitor their sleep cycles more closely.

Anti-anxiety drugs such as benzodiazepenes can reduce the frequency of night terrors. However, medication for night terrors is not normally prescribed to children and is only rarely used to treat adults.

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Last Updated: 11-5-2019