Parasomnias
Sleep Terrors (Night Terrors)
Sudden episodes of screaming, fear and thrashing early in the night, during which the person is hard to wake and remembers little.
Overview
Sleep terrors, often called night terrors, are episodes of intense fear that begin with a sudden scream or cry during deep non-REM sleep, usually in the first third of the night. The person may sit up, look terrified, sweat, breathe fast and have a racing heart, but they are not fully awake and are hard to comfort.
They are most common in young children and are usually outgrown. Episodes typically last a few minutes, and the child goes back to sleep with no memory of it in the morning. This is different from nightmares, which happen later in the night during REM sleep and are remembered.
Although frightening for parents, sleep terrors are rarely a sign of a serious problem. Adults can have them too, often with triggers such as stress, sleep loss or alcohol.
Clinical reviews estimate that sleep terrors affect roughly 1% to 6.5% of children aged 1 to 12, and around 2% of adults.
Common symptoms
- Sudden screaming or shouting in sleep
- Sitting up in bed looking frightened
- Sweating, fast breathing and racing heart
- Thrashing or getting out of bed
- Being hard to wake or comfort
- Little or no memory of the episode
- Episodes in the first few hours of sleep
Causes and risk factors
- Family history of sleep terrors or sleepwalking
- Being overtired or sleep deprived
- Stress or emotional upset
- Fever or illness
- Sleep apnea or other disorders that fragment sleep
- Alcohol in adults
How it is diagnosed
Sleep terrors are diagnosed from a description of the episodes, ideally with a video. A sleep study is considered if episodes are frequent, dangerous, start in adulthood or might be seizures, or if sleep apnea is suspected.
Treatment options
Reassurance and safety
Most children need no treatment beyond a safe sleep environment.
Scheduled awakenings
Gently waking a child 15 to 30 minutes before the usual episode time can break the pattern.
Treating triggers
Ensuring enough sleep and treating sleep apnea or stress.
Therapy or medication
Occasionally used in adults or for frequent, dangerous episodes, under specialist care.
What you can do yourself
- Stay calm and keep the person safe without trying to wake them
- Keep a regular, early enough bedtime to prevent overtiredness
- Make the bedroom safe and lock windows and doors
- Keep a diary of when episodes happen
- Avoid alcohol (adults)
When to see a doctor
- Episodes are frequent or disrupt family sleep
- There is a risk of injury
- Episodes continue into the teenage years or start in adulthood
- Your child snores or has breathing pauses
Frequently asked questions
What is the difference between night terrors and nightmares?
Night terrors happen early in the night during deep sleep, the person is hard to wake and remembers little. Nightmares occur later in the night during REM sleep, the person wakes fully and can recall the dream.
Should I wake my child during a night terror?
Usually no. Trying to wake them can make them more agitated. Stay nearby, keep them safe and let the episode pass.
Will my child outgrow night terrors?
Most children outgrow them by adolescence. Ensuring enough sleep often reduces episodes.
Can adults have night terrors?
Yes. In adults they are often linked to stress, sleep deprivation, alcohol or other sleep disorders, and a clinician evaluation is worthwhile.
Sources
This page is general information, not a diagnosis or medical advice. Read our medical disclaimer.