Night Terrors

Overview

Night terrors are a sleep disorder that causes a person to suddenly wake up from deep sleep in a frightened, confused state. They may scream, cry, flail, or sit up in bed, but they are not truly awake and usually do not remember the episode the next morning.

Yes. Night terrors are fairly common in children and affect about 1 in 10 kids. They are much rarer in adults.

Night terrors most often appear in children between the ages of 3 and 12. They can also affect older children and adults, especially after stress or poor sleep.

Symptoms

Common symptoms

• Suddenly sitting up in bed
• Screaming or crying out
• Sweating, breathing fast, or having a racing heart
• Wide open eyes with a glassy stare
• Kicking, thrashing, or trying to get out of bed
• Not responding to others or seeming confused
• Having no memory of the episode in the morning

Causes

Main causes

• The exact cause is not fully known. Night terrors are a type of 'arousal disorder' — the brain partially wakes up from deep sleep in a misfired way.
• They can be triggered by sleep deprivation, irregular sleep schedules, stress, fever, or some medicines.
• They also tend to run in families.

Risk factors

• Being a child (especially between ages 3 and 12)
• Having a family history of night terrors or sleepwalking
• Stress, anxiety, or major life changes
• Sleep deprivation or irregular sleep patterns
• Fever
• Certain medications that affect sleep
• Other sleep disorders such as obstructive sleep apnea

When to see a doctor

See a doctor urgently if:

• If a night terror leads to an injury.
• If episodes happen very often, for example every night.
• If the person also snores loudly or gasps for air during sleep.
• If night terrors first begin in adulthood.
• If you suspect a seizure disorder (jerking, biting tongue, or losing bladder control).

Book a routine appointment if:

• Make an appointment with a healthcare provider if night terrors are making sleep difficult or affecting daily life.
• If they are causing worry for you or your child.
• If you would like a general check-up to rule out other sleep problems.

Diagnosis

A healthcare provider will ask about symptoms, sleep habits, and family history. They may also do a physical exam to check for other causes. Usually no special test is needed.

Tests that may be done

• In some cases, a healthcare provider may suggest a sleep study (polysomnography).
• A sleep study involves staying overnight in a sleep clinic while your brain, breathing, and heart activity are monitored.
• This is mostly used if the diagnosis is unclear or if other sleep disorders are suspected.

What to expect at your appointment

The provider may ask you to keep a sleep diary for a few weeks, recording when episodes happen and what they look like. They may also ask about stress, medications, and any other symptoms. You will leave with practical advice for sleep habits and safety.

Treatment

Treatment for night terrors is not usually needed, especially for children. The first step is to improve sleep routines and safety. If a medical condition is causing them, that condition is treated. For adults with frequent, severe episodes, a specialist may recommend approaches like scheduled waking, sleep studies, or therapy.

Self-care at home

• Keep a consistent sleep schedule, going to bed and waking up at the same time every day.
• Create a calm, relaxing bedtime routine — such as reading or listening to soft music.
• Avoid caffeine, heavy meals, and screens for at least an hour before bed.
• Make sure the bedroom is cool, quiet, and dark.
• Remove sharp or potentially harmful items from around the bed to prevent injury.
• If someone has an episode, do not try to wake them or shout. Gently guide them back to bed and keep a safe distance.

Medical treatments

If night terrors are related to another sleep disorder, such as obstructive sleep apnea, that disorder will be treated (for example, with a CPAP machine). For very severe or frequent episodes, a doctor may suggest cognitive behavioural therapy (CBT) to reduce stress and improve sleep. Medication is rarely used and only under specialist advice; no medication is recommended as a first-line treatment.

Living with this condition

Night terrors can be alarming, but there are ways to make them easier to live with. Keep a regular sleep routine and a restful bedroom. Put a safety gate around stairs or lock windows if someone sleepwalks or moves during an episode. Let a partner or family member know what to do: stay calm, keep the person safe, and avoid waking them suddenly.

Lifestyle tips

• Get regular physical activity, but not too late in the evening.
• Find ways to relax, like deep breathing, meditation, or gentle stretching before bed.
• Limit alcohol and nicotine, especially in the evening.
• Keep a sleep diary to spot patterns and triggers.

Diet and exercise

Eating a balanced diet and getting regular exercise can improve sleep quality. However, avoid large meals, spicy food, and intense exercise right before bedtime, as they can disrupt sleep.

Mental health and emotional wellbeing

Night terrors can cause worry or embarrassment, but they are a sleep problem, not a mental health condition. If you feel anxious about sleep or about having an episode, talk to a healthcare professional. Managing stress and talking about your concerns can help you feel more in control.

Prevention

Night terrors can't always be prevented, but you can reduce your risk by keeping a regular sleep routine, getting enough sleep, managing stress, and staying healthy. For children, reassuring them after a bad dream and keeping a consistent bedtime can help.

Complications

If left untreated

• In most cases, night terrors go away on their own and do not lead to other problems.
• Rarely, a person may injure themselves during an episode.
• Poor sleep may cause daytime fatigue, tiredness, or mood changes.
• In adults, frequent night terrors can affect relationships and quality of life.

Long-term outlook

The outlook is very good. Most children outgrow night terrors by their teenage years, and adults can see improvement with better sleep habits and treatment of any underlying causes. With understanding and proper guidance, you can manage them well.

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