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Sleep terrors (night terrors)

Sleep terrors are episodes of screaming, intense fear and flailing while still asleep. Also known as night terrors, sleep terrors often are paired with sleepwalking. Like sleepwalking, sleep terrors are considered a parasomnia — an undesired occurrence during sleep.

Although sleep terrors are more common in children, they can also affect adults. A sleep terror episode usually lasts from seconds to a few minutes, but they may last longer.

Sleep terrors are relatively rare, affecting only a small percentage of children — often between ages 4 and 12 — and a smaller percentage of adults. However frightening, sleep terrors aren't usually a cause for concern. Most children outgrow sleep terrors by their teenage years.

Sleep terrors may require treatment if they cause problems getting enough sleep or they pose a safety risk.

Symptoms Causes Risk factors Complications

Sleep terrors differ from nightmares. The dreamer of a nightmare wakes up from the dream and may remember details, but a person who has a sleep terror episode remains asleep.

Children usually don't remember anything about their sleep terrors in the morning. Adults may recall a dream fragment they had during the sleep terrors. Also, nightmares generally occur in the last half of the night, while sleep terrors occur in the first half of the night.

During a sleep terror episode, a person might:

  • Sit up in bed
  • Scream or shout
  • Kick and thrash
  • Sweat, breathe heavily and have a racing pulse
  • Be hard to awaken, but if awakened be confused
  • Be inconsolable
  • Stare wide-eyed
  • Get out of bed and run around the house
  • Engage in aggressive behavior (more common in adults)

When to see a doctor

Occasional sleep terrors aren't usually a cause for concern. If your child has sleep terrors, you can simply mention them at a routine well-child exam. However, consult your doctor if sleep terrors:

  • Become more frequent
  • Routinely disrupt sleep or the sleep of other family members
  • Cause you or your child to fear going to sleep
  • Lead to dangerous behavior or injury
  • Appear to follow the same pattern each time
  • Persist beyond the teen years or begin in adulthood

Various factors can contribute to sleep terrors, such as:

  • Sleep deprivation and extreme tiredness
  • Stress
  • Fever (in children)
  • Sleeping in unfamiliar surroundings
  • Lights or noise
  • An overfull bladder

Sleep terrors sometimes are associated with underlying conditions that affect sleep, such as:

  • Sleep-disordered breathing — a group of disorders characterized by abnormal breathing patterns during sleep, the most common of which is obstructive sleep apnea
  • Restless legs syndrome
  • Migraines
  • Head injuries
  • Some medications

Sleep terrors tend to run in families. Some adults who have sleep terrors may have a history of depressive or anxiety disorders, although most don't have a mental health condition.

Some complications that may result from experiencing sleep terrors include:

  • Excessive daytime sleepiness, which can lead to difficulties at school or work, or problems with everyday tasks
  • Disruptions to family members
  • Embarrassment over sleep terrors
  • Injury to oneself or others
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