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.
Sleep terrors generally occur in the first third to first half of the night, and rarely during naps. A sleep terror may lead to sleepwalking.
During a sleep terror episode, a person may:
- Begin with a frightening scream or shout
- Sit up in bed and appear frightened
- Stare wide-eyed
- Sweat, breathe heavily, and have a racing pulse, flushed face and dilated pupils
- Kick and thrash
- Be hard to awaken, and be confused if awakened
- Be inconsolable
- Have no or little memory of the event the next morning
- Possibly, get out of bed and run around the house or have aggressive behavior if blocked or restrained
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 the sleep of the person with sleep terrors or other family members
- Lead to safety concerns or injury
- Result in daytime symptoms of excessive sleepiness or problems functioning
- Continue beyond the teen years or start in adulthood
Sleep terrors are classified as a parasomnia — an undesirable behavior or experience during sleep. Sleep terrors are a disorder of arousal, meaning they occur during N3 sleep, the deepest stage of non-rapid eye movement (NREM) sleep. Another NREM disorder is sleepwalking, which can occur together with sleep terrors.
Various factors can contribute to sleep terrors, such as:
- Sleep deprivation and extreme tiredness
- Sleep schedule disruptions, travel or sleep interruptions
Sleep terrors sometimes can be triggered by underlying conditions that interfere with sleep, such as:
- Sleep-disordered breathing — a group of disorders that include abnormal breathing patterns during sleep, the most common of which is obstructive sleep apnea
- Restless legs syndrome
- Some medications
- Mood disorders, such as depression and anxiety
- In adults, alcohol use
Sleep terrors are more common if family members have a history of sleep terrors or sleepwalking. In children, sleep terrors are more common in females.
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
- Disturbed sleep
- Embarrassment about the sleep terrors or problems with relationships
- Injury to oneself or rarely to someone nearby
July 21, 2017
- Sateia M. Sleep terrors. In: International Classification of Sleep Disorders. 3rd ed. Darien, Ill.: American Academy of Sleep Medicine; 2014. http://www.aasmnet.org/EBooks/ICSD3. Accessed May 11, 2017.
- Parasomnias. Merck Manual Professional Version. http://www.merckmanuals.com/professional/neurologic-disorders/sleep-and-wakefulness-disorders/parasomnias. Accessed May 10, 2017.
- Non-rapid eye movement sleep arousal disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed May 9, 2017.
- AskMayoExpert. Parasomnias. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
- Kotagal S. Sleepwalking and other parasomnias in children. https://www.uptodate.com/home. Accessed May 10, 2017.
- Foldvary-Schaefer N. Disorders of arousal from non-rapid eye movement sleep in adults. https://www.uptodate.com/home. Accessed May 10, 2017.
- Fleetham JA, et al. Parasomnias. Canadian Medical Association Journal. 2014;186:E273.
- Olson EJ (expert opinion). Mayo Clinic, Rochester, Minn. May 18, 2017.
Sleep terrors (night terrors)