To diagnose sleep terrors, your doctor reviews your medical history and your symptoms. Your evaluation may include:
- Physical exam. Your doctor may do a physical exam to identify any conditions that may be contributing to the sleep terrors.
- Discussing your symptoms. Sleep terrors are usually diagnosed by your doctor based on your description of the events. Your doctor may ask about your family history of sleep problems. Your doctor may also ask you or your partner to fill out a questionnaire about your sleep behaviors.
- Nocturnal sleep study (polysomnography). In some cases, your doctor may recommend an overnight study in a sleep lab. Sensors placed on your body record and monitor brain waves, the oxygen level in your blood, heart rate and breathing, as well as eye and leg movements while you sleep. You may be videotaped to document your behavior during sleep cycles.
Treatment for infrequent sleep terrors isn't usually necessary.
If the sleep terrors lead to the potential for injury, are disruptive to family members, or result in embarrassment or sleep disruption for the person who has sleep terrors, treatment may be needed. Treatment generally focuses on promoting safety and eliminating causes or triggers.
Treatment options may include:
- Treating any underlying condition. If the sleep terrors are associated with an underlying medical or mental health condition or another sleep disorder, such as obstructive sleep apnea, treatment is aimed at the underlying problem.
- Addressing stress. If stress or anxiety seems to be contributing to the sleep terrors, your doctor may suggest meeting with a therapist or counselor. Cognitive behavioral therapy, hypnosis, biofeedback or relaxation therapy may help.
- Anticipatory awakening. This involves waking the person who has sleep terrors about 15 minutes before he or she usually experiences the event. Then the person stays awake for a few minutes before falling asleep again.
- Medication. Medication is rarely used to treat sleep terrors, particularly for children. If necessary, however, use of benzodiazepines or certain antidepressants may be effective.
Lifestyle and home remedies
If sleep terrors are a problem for you or your child, here are some strategies to try:
- Get adequate sleep. Fatigue can contribute to sleep terrors. If you're sleep deprived, try an earlier bedtime and a more regular sleep schedule. Sometimes a short nap may help. If possible, avoid sleep-time noises or other stimuli that could interrupt sleep.
- Establish a regular, relaxing routine before bedtime. Do quiet, calming activities — such as reading books, doing puzzles or soaking in a warm bath — before bed. Meditation or relaxation exercises may help, too. Make the bedroom comfortable and quiet for sleep.
- Make the environment safe. To help prevent injury, close and lock all windows and exterior doors at night. You might even lock interior doors or put alarms or bells on them. Block doorways or stairways with a gate, and move electrical cords or other objects that pose a tripping hazard. Avoid using bunk beds. Place any sharp or fragile objects out of reach, and lock up all weapons.
- Put stress in its place. Identify the things that stress you out, and brainstorm possible ways to handle the stress. If your child seems anxious or stressed, talk about what's bothering him or her. A mental health professional can help.
- Offer comfort. If your child has a sleep terror episode, consider simply waiting it out. It may be distressing to watch, but it won't harm your child. You might cuddle and gently soothe your child and try to get him or her back into bed. Speak softly and calmly. Shaking your child or shouting may make things worse. Usually the episode will shortly stop on its own.
- Look for a pattern. If your child has sleep terrors, keep a sleep diary. For several nights, note how many minutes after bedtime a sleep terror episode occurs. If the timing is fairly consistent, anticipatory awakenings may help.
Preparing for your appointment
For children, sleep terrors tend to go away by the time they're teenagers. However, if you have concerns about safety or underlying conditions for you or your child, consult your doctor, who may refer you to a sleep specialist.
Keeping a sleep diary for two weeks before the appointment can help the doctor understand more about the sleep schedule, factors that affect sleep and when sleep terrors occur. In the morning, record bedtime rituals, quality of sleep, and so on. At the end of the day, record behaviors that may affect sleep, such as sleep schedule disruptions and any medications taken.
You may want to take a family member or friend along, if possible, to provide additional information.
What you can do
Before your appointment, make a list of:
- Any symptoms experienced, including any that may seem unrelated to the reason for the appointment
- Key personal information, including any major stresses or recent life changes
- All medications, vitamins, herbs or other supplements being taken, and the dosages
- Questions to ask your doctor to help make the most of your time together
Some questions to ask your doctor may include:
- What is likely causing these symptoms?
- What are other possible causes?
- What kinds of tests are needed?
- Is the condition likely temporary or chronic?
- What's the best course of action?
- What are the alternatives to the primary approach you're suggesting?
- Are there any restrictions that need to be followed?
- Do you recommend seeing a specialist?
- Are there any brochures or other printed material that I can have? What websites do you recommend?
Don't hesitate to ask other questions during your appointment.
What to expect from your doctor
Your doctor is likely to ask a number of questions. Be ready to answer them to reserve time to go over any points you want to spend more time on. Your doctor may ask, for example:
- When did the sleep terrors begin?
- How often do the sleep terrors occur?
- Have there been sleep problems in the past?
- Does anyone else in your family have sleep problems?