Monday, September 01, 2014

Definition

Sleep terror disorder or "night terrors" is a condition that occurs during stages 3 or 4 of non-rapid eye movement (NREM) sleep. It is characterized by repeated episodes of abrupt awakening, usually with a panicky scream, and accompanied by intense anxiety, confusion, agitation, disorientation, unresponsiveness, marked motor movements, and total amnesia concerning the event.

Description

Night terrors usually occur 1/2 hour to 3 1/2 hours after falling asleep. During these episodes people wake up sweating heavily, their hearts pounding and eyes glazed over, screaming in fear. They are unaware of their surroundings and unresponsive to attempts to comfort them. They may not calm down for 10 or 15 minutes, although they return to sleep quickly once the episode ends.

Generally they do not remember what scared them, but rarely a person will retain a vague image of something terrifying. A few children and adults who experience night terrors will sleepwalk during the episode.

Causes

Night terrors strike children, usually between the ages of 3 years and 8 years. They rarely occur in older children, adolescents and adults.

In both adults and children, night terrors may be caused by unresolved psychological conflicts, traumatic events or fatigue. In children, traumas such as the loss of a favorite toy, overhearing a loud argument between parents, watching scenes of violence on television or listening to frightening stories could trigger a night terror.

Particularly among adults, prescription drugs such as antihistamines, decongestants, levodopa, reserpine, beta blockers, and antidepressants, as well as withdrawal from addictive drugs, all can provoke sleep disturbance.

Treatment

Night terrors in children usually disappear with adolescence, so standard medical treatment is not necessary. The doctor may advise the parents to adjust the sleep habits of the child to allow for more sleep time, and eliminate stresses in the child's life.

Additionally, the parents should determine when the night terrors usually occur and fully awaken the child about 15 minutes before that time. After 4 or 5 minutes, the child can return to sleep. The waking is discontinued once the terrors stop, which in most circumstances is usually within a week.

In severe cases of night terrors the doctor may prescribe an antidepressant such as imipramine (Tofranil) or a benzodiazepine drug called chlordiazepoxide which relieves nervousness or tension and also treats insomnia.

Night terrors in adults can be treated with medications such as an antidepressant called Tofranil or benzodiazepine drugs such as Klonopin or Valium. Additionally, the doctor may recommend psychotherapy, which is a method of treating emotional problems. In psychotherapy, the patient talks with a therapist about their concerns and problems that may be linked to this sleep disturbance.

Note: never yell or shake a person experiencing a night terror, this will only confuse and upset them more. Comforting them with a hug or gently restraining them will help.

Questions

Is there a psychological cause such as depression, emotional trauma, or stress?

Is it related to any medications that are currently being taken?

Should any changes be made in the medications currently being taken?

Would psychotherapy help?

What can be expected from psychotherapy?

Will a person grow out of night terrors?