Night Terrors

Medically Reviewed by Poonam Sachdev on December 06, 2023
6 min read

Night terrors are episodes of intense screaming, crying, thrashing, or fear during sleep that happen again and again, usually in children ages 3 to 10, but most often in the 3-7 age group. 

There are two main types of sleep: rapid eye movement (REM) and non-rapid eye movement (non-REM). Night terrors happen during non-REM sleep, usually about 90 minutes after a child falls asleep.

About 1 to 6 in 100 children have night terrors, also known as sleep terrors, according to the American Academy of Sleep Medicine. They happen to both boys and girls and to children of all races. Night terrors tend to run in families. 

Night terrors vs. nightmares

Night terrors are different from common nightmares, which happen during REM sleep. Your child likely won't remember a night terror episode the next morning, unlike nightmares, which they'll often remember. Nightmares usually take place in the last third of the night, while night terrors usually happen in the first third of the night.

Night terrors in adults are rare, but they do happen. About 2% of adults experience night terrors, according to the American Academy of Sleep Medicine. They are usually caused by stress, PTSD, or taking certain drugs such as antidepressants. PTSD (posttraumatic stress disorder) is a mental disorder that occurs from witnessing or being part of a traumatic event such as war or rape. One of the symptoms of PTSD is having problems with sleep, such as nightmares, night terrors, and insomnia.

Dangers of night terrors in adults

Adults may thrash around, scream, cry, or try to jump out of bed and run through a door, though they usually have no memory of doing these things. All that movement could lead to accidentally hitting your bedmate or injuring yourself if you get out of bed. Other problems that could arise include exhaustion, daytime sleepiness (from not getting restful sleep), and dependence on sleep medications or alcohol taken in hopes of getting sleep.

 

Night terrors in children may cause:

  • Fast heart rate
  • Fast breathing
  • Sweating
  • Dilated pupils

During a night terror episode, a child might:

  • Sit up in bed
  • Flail around in bed
  • Scream
  • Look awake but be confused
  • Seem like they don’t know that a parent is there
  • Not talk
  • Not respond when a parent comforts them

Most episodes last only a few minutes, but it may take up to 30 minutes before the child relaxes and goes back to sleep.

When to call your doctor

Night terrors are not typically dangerous, but they can disrupt your child's sleep. They're part of a group of sleep disturbances called parasomnias and include sleepwalking (somnambulism), sleep talking (somniloquy), and waking up in a confused state. Parasomnias occur in about half of all children.

It might help ease your anxiety to talk to your child’s doctor. Let them know if your child’s night terrors keep them up often or for more than half an hour. They might be able to rule out other health conditions that can cause night terrors.

Night terrors tend to run in families. Most of the time, they have no specific cause. But certain things might play a role, including:

  • Sleep deprivation
  • Stress
  • Depression or anxiety
  • Fever
  • Too much caffeine
  • Sleeping in a different place or away from home
  • Lack of sleep
  • Sleep problems like sleep apnea
  • Restless legs syndrome
  • Medications that affect the central nervous system (the brain)
  • Recent anesthesia for surgery

 

Your child’s doctor can usually diagnose night terrors based on their medical history and a physical exam.

If they suspect other health problems, they might give tests including:

  • An EEG, which measures brain activity, to check for a seizure disorder
  • A sleep study (polysomnography) to check for a breathing disorder

 

There’s no treatment for night terrors apart from comforting your child, but this disorder usually stops as a child gets older.

In rare cases, if the episodes are affecting your child’s daily activities (for example, how they’re doing in school or their relationships with friends and family), their doctor might prescribe low-dose benzodiazepines (such as clonazepam) or tricyclic antidepressants (such as imipramine).

Treatment for night terrors in adults

For adults, the following treatments are used:

Therapy. Since sleep terrors are often a result of PTSD or another trauma, psychotherapy is often recommended. This focus will be on exposure and stress management, using cognitive behavioral therapy, hypnosis, biofeedback, or relaxation therapy. The therapist may suggest keeping a sleep diary or making video recordings at night to figure out underlying triggers, and may talk to your bed partner as well.

Anticipatory awakening. This is a technique where you're awakened 15 minutes before the time you usually experience a night terror. You stay awake for a few minutes and then you fall asleep again.

Medication. Drugs are rarely given as treatment for night terrors, even for adults. But if you have a lot of attacks, your doctor may prescribe benzodiazepine, selective serotonin reuptake inhibitors, or tricyclic antidepressants.

 

 

 

 

Parents might take one or more of these steps:

  • Make your child’s room safe so they aren’t hurt during an episode.
  • Get rid of anything that might disturb their sleep, like electronic screens or noises.
  • Try to lower your child’s stress levels.
  • Make sure your child gets enough rest. Don’t let them become too tired or stay up too late.
  • Create a relaxing bedtime routine, and stick to it.
  • Keep the same wake-up time every day.

Don’t wake your child during an episode. It can make them even more confused, and they might take longer to go back to sleep. Try to wait it out, and make sure they don’t get hurt by thrashing around or tripping on something in their room.

For adults, some of these same tips apply, along with others:

  • Fatigue can increase sleep terrors, so stick to a regular sleep schedule
  • If you're sleep deprived, try to get to bed earlier.
  • Create a relaxing bedtime routine. Take a warm bath or shower. Don't stare at your phone or TV before bedtime. 
  • Make sure your bed is comfortable and the lighting and noise are favorable for sleep.
  • Check that your room is safe so you can't hurt yourself during a night terror episode.
  • Exercise but not within 4 hours of sleep.
  • Avoid drugs and alcohol, which can make night terrors worse. 

If your child has a lot of night terrors, there are things you can try that might help. Breaking up their sleep is one example.

  • First, note how many minutes after bedtime the night terrors start.
  • Wake your child 15 minutes before the expected night terror, and keep them awake and out of bed for 5 minutes. You may want to see if they’ll use the bathroom.
  • Continue this routine for a week.

Night terror episodes are short and usually happen over several weeks. Most children outgrow them by their teen years.

Most of the time children grow out of night terrors. Waking your child 15 minutes before an expected episode and keeping them awake for 5 minutes can help lessen them. So can practicing good sleep hygiene (regular bedtimes, limited use of screens before bed). For adults who have night terrors, psychotherapy can be very useful.

Are night terrors genetic?

Yes, it appears so. A small study from 1980 showed that 96% of participants who experienced night terrors had a family member who did as well. However, environmental factors, such as stress, could play a role as well.

Can certain foods trigger night terrors?

This isn't a topic that has been studied scientifically very often, although some people swear eating cheese will give you bad dreams. In a survey of Canadian college students, 17% said food influenced their dreams and of that group, 44% said eating dairy (cheese, milk, ice cream, pizza) gave them disturbing dreams. But the study authors cautioned that this link could be due to eating the food late at night/poor digestion, the influence of folklore, or a dairy sensitivity, and not necessarily because cheese has something in it that triggers nightmares. If you have night terrors, you should avoid greasy and fatty foods close to bedtime, mainly because these are hard to digest and could affect your sleep.