Night terrors are a type of parasomnia or partial-sleep disorder, characterised by bouts of screaming, intense fear and flailing while still asleep. Also known as sleep terrors, night terrors are commonly observed in children and are often accompanied by somnambulism or sleepwalking, in one-third of the cases. An episode of night terror generally lasts from a few seconds to a few minutes, but some episodes may continue for a prolonged period. Night terrors take place in the deepest stage of sleep and are marked by an abrupt arousal. It generally occurs within the first hour of sleep. The person, under the bout, looks terrified and may sit upright in acute fright, shrieking, thrashing, crying inconsolably and flailing. Night terrors, in children occur as a result of immature sleep patterns with a sudden activation of the flight or fight reaction.

Studies showthat although people of all age groups are susceptible to night terrors, it isparticularly observed in children aged between three and five. Approximately 40percent children and 3 percent adults suffer from night terrors. About of sleep terror usually strikes fifteen minutes to one hour afterfalling asleep. Like most parasomnias, night terrors too are dissociated sleepstates which occur during the shift from wakefulness to NREM (Non-rapid eyemovement) sleep or wakefulness to REM (Rapid eye movement) sleep, they hardlyever occur during naps. Some people are oblivious to their fit of night terrorwhereas the others vaguely remember their ordeal. 

In children,such partial confusional arousals could be stimulated by stress, anxiety andfatigue. It could also be triggered due to a loud noise or other unusualinterruptions, or even a change in the usual sleeping pattern, or a fullbladder. In adults, night terrors are mostly associated with medicinalside-effects, traumatic experiences or post-traumatic stress, and thereforecould be more critical. During the fit of night terror, the person feelsextremely bewildered and disoriented, along with profuse sweating, a rapid risein the heartbeat, fast breathing and an elevated blood pressure. It is oftenseen that night terrors mostly run in families, even though no scientificevidence of involvement genetic factors has been found. In children, parasomniais mostly a developmental process and not particularly a consequence of mentalor physical ailment. Such nocturnal episodes of night terrors cease to persistafter the age of 12, or at least decrease in frequency. Hence,occasional sleep terrors are not a matter of severe concern in most cases. 

Sleepterrors may require medical intervention in case the sufferer doesn’t getenough sleep and as a result gets fatigued, or they pose a risk to themselvesor their surroundings due to aggressive fits. Also if the bouts become frequentand continue beyond 12 years of age, the advice of a doctor should be sought.During a bout of night terror, one shouldn’t try to awaken the person. It mightprove to be futile to try to console such a person, though holding the personand speaking softly might help them to fall back to sleep. 

In severecases, hypnosis, biofeedback and various other relaxation techniques are todecrease or stop such episodes of night terrors. For children, soothing musicor bedtime stories are advised to lull a child into deep slumber. Additionally,doctors also advise against taking heavy or spicy meals before bedtime asindigestion also acts as a trigger for parasomnia.

Dr.Meena Gnanasekharan, Consultant – Psychiatry, Columbia Asia Referral Hospital Yeshwanthpur 

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