Sleep Terrors (307.46

who never have done it before.

Sleep terrors or “night terrors” are similar in origin to sleepwalking but with different behaviors.

It is an arousal disorder in which the patient awakens partially from a non-REM sleep state.

This usually happens in children who will awaken suddenly, scream or cry without consolation

for up to 30 minutes. There are autonomic indications of fear as well. These things will only

happen at night and will not happen during naptime. It usually occurs in the first third of the

sleep period.

Sleep terrors are not the same as awakening from a nightmare, even when they happen during

deep sleep. The person awakening from a nightmare will be awake and will remember the

nightmare. There may be fragments of a dream remembered in sleep terrors but not to the

degree that they are remembered in a simple nightmare. The sleep terror individual cannot be

consoled and will not be oriented. Nightmares occur in REM sleep and not in NREM sleep.

Episodes of sleep terrors do not necessarily qualify as having sleep terror disorder; there needs

to be marked distress and impairment for this to be a disorder. It cannot be secondary to

drugs, medications, medical condition, or psychological problem. It is seen in early childhood

and usually resolved by adulthood. Episodes can be seen in about 37 percent of those kids at

18 months, with a prevalence of episodes at about 20 percent by 30 months of age. Episodes

can be seen in adults at a rate of 2 percent but this does not necessarily qualify as a disorder.

There is no specific treatment for sleep terrors except engaging in better sleep hygiene. Most

children outgrow the disorder with time. Adults with the disorder can undergo CBT to help

them improve the quality of their sleep so they can have improved daytime functioning. The

distress seen with the disorder can be seen by the parents of an affected child or by the

sleeping partner if the individual is an adult. Things that should be ruled out include PTSD,

which generally causes nightmares rather than true sleep terror episodes.