What are the symptoms of night terrors?

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Symptoms of Night Terrors

Night terrors, also known as sleep terrors, are a type of parasomnia characterized by sudden arousals from sleep accompanied by intense fear and autonomic arousal. This article synthesizes the key symptoms associated with night terrors based on multiple research studies.

Sudden Awakening and Intense Fear

One of the hallmark symptoms of night terrors is the abrupt awakening from sleep, often accompanied by a loud scream or cry. The individual, typically a child, may sit upright in bed or even jump out of bed in a state of intense fear and panic . This sudden arousal usually occurs during the first few hours of sleep, specifically during stages three or four of non-rapid eye movement (NREM) sleep .

Confusion and Incoherence

During a night terror episode, the individual often appears confused and disoriented. They may exhibit disorganized verbalizations and are generally difficult to console or awaken fully . Despite appearing awake, the person is usually not responsive to external stimuli and may not recognize familiar people or surroundings.

Autonomic Hyperactivity

Night terrors are frequently accompanied by significant autonomic hyperactivity. Symptoms include tachycardia (rapid heart rate), tachypnea (rapid breathing), diaphoresis (sweating), flushed face, dilated pupils, and increased muscle tone . These physiological responses are part of the body's fight-or-flight reaction to the perceived threat.

Behavioral Manifestations

Behavioral symptoms during night terrors can include motor activities such as sleepwalking or other automatic behaviors. The individual may exhibit actions that seem purposeful but are performed unconsciously . These behaviors are often a response to the intense fear experienced during the episode.

Amnesia for the Episode

A common feature of night terrors is retrograde amnesia, where the individual has little to no memory of the episode the following morning . This lack of recall differentiates night terrors from nightmares, which are typically remembered upon waking.

Duration and Frequency

Night terror episodes are usually brief, lasting from a few minutes to up to 20 minutes, after which the individual often returns to normal sleep . The frequency of these episodes can vary, with some individuals experiencing them nightly, while others may have them less frequently.

Conclusion

Night terrors are characterized by sudden awakenings from NREM sleep, intense fear, confusion, autonomic hyperactivity, and amnesia for the episode. These symptoms can be distressing for both the individual and their family, but understanding the nature of night terrors can help in managing and alleviating the condition. Most children outgrow night terrors by late adolescence, and in many cases, no specific treatment is necessary beyond reassurance and ensuring good sleep hygiene .