- Hi, I'm Dr. Tracey Marks, a psychiatrist,
and I make mental health education videos.
Today I'm talking about night terrors,
also called sleep terrors.
And this is based on a few viewer questions.
Night terrors, also called sleep terrors,
are what we call parasomnias.
You can have parasomnias during two parts of your sleep.
They can occur during the rapid eye movement sleep,
or REM sleep, or they can occur during non-REM sleep.
Most of your sleep is non-REM,
and only a portion of your sleep is REM,
and that's when you do most of your dreaming.
Night terrors are different from nightmares.
Night terrors occur during non-REM sleep,
usually in the deep phase of sleep.
When you're in deep sleep, you have slower brain waves.
And we get the bulk of our slow wave sleep
during the first half or third of the night.
So most times, night terrors occur
in the first two to three hours after you go to sleep.
Normally, your body prepares you to wake up
by having fewer and shorter phases of deep sleep,
until you finally wake up from the lighter stages of sleep.
But with night terrors,
you abruptly wake up from deep sleep.
It's like going from a near coma to being shaken awake.
You wake up with a lot of confusion and disorientation.
You can wake up screaming, sweating, and your heart racing,
almost like you're having a panic attack.
This is a central nervous system arousal
that is involuntary.
It's not a bad reaction to a dream.
Remember, before you woke up, you were in a deep sleep,
which is a stage of sleep where not much dreaming happens.
And I say this because I've heard people say,
I have PTSD and it gives me night terrors.
You can have both conditions,
but the night terrors are not triggered
by having an upsetting dream.
If you're into science fiction,
think of it like the scene in Aliens
or any of the movies where the crew on board
is put into a hypersleep state
that's controlled by a computer.
Then the computer wakes them up prematurely.
That's what happens here.
Your brain's computer chip wakes you up
during a deep stage of sleep,
and you wake up confused and afraid.
You can stay in this state for a few minutes
or up to about a half an hour then fall back asleep.
And you can fall back asleep on your own,
but you can stay in this state longer
if someone tries to wake you up or talk to you.
Night terrors can be dangerous
because you can do things like thrash in the bed
or walk around and do things
without being fully aware of what you're doing.
Night terrors are common in children,
but occurs in about 3% of adults.
It can run in families,
and is related to a similar parasomnia, sleepwalking.
The clinical term for sleepwalking is somnambulism,
just so you know.
When a child has a night terror,
they usually don't remember the incident.
Adults can have some fragmented memory
of having this thing happen while they were asleep,
and they may remember feeling afraid
in the middle of the night
and therefore conclude that they had a nightmare,
even though it really wasn't a nightmare.
How are these different though from nightmares?
Nightmares occur during REM sleep.
And this is a lighter stage of sleep
where you do most of your dreaming.
Your brain waves are faster,
and if you wake up from this stage, you're not as confused
and you can remember that you were dreaming.
You may only remember parts of the dream,
or you may remember most of the dream.
Another difference that we see
between night terrors and nightmares
is that nightmares tend to happen
in the latter half of your sleep cycle
because that's when you have more of your REM sleep.
The first half of your sleep is front loaded
to get in your deep sleep,
and the second half is the lighter, more dream sleep.
But you can still have a night terror later in the night.
What causes night terrors?
They're common in children,
and can be due to brain immaturity
and not necessarily a sign of a medical problem.
But if they persist, you should see a medical professional
for an evaluation.
In adults, night terrors can be caused by stress,
depression, anxiety, sleep apnea, pain, and alcohol.
And sleep deprivation can also cause this.
What can we do about this?
The first thing to do is to make sure
you have good sleep hygiene,
like going to bed at a regular time each night,
and limiting food and drink before bed.
If you tend to wake up to go to the bathroom
during the night, you can help this
by not having anything to drink one hour before bed,
and then emptying your bladder just before you go to sleep.
It's okay to go to bed thirsty.
It may not feel good, but even if you drink
just a little bit of water to wet your whistle,
your bladder could still wake you up several hours later.
And then that breaks up your sleep,
leading to a disrupted sleep pattern.
This may not make a huge difference for most people.
But if you have a sleep problem,
you wanna make all the tweaks that you can.
Another thing you can do if you have frequent night terrors
and they occur around the same time each night,
you can have someone wake you up or set your alarm
to wake up about 30 minutes beforehand to break the pattern.
This is a sleep intervention called scheduled awakenings.
It's used for children who are not
sleeping through the night
and keep waking up around the same time each night.
You interrupt that pattern by waking them
before they wake up, and this helps them
sleep through that wake-up time.
Here's a last point about sleepwalking.
Sleepwalking is another parasomnia
that occurs during non-REM sleep.
You're aroused during the deep sleep phase,
but you're not completely awake,
even though your eyes are open.
You can do things, but they're usually basic things
that you can do without thinking much about them
like maybe changing your clothes
or getting something to eat.
You probably can't balance your checkbook.
Sleepwalking is an amnestic event,
so you don't remember what you were doing in the morning.
Sleepwalking is also common in children
and most people grow out of it.
But it can persist in adults,
usually happening less frequently though
than it did in childhood.
If it's something that occurs regularly like weekly,
you should see your doctor to see
if there's a treatable cause like a medication side effect.
Sleepwalking can happen as a side effect
of sleeping medications.
I mention sleepwalking because it can also happen
along with the night terrors.
You can get jolted awake with the screaming
and the racing heart,
and then get up and start walking around
before you eventually get back in your bed.
And this can be very disturbing for the people around you
and they may even be tempted to wake you up.
But this can make matters worse,
and make you become agitated.
So unless the person is at risk of harming themselves,
it's best to leave them alone
and let the episode pass on its own.
That's it on night terrors.
See you next time.