Sleep Disorder – Night Terror
A night terror, also known as pavor nocturnus, is a parasomnia sleep disorder characterized by extreme terror and a temporary inability to regain full consciousness. The subject wakes abruptly from slow-wave sleep, with waking usually accompanied by gasping, moaning, or screaming. It is often impossible to fully awaken the person, and after the episode the subject normally settles back to sleep without waking. A night terror can occasionally be recalled by the subject. They typically occur during non-REM sleep.
Night terrors are distinct from nightmares in several key ways. First, the subject is not fully awake when roused, and even when efforts are made to awaken the sleeper, he/she may continue to experience the night terror for
ten to twenty minutes. Unlike nightmares, which occur during REM sleep, night terrors occur during slow-wave sleep, the deepest levels of non-REM sleep. Even if awakened, the subject often cannot remember the episode except for a sense of panic, while nightmares usually can be easily recalled. After the night terror is complete, it can often result in a seizure, which is commonly a tonic-clonic type (although the subject may not be epileptic). The subject often has no recollection of the incident, nor the seizure.
Unlike nightmares, which are frequently a scary event dream (e.g. a monster under the bed, falling to one’s death, werewolves and monsters chasing you etc.), night terrors are not dreams. Usually there is no situation or event (scary or otherwise) that is dreamt, but rather the emotion of fear itself is felt. Often, this is coupled with tension and apprehension without any distinct sounds or visual imagery, although sometimes a vague object of fear is identified by the sufferer. These emotions, generally without a focusing event or scenario, increase emotions in a cumulative effect. The lack of a dream itself leaves those awakened from a night terror in a state of disorientation much more severe than that caused by a normal nightmare. This can include a short period of amnesia during which the subjects may be unable to recall their names, locations, ages, or any other identifying features of themselves. This state generally passes after only one or two minutes.
Children from age two to six are most prone to night terrors, and they affect about fifteen percent of all children, (although people of any age may experience them). Episodes may recur for a couple of weeks then suddenly disappear. The symptoms also tend to be different, like the child being able to recall the experience, and while nearly awake, hallucinate. Strong evidence has shown that a predisposition to night terrors and other parasomniac disorders can be passed genetically. Though there are a multitude of triggers; emotional stress during the previous day and a high fever are thought to precipitate most episodes. Ensuring that the right amount of sleep is gained is an important factor. Special consideration must be used when the subject suffers from narcolepsy.
Though the symptoms of night terrors in adolescents and adults are similar, the etiology, prognosis and treatment are qualitatively different. Adult night terrors are much less common, trauma-based rather than genetic, chronic, and usually require treatment in the form of psychotherapy and antidepressant medication.