What is Sleep Terror? Sleep Terror Symptoms and Treatment

Sleep terrors are a form of sleep disorder characterized by attacks in which a person suddenly experiences intense fear and/or anxiety while sleeping. It is a sleep disorder in the parasomnia group. Parasomnias can be described as undesirable events that occur while falling asleep, during sleep, or when waking up. Apart from sleep terror, confusional arousal, sleepwalking, nightmare disorder, REM sleep behavior disorder and sleep paralysis (nightmare) are some of the diseases in the parasomnia group. It is common in childhood, especially between the ages of 5-7. The general incidence has been reported to be 3-6% in children and less than 1% in adults.

What is Sleep Terror?

The answer to the question of what sleep terror is may be a matter of curiosity. Sleep terror is a sleep disorder that manifests itself with symptoms such as screaming, intense fear, and shaking, while the person is still asleep with his or her eyes open but looking at his or her brain waves, unable to perceive the surroundings. It usually occurs in attacks lasting from a few seconds to a few minutes. While it may seem scary, it’s not usually a sign of a serious problem. Attacks typically last between 30 seconds and 3 minutes, but in some cases the duration can be significantly longer. In most children, symptoms of the disorder disappear completely by the teenage years, without the need for any treatment.

What Causes Sleep Terrors?

During sleep terrors, the person is neither fully asleep nor fully awake. The exact underlying cause of this disorder, which is a state of partial wakefulness, is still unknown. However, there are some factors that are predicted to cause the disorder. These factors include the following:

• Stress
• physical fatigue
• Travel-related sleep disorders
• excessive sleep deprivation
• Some antidepressants and some drugs with stimulant properties
• alcohol intake

Sleep Terrors in Babies

Babies experiencing sleep terrors may appear panicked or afraid. They may not respond to the adults around them and may seem very confused. During sleep terrors, the baby may scream, cry, breathe rapidly, and have an increased heart rate. After the attack passes, it usually does not show any signs of distress. Sleep terrors do not indicate that the baby is having a bad dream, because these attacks occur in the non-dreaming phase. This process can be quite troublesome for mothers whose babies experience sleep terrors. Because there is nothing they can do to calm their babies down when they cry and scream. They do not respond to stimuli and it is very difficult, sometimes even impossible, to wake them up from sleep. The answer to the question of how to prevent sleep terrors in babies is often wondered by parents who experience this problem. Unfortunately, no strategies to prevent sleep terrors have been scientifically proven. However, some parents may find that keeping a record of their baby’s sleep terror attacks helps them identify triggers such as stress, fatigue, or certain foods. Some of the apps that can help prevent sleep terrors in babies include:

• Creating a soothing night routine
• Putting baby to bed at the same time every night to prevent fatigue
• Avoid giving the baby anything that contains caffeine
• Sleeping in the same room with the baby

Sleep Terrors in Children

A child experiencing a sleep terror attack may scream, yell, thrash around in bed, or even jump out of bed in extreme panic. Although his eyes are open, he is not fully awake. Sleep terror attacks in children usually occur in the early hours of the night and last a few minutes. It can last up to 15 minutes and sometimes recurs multiple times throughout the night. It is more common in people with a family history of sleep terrors or sleepwalking. Attacks can be triggered by various factors, including:

• Tiredness
• Fire
• some medications
• Excitement
• Anxiety
• sudden noise
• full bladder

If your child is experiencing sleep terrors, the best thing to do is to stay calm and wait until the situation returns to normal. Some practices to consider during sleep terrors are:

• The child should not be intervened or interacted with unless he or she is in a dangerous situation.
• Do not try to wake up
• You should know that the situation is harmless and try not to panic.

Touching, intervening, or trying to communicate with the child during an attack may cause the attack to worsen. Since the child is not fully awake at that time, he may not recognize his parents, may be afraid, and may scream more. Even if he does not remember anything when he wakes up in the morning, a general conversation about his sleep and before going to sleep the night before may be useful in order to learn the factors that triggered the situation. To help prevent attacks, the following practices may be helpful:

• Doing regular relaxing pre-sleep routines
• Avoid talking about attacks to the child or others around them in a way that may make them anxious, as this may increase their anxiety.
• If sleep terror attacks are frequent and occur at a certain time each night, waking the child before the attack can break the cycle. The child is woken up every night for 7 days 15 minutes before the expected time of the attack. This practice may be the easiest way to stop attacks without affecting sleep quality.

Sleep Terrors in Adults

Sleep terrors are more common in young children, but there are a small number of people who experience the disorder as an adult. In reality, this number may be higher because the data is unclear because many people sleep alone and cannot remember experiencing sleep terrors. Because sleep terrors in adults are so closely associated with mental trauma and psychological disorders, behaviors such as aggression, anxiety, memory loss and self-mutilation are common in many of these people. For this reason, treatment for sleep terrors in adults includes the use of medications aimed at reducing the underlying cause and symptoms related to the disorder. For example, the use of antidepressants in adults is one of the solution suggestions for sleep terrors.

What are the Symptoms of Sleep Terrors?

Sleep terrors differ from nightmares because the person having the nightmare can remember the details after waking up, but in sleep terrors the person does not wake up and does not remember what happened when he wakes up. The difference between the two stems from the stage of sleep in which night terrors occur. While nightmares occur in the REM period of sleep (that is, the phase in which most dreams occur), night terror attacks occur in the non-REM period of deep sleep. Since the deep sleep phase is more prevalent in the first half of the night, the incidence of sleep terrors is also higher in this period . After the attack, which usually lasts a few seconds to minutes, is over, the person goes back to sleep as if nothing had happened and does not remember what happened when he wakes up. Possible sleep terror symptoms include:

• Screaming, yelling, crying, making meaningless sounds
• Autonomic findings such as rapid breathing, facial flushing, rapid heartbeat, and sweating
• Don’t look with fearful eyes
• Eyes open and appearing awake from the outside
• Difficulty waking up
• Becoming aggressive if interfered with, prevented, or tried to wake up
• Confusion and confusion if awakened during the attack
• Sitting in bed, struggling, jumping
• Not remembering the attack when waking up

Difference Between Sleep Terrors and Epilepsy

Examination alone may not be sufficient to differentiate between sleep-related epileptic seizures and parasomnias seen in the non-REM period of sleep, including sleep terrors. Nocturnal frontal lobe epilepsy is characterized by seizures with complex, often bizarre, violent behavior that occur during sleep. These unusual seizures occur during sleep, and EEG examination and radiological findings taken during wakefulness are usually detected within normal limits. This makes it very difficult to distinguish seizures from parasomnias. Polysomnography is a sleep test performed in sleep centers to evaluate sleep quality . In addition, video polysomnography (VPSG-EEG) examination, which is performed during the whole night’s sleep accompanied by multi-channel EEG and also records images during attacks, is very useful in distinguishing these disorders.

How to Treat Sleep Terrors?

Treatment for sleep terrors, which occur rarely, is usually not necessary. However, if it recurs very frequently, causes a risk of injury, disturbs family members, or results in distress such as embarrassment or inability to sleep, treatment may be needed. The following steps can be followed in treatment:

• To treat sleep terrors, the underlying cause, if any, is first eliminated.
• If it is thought that stress or anxiety triggers sleep terrors, it may be useful to consult a psychologist.
• If attacks occur at the same time every night, waking the person 15 minutes before gives beneficial results. The person remains awake for a few minutes before falling asleep again, and this practice is continued for a while to try to break the cycle.
• Medicines are mostly preferred in adults. It is rarely used in children.

If you think you are experiencing symptoms related to sleep terrors or a similar sleep disorder, you can contact a health institution for diagnosis and treatment and have the necessary examinations and examinations.