If you've ever seen a loved one wake up screaming, you know how disorienting and concerning it can be. Similarly, if you've experienced waking up screaming yourself, you may feel confused and unsure about what this means for you.
Typically, people wake up screaming due to night terrors. Night terrors are a type of sleep disorder that is common in children but quite rare in adults.
Let's explore night terrors, how they manifest, what causes them, and what to do if you or a loved one is experiencing them.
What Are Night Terrors?
Night terrors, also known as "sleep terrors" or "pavor nocturnus," are a type of parasomnia or sleep disorder. They usually occur during non-rapid eye movement (NREM) sleep, a state between dreaming and waking. This stage is part of the deep sleep cycle, specifically the third stage of NREM, known as the most restorative phase of sleep.
During night terrors, individuals are not fully conscious and typically do not remember the event. If you're searching for "I wake up screaming," it's likely because someone has informed you of this behavior rather than you being aware of it during the episode. Night terrors can be quite distressing to observe but often do not cause any harm to the person experiencing them.
Night terrors can last from 20 minutes to as long as 45 to 90 minutes. This disorder is fairly common in children from preschool age to puberty but is much less common in adults, affecting only about 1 to 4% of adults. In children, the frequency of night terrors often decreases as they grow older and their sleep patterns mature.
Night Terrors vs. Nightmares
People often confuse night terrors with nightmares, but there are key differences:
Memory: Individuals who have nightmares usually remember the events, whereas those with night terrors typically do not. Nightmares occur during REM sleep, which is associated with vivid dreams and memories of those dreams.
Dreaming: Nightmares involve scary and unsettling dreams, while night terrors do not occur during dreaming. Instead, night terrors occur during deep sleep stages when dreaming is not as prevalent.
Triggers: Nightmares are often triggered by an upsetting experience, trauma, or a scary movie, whereas the triggers for night terrors are usually harder to identify and can be linked to physiological or environmental factors.
What Are the Symptoms of Night Terrors?
Night terrors generally occur early, between 12 a.m. and 2 a.m. Symptoms can appear suddenly and unexpectedly. Common signs include:
Sudden wake-ups involving yelling and screaming
Thrashing and violent movements
Increased heart rate, sweating, and hyperventilating
Dilated pupils
A look of fear or alarm on the face
Although people who experience night terrors don't usually remember them, they may feel shame or embarrassment when they find out about the episodes. Night terrors can also be associated with sleepwalking, another common parasomnia.
Other symptoms can include sitting up in bed, kicking, and making other aggressive movements. Some individuals may even get out of bed and run around the room. It's important to ensure the environment is safe to prevent injuries during these episodes.
What Causes Night Terrors?
Night terrors can have multiple causes, and it’s often difficult to pinpoint a specific reason. Possible causes and risk factors include:
Genetics: Night terrors tend to run in families, indicating a genetic predisposition. If a parent or sibling has experienced night terrors, there is an increased likelihood that other family members may experience them as well.
Illness and Fever: During times of illness, especially when accompanied by fever, night terrors can become more frequent.
Sleep Deprivation and Exhaustion: Lack of sufficient sleep and extreme tiredness can trigger night terrors. Ensuring a regular sleep schedule and good sleep hygiene can help mitigate this risk.
Physical Activity: Increased or excessive physical activity, especially close to bedtime, can disrupt normal sleep patterns and lead to night terrors.
Emotional Stress: Times of emotional conflict, heightened stress, and anxiety may make an individual more vulnerable to night terrors. Stress management techniques and addressing underlying anxiety can be beneficial.
Caffeine and Alcohol: Large amounts of caffeine and alcohol consumption can interfere with normal sleep cycles and trigger night terrors. Reducing intake of these substances, especially in the hours leading up to bedtime, can help reduce occurrences.
Health Issues: Conditions such as head injuries, thyroid problems, and encephalitis (inflammation of the brain) can increase the risk of night terrors. It's important to address and manage these underlying health issues with the help of a healthcare provider.
Medications: Certain medications, particularly those affecting the central nervous system, can increase the risk of night terrors. If you suspect your medication may be contributing to night terrors, consult your doctor for possible alternatives.
Other Sleep Disorders: Having another sleep disorder, such as sleep apnea, can make an individual more likely to experience night terrors. Addressing and treating these coexisting sleep disorders can help reduce the frequency of night terrors.
What to Do if You or a Loved One is Experiencing Night Terrors
If you or someone you care about is experiencing night terrors, here are some steps to take:
Create a Safe Environment: Remove any dangerous objects from the bedroom that could cause injury during a night terror episode. Ensure that windows and doors are secure to prevent accidental exits.
Regular Sleep Schedule: Maintain a consistent sleep routine with regular bedtimes and wake-up times. Ensuring adequate sleep can help reduce the frequency of night terrors.
Reduce Stress: Implement stress-reducing techniques such as relaxation exercises, mindfulness, or counseling to address underlying anxiety and emotional stress.
Limit Stimulants: Reduce or eliminate the intake of caffeine and alcohol, especially in the hours leading up to bedtime.
Medical Consultation: If night terrors are frequent or particularly severe, consult a healthcare professional. They can help identify any underlying health issues or medication side effects contributing to the problem.
Sleep Study: In some cases, a sleep study may be recommended to rule out other sleep disorders and better understand the nature of the night terrors.
Education and Support: Educate family members about night terrors to help them understand and respond appropriately. Support groups or therapy can also be beneficial for those affected.
Understanding night terrors and their causes can help you take steps to manage and reduce their occurrence, ensuring a safer and more restful night's sleep for you and your loved ones.
Night Terrors in Children vs. Adults
Night terrors are more common in children, with about 30% experiencing them. If your child has night terrors, it's important to consult their pediatrician to rule out any serious issues. However, most children outgrow night terrors by around 10 years old or after puberty.
In contrast, night terrors are rare in adults and can sometimes indicate a neurological disorder. If you experience night terrors as an adult, it's crucial to follow up with your healthcare provider. Adult night terrors can also be associated with trauma or emotional distress. Research shows that night terrors in adults are linked to sleep disorders, neuroses, and psychiatric conditions such as depression, bipolar disorder, and anxiety.
Treatment for Night Terrors
Waking up screaming from a night terror can be very distressing for both the individual and their loved ones, but help is available.
For Children
If your child experiences night terrors, consult their pediatrician. If the episodes are infrequent and not harmful, the pediatrician might adopt a “wait and see” approach, as night terrors often resolve on their own. In some cases, a sleep study may be recommended to rule out serious sleep disorders. Typically, staying calm and comforting your child during a night terror, reducing stress, and ensuring they get enough sleep can help reduce occurrences. Occasionally, therapy or medication may be necessary.
For Adults
Adult sleep disorders should be taken seriously due to their rarity and potential indication of more serious medical or mental health conditions. If you experience night terrors as an adult, promptly see a sleep specialist or psychiatrist. Treating adult night terrors involves identifying root causes, which may require a sleep study or psychiatric evaluation.
If no sleep disorder or psychiatric condition is diagnosed, lifestyle changes might help reduce night terrors:
Practicing good sleep hygiene
Getting sufficient sleep
Limiting caffeine and alcohol before bed
Reducing stress, especially before bedtime
Maintaining a consistent sleep and wake schedule
Keep in Mind
Waking up screaming is usually associated with night terrors. However, if you or a loved one wakes up screaming for an unknown reason, consult a healthcare provider. While this can be unsettling, help is available, and there are effective ways to manage these symptoms.
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