Sleep terrors (night terrors)

Diagnosis

To diagnose sleep terrors, your doctor or other healthcare professional may:

• Talk about your medical history. Your healthcare professional will likely discuss your medical history. You may have a physical exam to identify any conditions that may be part of the reason for your sleep terrors. You may be asked about your family history of sleep problems.
• Talk about your symptoms. Sleep terrors are usually diagnosed based on your description of the events. The health professional also may ask you or your bed partner some questions about your sleep behaviors. A video of a sleep terror episode can be helpful.
• Recommend an overnight sleep study. In some cases, your health professional may recommend an overnight study in a sleep lab. Sensors placed on your body record and monitor brain waves, the oxygen level in your blood, heart rate and breathing during sleep. The sensors also record eye and leg movements while you sleep. You may be videotaped to document your behavior during sleep cycles.

Treatment

Treatment usually isn't needed for sleep terrors that happen rarely. Children typically outgrow sleep terrors.

Treatment may be needed if the sleep terrors cause a safety risk, interfere with sleep, don't go away with time or happen more often. Being embarrassed or disrupting the sleep of others may lead some people to seek treatment.

Treatment generally focuses on plans for safety and getting rid of causes or triggers for sleep terrors.

Treatment options may include:

• Treating any underlying condition. If the sleep terrors are linked with a medical or mental health condition or another sleep disorder, such as obstructive sleep apnea, treatment is aimed at the underlying problem.
• Addressing stress. If stress or anxiety seems to be part of the cause of the sleep terrors, your healthcare professional may suggest meeting with a sleep specialist. Cognitive behavioral therapy, hypnosis or relaxation therapy may help.
• Anticipatory awakening. This involves waking the person who has sleep terrors about 15 minutes before the person usually has the event. Then the person stays awake for a few minutes before falling asleep again.
• Medicine. Medicine is rarely used to treat sleep terrors, especially for children. But if needed, the healthcare professional may prescribe medicines that help with sleep, such as benzodiazepines or certain antidepressants.

Lifestyle and home remedies

If sleep terrors are a problem for you or your child, here are some tips:

• Get enough sleep. Extreme tiredness can contribute to sleep terrors. If you're not getting enough sleep, try an earlier bedtime and a more regular sleep schedule. Sometimes a short nap may help. If possible, avoid noises or other stimuli that could interrupt sleep.
• Establish a regular, relaxing routine before bedtime. Do quiet, calming activities before bed. Read books, do puzzles or soak in a warm bath. Meditation or relaxation exercises may help too. Make the bedroom comfortable and quiet for sleep. Avoid caffeine close to bedtime.
• Make the area safe. To help prevent injury, close and lock all windows and outside doors at night. You might even lock inside doors or put alarms or bells on them. Block doorways or stairways with a gate. Move electrical cords or other objects that might be a tripping hazard. Don't use bunk beds, if possible. Place any sharp or fragile objects out of reach. Also, lock up all weapons.
• Put stress in its place. Identify the things that cause stress. Think of ways to handle the stress. If your child seems anxious or stressed, talk about what's bothering your child. A mental health professional can help.
• Offer comfort. If your child has a sleep terror, consider simply waiting it out. It may be upsetting to watch, but it won't harm your child. You might cuddle and gently soothe your child. Then try to get your child back into bed. Speak softly and calmly. Don't shout. Trying to wake your child or keep your child from moving may make things worse. Usually the event will shortly stop on its own.
• Look for a pattern. If your child has sleep terrors, keep a sleep diary. For a few weeks, note how many minutes after bedtime a sleep terror occurs. If the timing is fairly consistent, anticipatory awakenings may help.

Preparing for your appointment

Sleep terrors in children tend to go away by the time they're teenagers. But if you have concerns about safety or underlying conditions for you or your child, talk to your healthcare professional. Your health professional may refer you to a sleep specialist.

Keep a sleep diary for two weeks before the appointment. A sleep diary can help the healthcare professional understand more about the sleep schedule, issues that affect sleep and when sleep terrors happen. In the morning, record bedtime rituals, quality of sleep, and anything else you think is important. At the end of the day, record behaviors that may affect sleep, such as sleep schedule changes and any medicine taken.

You may want to take a family member or friend along, if possible, to provide more information.

What you can do

Before your appointment, make a list of:

• Any symptoms, including any that may not seem related to the reason for the appointment. Bring a sleep diary to the appointment, if possible. A video recording of the sleep terror can be helpful.
• Key personal information, including any major stresses or recent life changes.
• All medicines, vitamins, herbs or other supplements being taken, and the doses.
• Questions to ask the healthcare professional to help make the most of your time together.

Some questions to ask include:

• What is likely causing these symptoms?
• What are other possible causes?
• What kinds of tests are needed?
• Is the condition likely to last a short time or a long time?
• What's the best course of action?
• What are other options to the primary actions you're suggesting?
• Do you recommend seeing a specialist?
• Are there any brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor or other healthcare professional is likely to ask several questions, for example:

• When did the sleep terrors begin?
• How often do the sleep terrors occur?
• When during the night do the episodes occur?
• Can you describe a typical episode?
• Have there been sleep problems in the past?
• Does anyone else in your family have sleep problems?
• Have the episodes resulted in any injuries.

Be ready to answer questions so you have time to go over information you want to spend more time on.