Keywords: Sleep Terror, night terror, NREM sleep, REM sleep, night mares, bad dreams, sleep hygiene.
Introduction.
Sleep Terror – What Is That? What is sleep terror? Is sleep terror the same as night mares? What causes sleep terror? Are there complications from having sleep terrors? What should you do?
When people get married, most often, they don’t reveal everything about themselves to their partners.
Some issues that most people don’t easily discuss during the courting period are sleep disorders. This is because many a times, we don’t see such issues as illnesses, but as evil possession. Sometimes, we see them as the work of our village people, projecting evil. And no one would like to reveal that he or she is possessed, or that villagers are projecting evil.
Then in the course of the marriage, you will start to noticing strange things, from your partner, like sleep terror. This sleep or night terror, is usually a frightening scenario for an unsuspecting person like you. And you with your partner, may end up going from one native doctor to another. Or you may go from church to church or from hospital to hospital.
Incidentally, sleep terror occurs more in children. When unsuspecting couples witness such in their child, it can disorganize the family.
What is sleep terror?
A typical scenario:
In a typical scenario, if you are living with someone who usually have episodes of sleep terror, you will observe:
At night, when the affected person is sleeping, child or adult, will suddenly let out a very loud and sharp cry. This loud cry, will wake you up and get you running to see what is wrong with the person. On getting there, you could see the person displaying with his or her limbs as if struggling with someone. This child or adult will be kicking and swinging the arms, while screaming and crying with the face looking terrified.
On some occasions, by the time you get to the scene, the child or adult is already seated on the bed. If you observe the eyes, it will seem as if he or she is staring into space frightened. Most attempt to wake the person, or stop him or her from crying, is usually fruitless.
But if you are patient and not panicky, you will notice something. You will see that after 1 to 10 minutes of display, the child or adult will go back to bed. And the child or adult will quietly lie down and sleep off. Then in the morning, this child or adult will not remember any of this scenario. But for some people, this fear and terror display may last up to 40 minutes.
What is actually happening in the brain and body of the person with night terror disorder:
Sleep terror occurs at the stage of sleep called the None Rapid Eye Movement (NREM) sleep. And it usually happens within 2 to 3 hours of having fallen asleep. And in the deepest part of the NREM sleep phase.
So in such a person, part of the brain is asleep, usually the frontal areas, while back parts are awake.
Then the sympathetic nervous system will go into excessive activation, via the neurotransmitter noradrenalin and adrenalin. Because the sympathetic nervous system controls many body regions, these regions will become very active.
One region activated by the sympathetic nervous system is the heart. The heart will start beating fast (palpitations) and blood pressure will increase. And the muscles in the body will contract, with increased sweating. The person will begin to have fast breathing in an attempt to take in more oxygen. And the whole scenario presents like a panic attack.
It is important to know that during NREM sleep, the body muscles are not paralyzed. This is in contrast to what happens during the Rapid Eye Movement (REM), when the muscles are paralyzed. These muscles are paralyzed because most dreams occur during the REM sleep phase, to prevent dreams being acted out.
The dreams at REM sleep are easily remembered. But dreams that occur during the NREM sleep phase, are not remembered. That is the reason the child or adult with sleep terror, don’t remember the night’s activities.
Is night terror the same as night mare?
Night terrors are not the same as night mares. As already mentioned, night terrors occur at the NREM sleep phase. But night mares occur during the REM sleep phase.
Might mares are terrifying dreams that are threatening and worrisome. They usually wake up the person from sleep. And once the person wakes up, he or she is immediately alert and will remember all or most aspects of the dream.
The fact is that many people have night mares occasionally, but there are some people who frequently have night mares. These people are said to have night mare disorder.
Bad dreams on the other hand, are a milder form of night mares that occur at the REM sleep stage. But they do not wake the person from sleep, because they are not as emotionally charged as night mares.
What causes sleep terror?
There is a risk for someone who is on medications that depress the central nervous system, to have night terrors. Being tired or stressed, physically or emotionally are also risk factors, as well as not having enough sleep. Family conflicts are risk factors. Fevers can bring it about.
Post Traumatic Stress Disorder (PTSD), depression, phobias, low self-esteem can all be risk factors. Anxiety, including separation anxiety in children can bring it about.
People who have a family history for sleepwalking, have an 80% chance of having sleep terrors.
Other conditions that can bring it about are, chronic headaches, like migraine, head injuries, and even substance abuse.
It is important to note that night or sleep terrors are more common in children ages 4 to 12 years of age. Although it usually ends by teenage, but for some people, their illness will continue to adulthood. And for some people, theirs start in adulthood, between the ages of 20 to 30 years. For such adults, theirs may last for the rest of their lives.
Are there complications from having sleep terrors?
People with sleep terrors are usually not fully awake, even though their eyes and facial expression shows fear. So attempting to awaken them can make them become violent, harming the next person or even themselves. In an attempt to also escape, they may knock over things in the room. And if the door locks are not secured, they can leave the house, into the streets.
What should you do?
Being a parent or a partner watching your love one going through sleep terror, can be quite frightening. Your first reaction will be to wake up the person and give comfort. But this is not the right thing to do.
First thing to do when your loved one is having an attack of sleep terror, is to be present at the scene. And make sure that the environment is safe, so that within the actions, your loved one remains safe. Don’t touch the person, unless it is to redirect and guide him or her back to bed. After the episode, the person will go back to sleep and in the morning will not remember a thing.
Prevention:
We do know that for most people, sleep terrors do stop by the time the person is in the teens. But unfortunately for a few, especially for those whose illness start in adulthood, there is a chronic course.
Sleep hygiene:
This can help in reducing the number of sleep terrors.
Establish a bed time routine. For toddlers, put them to bed at the same time every night. It is important to dim the lights and read a bedtime story to them. Limiting screen time before bed is also very important.
Do stress management:
Exercises during the daytime is good. Close to bedtime, you can do deep breathing and muscle relaxation exercises.
For children, reduce the amount of stress you put them through during the day. This includes reducing or stopping child abuse in any form.
Education:
This is very important and it can be a form of reassurance for the family members. You can get a lot of information from the net.
Need for a safe sleeping environment:
Removing all harmful objects in the room can prevent harm to the person and to other family members. Also make sure that the outlet doors and windows are locked or barricaded.
There may be need to pad the furniture in the room, or the floor around the bed. Putting barriers at the stair top and locks on refrigerators are also necessary. It is also extremely important to remove sharp objects from the room and the reach of the person.
Avoid sleep deprivation:
Make sure that you get good night sleep every day. The amount of sleep one need every night is usually age specific for children. But from the adolescent age upwards, it is 7 to 9 hours of sleep.
A child should not be allowed to stay awake late at night. Children, depending on their age, must get the right amount of sleep.
Avoid these substances:
It is important that the affected person avoids these substances. The substances include alcohol, cannabis, cocaine, meth., kola nuts and all stimulant drinks. These stimulant drinks include chocolate drinks, tea, coffee, cola drinks, etc. But if these drinks must be taken, they should be taken before 3pm. And this includes children.
Scheduled waking:
Sleep terrors occur most often early in the night. So you can schedule awakening.
If you know the time your sleep terrors occurs most often, then set an alarm to wake you up. Set the alarm to wake you about 15 minutes to the time it usually occur. You can also get someone to wake you up. Once you are up, you should stay awake for another 10 minutes. This will help prevent a sleep terror.
For children, you can also do this. But allow the child to keep awake for only 5 minutes after the scheduled awakening. It can help prevent a sleep terror.
Treatment:
Once the sleep terror has started, you should not attempt to wake the child or your loved one. Once you attempt to wake up the person, he or she will get more frightened. This may lead to the person attacking you or destroying things in the environment. And in the process, the person may get harmed. It may also lead to prolongation of the attack.
All you need do is to watch the entire process play out. You will only intervene if the person is in any danger. And in such a case, all you will do is to remove all harmful objects in the environment and gently turn the person back to bed.
Medical treatment may be necessary if the episodes of sleep terrors are much, or the person is at danger. Treatment is also necessary if the disorder lasts into adulthood.
The types of treatment done are psychotherapy and medications. In psychotherapy, the clinical psychologists use Cognitive Behavioural Therapy (CBT). For most people with this disorder, especially for children, this might be all that is needed.
But for adults who have the chronic condition or who have developed psychiatric complications, there is need to see psychiatrist. The psychiatrist will use appropriate medications.
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