Night terrors – illustration of a person in a fetal position in bed as red skeletal arms reach towards them
Illustration: @Alinanajlis
Health

Why We Have Night Terrors

We spoke to an expert who says night terrors and nighttime panic attacks are on the rise.
June 7, 2021, 8:15am

This article originally appeared on VICE en Español.

If you’ve ever witnessed a child, partner or housemate suddenly awake from sleep, screaming, pallid and looking like they’ve seen a particularly awful demon, you might have just watched someone emerge from a night terror

As the name suggests, night terrors are extremely scary. According to the NHS, they are most common in children between the ages of three and eight, but they can also occur in adults. Over the course of the pandemic, neurologists have observed an increase in cases of sleep disturbances like insomnia and night terrors, both in people who have had COVID-19 and in the general population. 

Dr Mirta Averbuch is head of the Sleep Medicine Unit of the Neuroscience Institute at the Favaloro Foundation University Hospital in Buenos Aires. She explained what happens in our minds during night terrors, and why you might have been experiencing them again recently, even if you thought you’d left them behind.

VICE: What are night terrors?
Mirta Averbuch:
There is a group of sleep disorders called parasomnia, which includes night terrors, sleepwalking and wetting the bed, among others. They all occur in a stage of deep sleep that typically spans the first three hours after dozing off.

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What would be the difference between a night terror and a nightmare?
We normally dream three or four times a night. Nightmares happen during REM sleep [Rapid Eye Movement, a phase when your eyes move despite being closed]. They are catastrophic dreams intimately linked to people’s memories. Generally, when someone wakes up after a nightmare, they consciously remember what they dreamt about, while after night terrors they don’t remember anything. Even if the person is shouting, with their eyes open and sitting up in bed, they are deeply asleep. It might seem very distressing, but the next day they won’t remember it.

What is the best thing to do if you witness someone experiencing a night terror?
If you see it happening in a child, the best thing you can do is stay by their side and try to calm them down, but you shouldn’t wake them up because it can provoke a violent reaction. Instead, hug them and massage their back. The incident won’t last long, only a few seconds. It also helps to turn on a light, so that if they wake up they can see with clarity, helping them avoid a state of confusion, and staying calm. Night terrors are not dangerous in and of themselves.

It’s also important to make sure they sleep enough, because these episodes can be caused by a lack of sleep. An adult should get seven to eight hours of sleep each night.

Why does it affect children more than adults?
All types of parasomnia are like that. Sleepwalking, night terrors – they all affect children more because their brains are still developing. There are also hereditary factors – it’s more common for children to experience night terrors or sleepwalking in families where the parents have experienced the same disorders. 

I always ask myself what these children are seeing that we can’t, when their eyes are open wide with that expression of terror. It’s a big question mark that’s still unanswered, and it’s something that needs to be better understood.

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There are some factors that can trigger these sorts of disorders – stress, lack of sleep or a fever. But what we are seeing today, after a year or so of pandemic and isolation, is that panic attacks may have increased. The panic attack can happen during the day or it can be nocturnal. If it occurs at night, it can be experienced in a way that’s similar to a night terror, but in this case the person wakes up and may have some tachycardia, paleness and shortness of breath.

So there is a big difference between a night terror and a nighttime panic attack?
Yes. Panic attacks wake the person up with a sensation of imminent death. In these cases, when the person wakes up, they recognise what is happening to them, and the best thing they can do is breathe deeply, drink water and try to calm down. We are currently seeing this more often in adults – a rise in nightmares and in panic attacks.

What can you do to minimise these issues?
In the case of night terrors, if we are talking about adults, I advise you to try to get a better quality of sleep. Don’t drink too much alcohol before bed time, don’t eat too much at mealtimes. If you’re having panic attacks, I recommend breathing or relaxation exercises. If they happen very often – as in, three times a week – you should see a specialist before taking any medication, because another problem we are seeing is people increasingly using unprescribed anxiolytics [anti-anxiety drugs].

Is there a chance you could harm someone around you during or after experiencing a night terror?
In general, no. The person having a night terror is asleep – they can’t do anything. Many people experience night terrors in their beds, for only a few seconds, and then go back to sleep. What can sometimes happen is that night terrors go hand in hand with sleepwalking – when a person sits up, opens their eyes, screams and sometimes runs out of the room. 

If you’re experiencing sleepwalking, you can take precautionary measures. You mustn’t sleep in a bunk bed, because you could fall, and you should put away things that could harm you. You should also lock doors and take the key out, don’t leave windows open, and avoid leaving things around that could make you trip or fall. It is also important to stay calm.