Night Terrors in Adults

Kirsten Schuder
Reviewed by Terri Forehand RN
Night Terror

Night terrors in children are often considered to be due to their developing imaginations and minds, with genetic factors playing a role, and they tend to outgrow them by adolescence. While less common in adults, sleep terrors can be indicative of more serious, underlying emotional, mental, or physical issues and are usually of a persistent nature. Night terrors and their causes can be difficult to diagnose.

What Are Night Terrors?

Night terrors, or what clinicians refer to as sleep terror disorder, is one of the parasomnias, which include nightmare disorder, night terror disorder, and sleepwalking disorder. These disorders are distinguished from each other in terms of the amount of physical arousal and level of awareness during the episodes.

  • Nightmare disorder has the least amount of physical symptoms. People having nightmares, whether frequently or infrequently, or no matter how frightening, are able to be awakened, and remember a good portion of the dream or the dream in its entirety.
  • Sleepwalking is on the other end of this continuum, where people have complete amnesia of the episode and also experience the most physical symptoms during sleep, sometimes wandering great distances in their nightclothes.
  • Night terrors are in the middle of this continuum. During night terror episodes, people can be quite physically active as they experience the night terror. Common observations are screaming out or flailing about in bed.

Unlike nightmares, where people are able to be awakened and comforted, people experiencing night terrors will be nonresponsive to words of comfort and cannot be shaken awake out of the dream. They often awaken, confused, either with no memory of the incident, or might only have a general recollection of what the dream was about or remember being terrified, but not remember their screaming or the details of the dream. In addition to particular behaviors, there are other behavioral and physical symptoms that are part of the disorder and are thought to occur because of the body's physical response to fear.

Less than one percent of adults are thought to have night terrors, which occur during stages three and four of sleep (referred to as slow wave sleep) as well as during non-rapid eye movement (NREM) sleep.

Causes

The causes of night terrors are not known with specificity. Rather, myriad physical, emotional, and mental factors have been found to contribute to increased incidences of night terrors in adults.

Some of the factors associated with higher rates of night terrors are:

  • Past emotional trauma
  • Alcohol consumption
  • Dysfunction due to mental disorders such as depression, anxiety disorders, phobias, and obsessive/compulsive disorder
  • Brain dysfunction due to brain tumors
  • Breathing disorders, such as sleep apnea
  • Drugs, including prescription medications "such as antihistamines, decongestants, levodopa, reserpine, beta blockers, and antidepressants" and withdrawal from illicit drugs.

It has been observed that night terrors run in families. However, the nature of why this occurs is unclear and has not been determined in research.

Diagnosis

It is very important to seek help from a qualified professional. Medical professionals are able to address the physiological conditions that are thought to contribute to night terrors or rule out other physical conditions often mistaken for night terrors. For instance, epilepsy is known to be confused with night terrors because people having seizures will show confusion during and after the episode and have a high degree of motor activity as people with night terrors do. Mental health professionals are able to address the behavioral, emotional, and mental causative factors of night terrors.

To diagnose sleep terror disorder, clinicians look at the many factors that are thought to contribute to the disorder, as well as differentiate it from other parasomnias. At times, diagnosis can be complicated, as it is common for people to experience more than one sleep disorder at a time.

  • Clinicians commonly take a complete medical history as well as ask direct questions about stress levels, depressive symptoms, illicit drug use, bedtime routines, major life changes, and other questions that cover the broad range of possible causes of night terrors.
  • Clinicians also might also check for sleep disordered breathing, use tests like a polysomnography sleep study or use an electroencephalograph (EEG) to measure brain patterns to test for epileptic seizures to see if these can either be ruled out or if they contribute to the night terrors.

Common Treatments

Night terrors and other sleep disorders are taken seriously. Sleep deprivation can contribute to mental and physical illness and be extremely disruptive. Moreover, sleep disorders can be indicative of a major medical or mental disorder, especially if the night terrors are of a more chronic nature. There are numerous treatment options for adults experiencing night terrors.

  • Upon identification of possible physiological reasons for the night terrors, clinicians typically treat any physical condition that is thought to contribute to the night terrors.
  • Medical doctors might refer a patient for psychotherapy.
  • Psychotherapists, clinical psychologists, and mental health counselors are qualified to help patients establish a lifestyle that will minimize the occurrences of sleep terrors. Psychotherapy helps patients support changes in lifestyle that will support good health, such as changes in bedtime routine, sleeping arrangement, and healthy eating are just some of the ways one can make changes to improve the occurrences of night terrors.
  • For extreme cases, benzodiazepines might be prescribed to address night terrors for adults. These medications are often used as a last resort.

Seek Professional Care

If you suspect that you or a loved one is experiencing night terrors, it is important to visit a licensed medical or psychological professional right away, as they are qualified to diagnose and treat adult night terrors. This article is for informational purposes only and should not be used to self-diagnose or treat night terrors or any other disorder or illness.

Night Terrors in Adults