Night terror
[5] The frequency and severity differ among individuals; the interval between episodes can be as long as weeks and as short as minutes or hours.
[8] While nightmares (bad dreams during REM sleep that cause feelings of horror or fear) are relatively common during childhood, night terrors occur less frequently.
[2] Night terrors have been known since ancient times, although it was impossible to differentiate them from nightmares until rapid eye movement was studied.
[10] During night terror bouts, sufferers are usually described as "bolting upright" with their eyes wide open and a having look of fear on their face.
In some cases, individuals are likely to have even more elaborate motor activity, such as a thrashing of limbs—which may include punching, swinging, or fleeing motions.
[6] Although sufferers may seem awake during a night terror, they will appear confused, inconsolable, and/or unresponsive to attempts to communicate with them and may not recognize others familiar to them.
Most individuals who experience terrors do not remember the incident the next day,[8] although brief dream images or hallucinations may occur and be recalled.
[7] Both children and adults may display behaviour indicative of attempting to escape a terrifying event; some may thrash about or get out of bed and begin walking or running around aimlessly while inconsolable, increasing the risk of accidental injury.
[13] During polysomnography, individuals with night terrors are known to have very high voltages of electroencephalography (EEG) delta activity, an increase in muscle tone, and a doubled or faster heart rate.
Night terrors are also associated with intense autonomic discharge of tachypnea, flushing, diaphoresis, and mydriasis[10]—that is, unconscious or involuntary rapid breathing, reddening of the skin, profuse sweating, and dilation of the pupils.
Abrupt but calmer arousal from non-rapid eye movement sleep, short of a full night terror episode, is also common.
[18] In children younger than three and a half years old, the peak frequency of night terrors is at least one episode per week (up to 3–4 in rare cases).
Pediatric evaluation may be sought to exclude the possibility that seizure disorders or breathing problems cause night terrors.
Adult night terrors are much less common and often respond to treatments to rectify causes of poor quality or quantity of sleep.
[21] A study on night terrors in adults indicated a prevalence of other psychiatric symptoms among most patients, suggesting potential comorbidity.
In some studies, a tenfold increase in the prevalence of night terrors in first-degree biological relatives has been observed—however, the exact link to inheritance is not known.
[10] In addition, some laboratory findings suggest that sleep deprivation and having a fever can increase the likelihood of a night terror episode occurring.
[26] Other contributing factors include nocturnal asthma, gastroesophageal reflux, central nervous system medications,[10] and a constricted nasal passage.
[10][28] Though the symptoms of night terrors in adolescents and adults are similar, their causes, prognoses, and treatments are qualitatively different.
Adults who have experienced sexual abuse are more likely to receive a diagnosis of sleep disorders, including night terrors.
[29] Overall, though, adult night terrors are much less common and often respond best to treatments that rectify causes of poor quality or quantity of sleep.
[36] Widening the nasal airway by surgical removal of the adenoid was previously considered and demonstrated to be effective;[27] nowadays, however, invasive treatments are generally avoided.
