Night terror
From Wikipedia, the free encyclopedia
| ICD-10 | F51.4 |
|---|---|
| ICD-9 | 307.46 |
A night terror, also known as pavor nocturnus, is a parasomnia sleep disorder characterized by extreme terror and a temporary inability to regain full consciousness. The subject wakes abruptly from the fourth stage of sleep, with waking usually accompanied by gasping, moaning, or screaming. It is often impossible to fully awaken the person, and after the episode the subject normally settles back to sleep without waking. A night terror can occasionally be recalled by the subject. They typically occur during non-REM sleep.
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[edit] Night terrors versus nightmares
Night terrors are distinct from nightmares in several key ways. First, the subject is not fully awake when roused, and even when efforts are made to awaken the sleeper, he/she may continue to experience the night terror for ten to twenty minutes. Unlike nightmares, night terrors occur during the deepest levels of non-REM sleep. Even if awakened, the subject often cannot remember the episode except for a sense of panic, while nightmares usually can be easily recalled. After the night terror is complete, it can often result in a seizure, which is commonly a tonic-clonic type (although the subject may not be epileptic). The subject often has no recall of the dream, nor the fit.
Unlike nightmares, which are frequently a scary event dream (e.g. a monster under the bed, falling to one's death, etc.), night terrors are not dreams. Usually there is no situation or event (scary or otherwise) that is dreamt, but rather the emotion of fear itself is felt. Often, this is coupled with tension and apprehension without any distinct sounds or visual imagery, although sometimes a vague object of fear is identified by the sufferer. These emotions, generally without a focusing event or scenario, increase emotions in a cumulative effect. The lack of a dream itself leaves those awakened from a night terror in a state of disorientation much more severe than that caused by a normal nightmare. This can include a short period of amnesia during which the subject may be unable to recall his name, location, age, or any other identifying features of himself. This state generally passes after only one or two minutes.
While each night terror is usually different, all episodes of the same person will generally have similar traits. One of the most common qualities of night terrors is a strong sense of danger. For these people there is always a being, tangible or otherwise, who wishes to hurt the sleeping person, or the sleeping person's loved ones. Many sufferers of night terrors are reluctant to speak of them because of their violent and often disturbing nature.
[edit] In children
Children from age two to six are most prone to night terrors, and they affect about fifteen percent of all youngsters,[1] (although people of any age may experience them). Episodes may re-occur for a couple of weeks then suddenly disappear. Strong evidence has shown that a predisposition to night terrors and other parasomniac disorders can be passed genetically. Though there are a multitude of triggers, emotional stress during the previous day and a high fever are thought to precipitate most episodes. Ensuring that the right amount of sleep is gained is an important factor. Special consideration must be used when the subject suffers from narcolepsy. Quite often the dream is manifest with a temporary paralysis with vivid recall of events leading up to, as well as the climax of the night terror. Finally, do not attempt to waken a subject during the dream, but, talk to them in a warm and comforting tone, as this can be very supportive to the person who is helplessly in the throes of a bad session.
[edit] Treating night terror episodes
The consensus for treating night terror episodes is three-pronged: gentleness, disposal of anything nearby that might hurt the subject, and avoiding loud voices or movements that might frighten the subject further. It is also critical to remember that the person experiencing the terror is unaware that they are experiencing one. As a result, they may become even more agitated if told that "it was just a dream," as they are quite convinced that the experience is real. The quickest remedy is simply to calm the person by telling the person that you are there for them or simply say, "I'm here". Telling the victim "It's OK" or "nothing's there" may agitate the sleeper further because feelings they are feeling are very real to them and obviously not "OK". However, simply knowing the person's source of "calm" helps immensely. If he/she has a favorite companion dog or cat, telling them that the cat or dog is warm in bed, safe and asleep, and that they need to sleep as well could also be a good trigger. Calm the person and convince them to "go back to sleep"
In some cases, they may be calmed by the mere presence of a familiar person. Night terrors are transitory, so medical help is often unnecessary, but options may range from treatment of sleep apnea to prescription of benzodiazepines and psychotherapy.
A successfully used method for treating night terrors is to have the sufferer sit down and engage them in something light-hearted and harmless, such as television or easy conversation. This helps to distract the sufferer from their perceived experience, and let them regain normal consciousness. More calming, positive reinforcement can then be administered. Turning on lights and appliances like the TV or radio can also help transition the individual into normalcy, as a lit room with noise is more normal (while awake) than a dark, quiet room.
[edit] Famous people suffering from night terrors
The most famous avowed sufferer of night terrors is probably H. R. Giger, though H. P. Lovecraft is widely believed to have experienced them as well.
