Night terror

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Night terror
ICD-10 F51.4
ICD-9 307.46

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

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 slow-wave 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 rarely be recalled by the subject. They typically occur during non-rapid eye movement sleep.

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, which occur during REM sleep, night terrors occur during slow-wave sleep, the deepest level of NREM sleep. Even if awakened, the subject often cannot remember the episode except for a sense of panic, while nightmares usually can be easily recalled.

Unlike nightmares, which are frequently dreams of a frightening nature, 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 subjects may be unable to recall their names, locations, ages, or any other identifying features of themselves.

In children

Children from age two to six are most prone to night terrors, and they affect about fifteen percent of all children,[1] (although people of any age may experience them). Episodes may reoccur for a couple of weeks then suddenly disappear. The symptoms also tend to be different, like the child being able to recall the experience, and while nearly arisen, hallucinate. 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. Also, Nyquil and Dayquil may increase risk of night terrors. Ensuring that the right amount of sleep is gained is an important factor. Special consideration must be used when the subject suffers from narcolepsy. They may be linked.

In adults

Though the symptoms of night terrors in adolescents and adults are similar, the etiology, prognosis and treatment are qualitatively different. Adult night terrors are much less common, occasionally trauma-based rather than genetic, chronic, and often respond to treatment in the form of psychotherapy and antidepressant medication. There is some evidence of a link between adult night terrors and hypoglycemia.

In addition to night terrors, some adult night terror sufferers have many of the characteristics of abused and depressed individuals including inhibition of aggression,[2] self-directed anger,[2] passivity,[3] anxiety, impaired memory,[4], and the ability to ignore pain.[5].

See also

References

  • Carranza, Christopher. Banishing Night Terrors and Nightmares Kensington Books, 2004.

Notes

  1. Iannelli, Vincent (March 23rd, 2003). "Night Terrors". Retrieved 2007-06-04. Check date values in: |date= (help) From about.com
  2. 2.0 2.1 Kales, J (1980). "Night terrors. Clinical characteristics and personality patterns". Archives of General Psychiatry. 37 (12): 1413–17. PMID 7447622. Retrieved 2007-05-31. Unknown parameter |coauthors= ignored (help)
  3. Kales, JC (1982). "Psychotherapy with night terror patients". American Journal of Psychotherapy. 36 (3): 399–407. PMID 7149087. Retrieved 2007-05-31. Unknown parameter |coauthors= ignored (help)
  4. Horowitz, MJ (1999). Essential papers on posttraumatic stress disorder. New York University Press. ISBN 0-8147-3559-2.
  5. Chu, J (2001). Rebuilding Shattered Lives: The Responsible Treatment of Complex Post-Traumatic and Dissociative Disorders. John Wiley & Sons. ISBN 0471247324.

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