Agitation and expression of fear are characteristic signs of Night Terror in children.

Night terrors are a sleep disorder and last for a few minutes. It can often be accompanied by sleepwalking. Although the prevalence is much higher in children up to 5 years old, it can occur in other age groups.

Mario Louzã, psychiatrist, doctor in Medicine at the University of Würzburg, and Affiliated Member of the Institute of Psychoanalysis of the Brazilian Society of Psychoanalysis of São Paulo, explains that night terrors (NT) is a sleep disorder that is included in the group of parasomnias. . “It is characterized by an abrupt behavior of motor agitation and fear or manifestation of terror, with brief duration, during sleep. Physical manifestations of terror/fear, such as tachycardia and sweating, occur. The person in general does not respond to stimuli from the environment,” he says.

“Typically, the child in the middle of the night screams, stirs in bed, has an expression of fear or terror; this lasts for a few minutes and she goes back to sleep as if nothing had happened. Due to the agitation, eventually the child can be injured, and there is often a need to contain him/her to avoid injuries. Usually the person doesn’t remember the day after the TN episode”, highlights Louzã.

The doctor points out that NT is typical of children, usually between 3 and 8 years of age (up to 6% prevalence), being rarer in adults (2% prevalence).

Night Terror X Nightmare

Louzã highlights that sleep is divided into REM (Rapid Eye Movements) and non-REM phases. NT occurs in the non-REM phase; nightmares, during the REM phase (the period of sleep in which dreams occur).

Psychologist Thais Khoury, an expert at Personare, explains that nightmares, in general, despite their impact, occur during deeper REM sleep, and in general they can be remembered without much confusion. “Many times the person does not even wake up or wakes up quickly, then goes back to sleep. Night terror, on the other hand, is accompanied by typical symptoms, and occurs in less deep sleep stages, causing disorientation and a feeling of dread. In general, the contents cannot be recalled,” she says.

Causes of Night Terror

It is not known exactly what the causes of NT are. “Genetic and neurodevelopmental factors may be involved. Apparently these lead to an instability of the slow waves of sleep. Some factors seem to increase the chance of NT: sleep deprivation, obstructive apnea (impaired breathing during sleep, with respiratory arrest due to airway obstruction)”, says Louzã.

Thais points out that the causes of night terrors may be linked to an immaturity of the Nervous System, which would make it possible to understand the prevalence in young children. “It is not uncommon for it to run in families, although there is no evidence that it is genetic. External factors such as sudden change of routine and stress can favor the appearance of crises. Sleep deprivation can be a contributing factor, as can medication use or withdrawal,” she points out.

Symptoms of Night Terror

Thais highlights the main signs of TN:

• Agitation;
• groans;
• Expressions of terror;
• Screams;
• Mental confusion that persists when waking up, may not recognize the people around and also present an aggressive behavior with themselves and with others.

It is worth remembering that, due to agitation, eventually the child/person may be injured during the night terror episode.

What to do during an episode of TN?

Thais emphasizes that one should avoid waking the child or adult. “The most direct measures involve observing so that they do not fall or get hurt, break objects or leave the room… Calm the child, if he wakes up, in a loving and understanding way. And, in cases where the recurrence is very frequent or intense with the possibility of self-harm, professional follow-up should be sought,” she says.

Louzã emphasizes that what parents should do is, basically, contain the child to avoid getting hurt. “They should still remain calm, try to talk to the child (although almost always the child does not interact in the conversation). And it is important to take the child for evaluation with the psychiatrist or neuropediatrician,” she says.

Treatment for Night Terror

According to Thais, the treatments revolve around psychotherapy, family monitoring and preventive measures, and eventually the prescription of medication. “With time and maturity, the symptoms tend to disappear. But in adults with recurrent episodes, treatment can be more difficult. Each case must be particularly evaluated for a better referral”, says the psychologist.

Louzã points out that in cases where the agitation is more severe, antidepressant drugs can be prescribed.

Ways to prevent Night Terror

To avoid NT, the guidelines of psychologist Thais are:

• Avoid stress factors that can increase the level of anxiety;
• Look for consistency in sleep schedule;
• Avoid foods that are difficult to digest, fatty and stimulants;
• Pay attention to medications in use that may trigger the episodes;
• Take care of the affective quality of relationships consistently.

“These are measures that can help to minimize the possibilities of the crisis occurring, although there are no guarantees. In some cases, it is important not to leave dangerous objects within reach or open doors that allow the exit to the street, in order to prevent risk situations for the person. Offering comfort at the moment when the person wakes up can also be of great value to calm and allow him to reestablish himself”, concludes the psychologist.

Although it doesn’t usually cause serious problems, it’s valid to have good habits in order to avoid night terror episodes. In the case of children, in particular – who represent the majority of patients with this disorder – parents must be vigilant to prevent them from getting hurt. They must also show all love and understanding in the way of dealing with them, in addition to not hesitate to seek professional help.

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.