Night Terrors Resource Guide

Night terrors are a sleep disorder most common in young children in which they suddenly appear to wake up terrified, often thrashing and yelling. While the name and symptoms can be startling, most times children have no memory of the event, which can last up to 90 minutes. (1)

Experts say about 30 percent of children experience night terrors, which are most common between the ages of three and seven. (1) Night terrors can occur in adults, too, but are much more rare in this group. (1)

After waking with night terrors or watching your child go through episodes, you may want to know how to stop them. (And quick!) Below, we’ll detail what causes night terrors and how you can better your chances of getting through the night with no such excitement.

Note: The content on Sleepopolis is meant to be informative in nature, but it shouldn’t be taken as medical advice, and it shouldn’t take the place of medical advice and supervision from a trained professional. If you feel you may be suffering from any sleep disorder or medical condition, please see your healthcare provider immediately. 

Long Story Short

• Night terrors are a sleep disorder most common in young children in which they suddenly appear to wake up terrified, often thrashing and yelling. (1)
• Most times, children have no memory of the event, which can last up to 90 minutes. (1)
• Experts estimate 30 percent of children experience night terrors, which are most common between ages three and seven. (1)
• Night terrors in adults happen now and then, but are much more rare. (1)
• Night terrors don’t have an official cause, but risk factors include sleep deprivation, a young age, medication conditions, sleep disorders, and genetic factors. (2)
• You can lower your risk for night terrors with good sleep hygiene, adequate sleep, and effective stress-squashing techniques. (2)

What Are Night Terrors?

Night terrors are considered a parasomnia — a type of sleep disorder that causes verbal and physical activity or outbursts. (1) (3) “Night terrors, sometimes called sleep terrors, occur during non-REM sleep and typically manifest with outward signs of intense fear, such as screaming and physical agitation followed by a return to sleep as if nothing had happened,” says Dr. Andrew Spector, sleep medicine physician and spokesperson for the American Academy of Sleep Medicine. (1) (4)

Most common in young children, night terrors cause the person experiencing them to appear extremely agitated during sleep. These episodes can last anywhere from 10 to 90 minutes, and are typically forgotten by the time the child wakes up. (1) (4) Some adults, though, do remember the experience, which can cause distress, says Spector. (5)

The Difference Between Night Terrors and Nightmares

Although they are both parasomnias, night terrors and nightmares can look pretty different to the person experiencing or observing them. (6) (7) Where nightmares typically happen in REM sleep, night terrors more often occur during non-REM sleep stages, says Spector. You’re also much more likely to remember a nasty nightmare than a night terror episode. (4) (6)

“People with nightmares can be comforted but might struggle to return to sleep due to the distressing images they can usually remember well, at least initially,” says Spector. On the flip side, most people don’t remember their night terrors or even wake up afterward. (6)

Sleep Stages

Your nightly sleep can be broken down into a few different stages: (3)

Non-REM Sleep:

• Stage 1 (N1): Light sleep
• Stage 2 (N2): Deeper sleep
• Stage 3 (N3): Deepest non-REM sleep (also known as slow-wave sleep, or SWS)

REM (Rapid-Eye Movement) Sleep: Stage of sleep in which your brain is most active and dreams occur.

What Causes Night Terrors?

The causes of night terrors are not fully known for any age group; however, research tells us some actions or situations can increase your risk, like illness or stress. (1) You may also be more prone to night terrors if you are sleep deprived and your sleep is disrupted, says Spector, which leaves you in a between-sleep state — the perfect setting for night terrors. (1)

Possible causes and risk factors of night terrors: (1) (6)

• Sleep deprivation: Chronic insufficient sleep
• Age: Most common between ages five and seven
• Medical conditions: Nocturnal asthma, GERD, fever, and illness
• Sleep disorders: Sleep disordered breathing (like sleep apnea) and restless leg syndrome 
• Mental health issues: Emotional distress, high stress levels, anxiety, and depression
• Lifestyle habits: Too much physical activity, caffeine, and alcohol 
• Genetic factors: Higher risk if other family members have night terrors 

Everyone reacts to these risk factors differently, and they may not all describe you. Let’s look at the signs and symptoms of night terrors in adults and children, and then we’ll give you some tips on how to handle them.

Signs of Night Terrors

Signs of night terrors can look intense, as the person experiencing them may scream and thrash around without knowing what they’re doing. (1) 

You may notice night terrors occurring over months or years — it can vary for everyone. The person experiencing one often moves suddenly, but don’t respond to a caregiver or partner during episodes, and rarely remembers it happening. (1)

Someone going through a night terror may speak or yell, but it usually doesn’t sound like anything understandable. Typically, as the episode (and heart rate) winds down, they fall back into a deep sleep. 

Signs of night terrors include: (1) 

• Terrified expression
• Screaming
• Thrashing in bed
• Abrupt awakening
• Fast heartbeat and breathing
• Sweating
• Confusion
• Agitation
• No memory of the episode in the morning

Even though any of these symptoms can happen during night terrors, Spector tells us some are more common than others. “The most common symptoms of night terrors are sitting up in bed, screaming or shouting, being difficult to awaken, being confused when awoken, and not remembering what took place,” says Spector, who adds some children with sleep terrors will also sleepwalk. (6)

Night Terrors in Children

Night terrors are the most common in children and often fade by the age of ten. Research shows that girls and boys experience night terrors equally, and about one in three kids have them. (1)

Though it can be distressing to see your child as they experience a night terror, Spector tells Sleepopolis that “night terrors in children are relatively common and typically cause more distress to the parents than the children who have no memory of their episodes.”

The causes of night terrors in children look much the same as they do in adults: fever, missing sleep, and emotional stress. The most common time for episodes in children is from midnight to 2 a.m. (4)

Children may seem frightened or confused during night terrors and don’t often respond to a parent’s comfort. (8) Typically, episodes last 10 to 20 minutes, after which the child may fall back into a more restful sleep state. (4)

Should You Wake Your Child During a Night Terrors? 

Waking a child during a night terror has no point or benefit, says Spector. “Waking them can cause confusion, disorientation, and agitation, making it harder for them to fall back asleep. If left undisturbed, children will usually return to peaceful sleep on their own.” (1)

Instead, you can stay close by and keep their environment calm and quiet. Once the episode ends, you can offer reassurance and soothing if they wake. If your child sleepwalks, be sure to remove any hazards in their path and gently guide them back to bed, says Spector. (1)

Night Terrors in Adults

Night terrors in adults are rare: only two percent of adults experience these episodes, and this number shrinks even further after the age of 65. (9) Often, night terrors in adults point to a mental health diagnosis like bipolar disorder or anxiety, says Spector. (1) (9)

Adults are more likely to get out of bed, Spector says. He adds that adults may also have more memories of the event after waking. (10) If you experience new night terrors as an adult, consider reaching out to your healthcare provider for help getting to the bottom of it.

How to Stop Night Terrors

You can try to stop night terror episodes through a mixture of good sleep hygiene, addressing life stressors, and treating any related disorders. (1) While no treatment exists for night terrors, you can avoid the risk factors. (1)

How to stop night terrors:

• Lower stress: One way to stop night terrors is to lower excessive stress. Even though you can’t banish stress by simply deciding to, you can participate in therapy and use relaxation techniques to cope with it. (1) 
• Schedule wake-up times: Some research shows people can also head off night terrors by scheduling wake-up alarms at strategic times through the night. (11)
• Get enough sleep: “You can also protect against night terrors by getting enough sleep. Because sleep deprivation can trigger night terrors, it’s also important to ensure you or your child gets enough restful sleep each night,” says Spector. (1)
• Use excellent sleep hygiene: Make your sleep space cool, dark, and comfortable, limiting caffeine and alcohol before bed, going to bed and waking up at the same time each day, and having a calming, consistent bedtime routine. (12) Also try and avoid heavy meals before bed—small snacks only! 
• Treat other sleep disorders: When you get your sleep apnea or restless leg syndrome under control, your sleep will be less disrupted, leaving fewer opportunities for night terrors. (6)

How Much Sleep Is Enough?

According to the American Academy of Sleep Medicine, you should get these amounts of these depending on your age (13):

• 1 to 2 years old: 11 to 14 hours per 24 hours
• 3 to 5 years old: 10 to 13 hours per 24 hours
• 6 to 12 years old: 9 to 12 hours a night
• 13 to 18 years old: 8 to 10 hours a night
• Over 18 years old: 7 or more hours a night

While you may be tempted to ask for medication to get you through your night terrors, this treatment is typically discouraged. (1) (14) Occasionally providers may prescribe short-term treatments with medications like clonazepam (Xanax), but this is rare. (11) If you think you may need further treatment, your provider can help you make a plan. 

When to See a Doctor 

Night terrors are considered normal in children, but they can be hard to distinguish from other sleep disorders, says Spector. “If you or your child experiences frequent night terrors that disrupt sleep, talk to your healthcare provider.”

When to see a doctor for night terrors: (4) (6)

• Episodes are severe and frequent.
• You notice daytime fatigue and sleepiness.
• They cause excessive distress.
• Episodes disrupt your sleep regularly.
• You experience injury during a night terror.

Your provider can help you decipher your symptoms and create a plan to lessen your night terror episodes.

FAQs

The Last Word From Sleepopolis 

Night terrors can feel intense whether you experience them or you watch a loved one go through them. Keep in mind, night terrors typically resolve on their own after 10 to 20 minutes, at which point you or your child may fall back asleep or accept comfort from a parent or sleep partner. Remember to adopt good sleep hygiene, get enough sleep, and search out effective stress-squashing techniques to put you at your lowest risk for night terror episodes.

Sources

1. Van Horn NL, Street M. Night Terrors. In: StatPearls. StatPearls Publishing; 2023. Accessed September 15, 2023. http://www.ncbi.nlm.nih.gov/books/NBK493222/
2. Gigliotti F, Esposito D, Basile C, Cesario S, Bruni O. Sleep terrors—A parental nightmare. Pediatric Pulmonology. 2022;57(8):1869-1878. doi:10.1002/ppul.25304
3. Futenma K, Inoue Y, Saso A, Takaesu Y, Yamashiro Y, Matsuura M. Three cases of parasomnias similar to sleep terrors occurring during sleep-wake transitions from REM sleep. Journal of Clinical Sleep Medicine. 18(2):669-675. doi:10.5664/jcsm.9666
4. Night terrors in children: MedlinePlus Medical Encyclopedia. Accessed August 13, 2024. https://medlineplus.gov/ency/article/000809.htm
5. Full article: Mental Activity During Episodes of Sleepwalking, Night Terrors or Confusional Arousals: Differences Between Children and Adults. Accessed August 22, 2024. https://www.tandfonline.com/doi/full/10.2147/NSS.S309868
6. Sleep terrors (night terrors) – Symptoms and causes – Mayo Clinic. Accessed August 13, 2024. https://www.mayoclinic.org/diseases-conditions/sleep-terrors/symptoms-causes/syc-20353524
7. Lagani  ère C, Gaudreau H, Pokhvisneva I, et al. Sleep terrors in early childhood and associated emotional–behavioral problems. Journal of Clinical Sleep Medicine. 18(9):2253-2260. doi:10.5664/jcsm.10080
8. Leung AKC, Leung AAM, Wong AHC, Hon KL. Sleep Terrors: An Updated Review. Curr Pediatr Rev. 2020;16(3):176-182. doi:10.2174/1573396315666191014152136
9. Sleep Terrors – Sleep Education by American Academy of Sleep Medicine. Accessed August 13, 2024. https://sleepeducation.org/sleep-disorders/sleep-terrors/
10. Night Terrors: What They Are, Causes, Symptoms & Treatment. Accessed August 13, 2024. https://my.clevelandclinic.org/health/diseases/night-terrors
11. Sleep terrors (night terrors) – Diagnosis and treatment – Mayo Clinic. Accessed August 20, 2024. https://www.mayoclinic.org/diseases-conditions/sleep-terrors/diagnosis-treatment/drc-20353529
12. Baranwal N, Yu PK, Siegel NS. Sleep physiology, pathophysiology, and sleep hygiene. Progress in Cardiovascular Diseases. 2023;77:59-69. doi:10.1016/j.pcad.2023.02.005
13. Sleep FAQs – Sleep Education by the AASM. Accessed May 8, 2024. https://sleepeducation.org/sleep-faqs/
14. Limbekar N, Pham J, Budhiraja R, et al. NREM Parasomnias: Retrospective Analysis of Treatment Approaches and Comorbidities. Clocks & Sleep. 2022;4(3):374-380. doi:10.3390/clockssleep4030031

Spector, Andrew, MD. Personal Interview. August 1, 2024.