What Sleep Experts Say About Night Terrors (and Why We Have Them)

When I was young, I slept at a friend's house expecting a fun, giggly night full of movies, snacks and preteen-girl gossip. And that's what I got, until shortly after we went to bed, when my brain and body were lurched from sleep by the sound of my friend's guttural screams. 

Petrified, I sank into my sleeping bag, smushing my body down as far as I could and covering my head. My friend left the bedroom and started down the hall. I thought of waking her parents as she banged her fists on the wall, but I was too scared to move. After about 10 minutes, the yelling abruptly stopped and my friend made her way back to the empty sleeping bag mere inches from mine. She settled back into a slumber without a peep. 

The most bizarre part was she remembered nothing the next morning -- she thought I must have dreamt the whole event. I later learned from my mom, who's a nurse, that my friend had probably experienced a night terror. 

I've been intrigued by the concept of night terrors since then. Why do we have them? How can we get rid of them? Why can't we remember them the next morning? I talked to several sleep specialists to learn more about this scary form of nocturnal wandering. (For more about what goes on in your brain while you sleep, read about what your dreams mean and the reason we experience terrifying dreams). 

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What are night terrors? 

The term "night terrors" covers any episode in which a sleeping person experiences or emotes various forms of fear, such as screaming, flailing or thrashing around, says Wayne Leslie Ross, senior sleep researcher at InsideBedroom. 

Such episodes are often paired with sleepwalking, he says, but always "involve vocal and physical behaviors associated with intense fear." The person may have a rapid heart rate, heavy breathing and tense muscles. They may also sweat profusely.

Can adults have night terrors?

Some adults experience night terrors, but night terrors are more common in children. Experts estimate a mere 2% of adults experience night terrors, whereas in children, the number is 3% to 6% -- still relatively rare. 

In reality, these numbers could be higher, Ross says, because people don't often remember night terrors. If you live alone, for example, no one would be there to observe your night terrors and you may never become aware you have them. 

What causes night terrors?

Scientists and doctors don't fully understand night terrors and what causes them, especially in adults. However, experts do know that night terrors typically occur when a person partially wakes up from deep, non-REM sleep due to overarousal of the central nervous system. 

In children, this may happen because the central nervous system isn't fully developed and is prone to short-circuiting, in a sense. This is similar to what happens to sleepwalkers. 

"Sleepwalking and sleep terrors are a similar disorder and it is not uncommon for a patient to have both," says Dr. Dawn Dore-Stites, sleep disorders specialist at Michigan Medicine Pediatric Sleep Medicine Clinic and advisor to Reverie. "There is also a genetic component, so if parents had sleepwalking or sleep terrors, there is a higher chance their children will as well." 

In adults, the following factors may contribute to night terrors:

• Medical conditions that cause you to wake up briefly at night, such as sleep apnea 
• Psychological complications, such as post-traumatic stress disorder, depression, anxiety and bipolar disorder
• Excessive fatigue, which may lead to more time spent in deep sleep, which means there's more time for a night terror to occur
• Being thrown off schedule or sleeping in an unfamiliar environment
• Use of alcohol and recreational drugs

Night terrors vs. nightmares

Night terrors and nightmares both involve sleep and fear, but they differ in a couple of ways. One key difference is the time at which they happen, says Dr. Alex Dimitriu, psychiatrist and sleep physician at Menlo Park Psychiatry and Sleep Medicine. 

Nightmares are scary dreams that usually occur during REM sleep, which is when dreams occur, Dimitriu says. This means nightmares commonly occur in the second half of the night, or early morning. 

Night terrors, on the other hand, more often occur during deep sleep, which is more clustered in the first half of the night, he says. People generally wake up with night terrors around 90 minutes after falling asleep.

Additionally, during nightmares, people usually wake up and remember the dream, Dimitriu says. But with night terrors, "People wake up startled, scared and confused, with no recall of what they were dreaming," he explains. 

Similarly, "Sleep terrors are scary to the observer, but the person experiencing it will have no recognition of what they are doing either in the moment or the next morning," Dore-Stites explains.

"For nightmares, the person will generally wake up and seek reassurance," she says. "They will also likely recall the event the next morning and even describe fears of going to sleep the next night."

Should you wake someone who is having night terrors? 

Just like sleepwalkers, people experiencing night terrors would likely experience shock and confusion if roused during an episode, says Dr. Abhinav Singh, sleep physician, facility director of the Indiana Sleep Center and medical review expert for SleepFoundation.org. 

The main concern is that waking someone up during a night terror could prolong the episode, because the person may believe in their half-asleep state that people or things in the room are dangerous, Singh says. It's also possible that someone experiencing night terrors will harm you out of fear. Children are often inconsolable and try to fight or escape.  

To ensure everyone's safety, gently guide the person back to bed without shouting or using too much physical contact, Singh says. Avoid stairwells, sharp objects, open windows or other dangerous areas and objects. 

When to seek help for night terrors 

If you're experiencing recurrent night terrors (whether you remember them yourself or someone else tells you about them), consider talking to a sleep physician or psychiatrist. Recurrent night terrors may indicate an underlying medical or psychological disorder, especially in adults. 

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