“I Wake Up Screaming:” What To Know About Night Terrors

If you have witnessed a loved one suddenly wake up screaming, you know how disorienting and concerning it can be. Likewise, if you have woken up screaming yourself, you may feel at a loss about what to do, and what this means for you.

Usually people who wake up screaming are doing so because they are experiencing a night terror. Night terrors are a kind of sleep disorder that are common in children, but quite rare in adults.

Let’s take a look at what night terrors are, what they look like, what causes them, and what to do if you or a loved one is experiencing them.

What Are Night Terrors?

Night terrors (sometimes referred to as “sleep terrors” or “pavor nocturnus” are a kind of parasomnia, or a sleep disorder. Usually, night terrors occur in non-rapid eye movement (REM) sleep, which is when you are in a state between dreaming and waking.

Night terrors can last from 20 minutes to upwards of 45 to 90 minutes. The disorder is fairly common in children, from preschool age to puberty. However, it’s far less common in adults, with only about 1 to 4% of adults experiencing it.

Night Terrors vs. Nightmares

Some people think of night terrors and nightmares as one in the same thing. But there are several distinct differences between the two:

• People who have nightmares usually remember what happened, whereas people who have night terrors usually have no memory of the incident
• Nightmares involve scary and unsettling dreams, but night terrors don’t happen while dreaming
• Nightmares are usually triggered by an upsetting experience or a scary movie, but the triggers of night terrors are usually harder to trace
  

What Are the Symptoms of Night Terrors?

Night terrors usually happen toward the beginning of the night, between the hours of 12 a.m. and 2 a.m. Symptoms can come on suddenly, and out of the blue.

Common signs include:

• Sudden wake ups that involve yelling and screaming
• The person who is having the night terror may thrash about and exhibit violent movements
• Night terrors cause the heart rate to increase and may involve sweating and hyperventilating
• You may notice that the person who is having the night terror has dilated pupils
• The person having the night terror may have a look of fear or alarm on their face
• Although people who have night terrors don’t usually remember them, they may experience feelings of shame or embarrassment once they find out
• People who experience night terror may also sleepwalk, as sleepwalking is also a common parasomnia
  

What Causes Night Terrors?

There are several different causes of night terrors. Usually night terrors have more than one cause, and it’s not always possible to pinpoint what the cause, or causes, are.

Some possible causes and risk factors for night terrors include:

• Night terrors may be genetic, as they tend to run in families
• Night terrors are more likely during times of illness and when you have a fever
• Night terrors can happen when you are sleep deprived or especially exhausted
• Increased or excessive physical activity can cause night terrors
• Times of emotional conflict and heightened stress may make you vulnerable to night terrors
• Large amounts of caffeine and alcohol consumption can trigger night terrors
• Health issues may increase the risk of night terrors, including head injuries, thyroid issues, and encephalitis (inflammation in the brain)
• Medications that you are taking may increase your risk of having a night terror
• Having another sleep disorder, such as sleep apnea, may make you more likely to experience night terrors

Night Terrors in Children vs. Adults

Night terrors tend to be a childhood occurrence—30% of children will experience a night terror. If your child is experiencing night terrors, you should speak to their pediatrician to rule out anything more serious. But for the most part, night terrors are something that children outgrow on their own, by the time they are 10 years old or so, or when they've moved beyond puberty.

On the other hand, night terrors are quite rare in adults. Sometimes, night terrors in adults suggest a neurological disorder, so it’s important to follow up with your healthcare provider if you experience night terrors. Adults who experience night terrors also may be working through trauma or other emotional upset.

Research has found that night terrors past the childhood years are also associated with sleep disorders, neuroses, and psychiatric disorders. Adults who have night terrors are more likely to live with depression, bipolar disorder, or anxiety.

Treatment for Night Terrors

Waking up screaming from a night terror can be a very distressing experience, whether you are doing it yourself or witnessing a loved one doing it. But help is out there, and there are ways to minimize night terrors.

Most of the time, though, all that’s needed is for you to remain calm while your child has a night terror, and comfort them as needed. Reducing stress and ensuring that your child gets enough sleep can reduce occurrences. Occasionally, therapy for your child and/or medication will be indicated.

Sleep disorders in adults need to be taken seriously, because they are so rare and because they may indicate a more serious medical or mental health condition. If you are experiencing night terrors as an adult, you should make a prompt appointment with a sleep specialist or a psychiatrist.

Treating night terrors in adults involves understanding the root causes, which may mean undergoing a sleep study in a sleep lab or undergoing an evaluation with a psychiatrist.

If a sleep disorder isn’t diagnosed, and psychiatric causes are ruled out, then simple lifestyle changes may help reduce occurrences of night terrors.

These may include:

• Practicing smart sleep hygiene
• Getting enough sleep overall
• Limiting caffeine and alcohol before bed
• Decreasing stress, especially before going to sleep
• Keeping a consistent sleep and waking schedule
  

Keep in Mind

Usually waking up screaming is associated with having a night terror. But if you are waking up screaming for some other reason—or you or a loved one are waking up screaming, but you don’t know why—you should speak to your healthcare provider. Experiencing or witnessing this can be very unsettling, but help is out there, and there are many effective ways to manage these symptoms.