Documenting & Researching Night Terrors

Information

For those of you unfamiliar with Night Terrors, or if you are just learning about them here it all is in a coffin- err I mean nutshell. O.o

A night terror, also known as a sleep terror or pavor nocturnus, is a parasomnia disorder characterized by extreme terror and a temporary inability to regain full consciousness. As many as 6.5 percent of children and 2.2 percent of adults experience night terrors. The subject wakes abruptly from slow-wave sleep, with waking usually accompanied by gasping, moaning, or screaming. It is often impossible to awaken the person fully, 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. The person may thrash around in bed and does not respond to comforting by others. A person’s heart rate can escalate during the terror generating a heart rate of 160 to 170 beats per minute. This is much faster than the normal heart rate that can be attained under most stressful circumstances. Along with this comes sweating and harsh breathing. This panic will often last anywhere from five to twenty minutes.

Most episodes last only a few minutes, but they may last up to 3 hours before the person relaxes and returns to normal sleep. The longer the person is in NREM (the stages before REM) before the night terror strikes, the more petrified they will be when it occurs. In some cases the night terror could be recalled by the person, depending on age and the nature of the episode.

Once the person awakes from the Night Terror, they may be confused and undergo brief, but very vivid and real hallucinations. Common hallucinations include snakes, spiders, shadowy figures, monsters and people. Often when someone appears to be woken from the dream, they are  actually still experiencing it and the effects though their eyes may be open and they may be speaking. It is important to know that if you are sharing a home with someone who has night terrors or if you share a bed, be mindful about waking them. Sometimes attempting to wake someone who has night terrors could bring on massive fear provoking violent outbursts. DO NOT physically restrain the person. If the television, radio or anything that is making loud noises or could be distracting is on, you may want to turn them off.

Things that can bring on terrors and should be avoided:

-working into a state of exhaustion (working out before bed is not for everyone)

-eating a heavy meal

-consuming liquor, high protein foods or foods high in sugar

-stress (learn to shelf your worries, there’s a time and place for everything)

-trauma, including past-or current experiences of abuse, PTSD (post traumatic stress disorder), depression

-anxiety

-fear/phobias (of spiders, outside, small spaces, touching, animals, etc) -I realize this can not be avoided but sometimes knowing can help management or at minimum acceptance and the beginning steps to work on it

I have composed this scale of parasomnia to help measure escalation and predict/track disorders.

1)High Quality Sleep (90% of the time no signs of EHS, ND, NT, RLS, or other parasomnia)

2)Quality Sleep (some of the time with a couple of nightmares of restless nights within a year)

3)Satisfactory Sleep (on average experiencing the “okay” quality of sleep mostly affected by stress, anxiety etc…)

4)Normal levels of discomfort (3-6 nights out of the month are accompanied by kicking in sleep, troubles falling to sleep, restless nights, body temperature changes, nightmares, etc…)

5)Unusual levels of discomfort (7+ nights out of the month with poor quality sleep attributed to “other” causes including “minor” levels of parasomnia)

*6)Parasomnia attributed sleep (30% of time in bed consists of low quality and quantity of sleep due to ND, NT, RLS, EHS, LD, REM, NLC, SB, SC, SW, etc…)

7)Parasomnia Based Sleep (When parasomnia represents the base of your sleepless nights at aprox 50% of the time spent in bed for several months)

8.) Parasomnia Bias (I call this a bias because often at this point your experiences with parasomnia have been so frequent that you can almost predict how the night will go before your head hits the pillow merely because the disorder is shadowing you. So it feels as though your decision of sleep quality has been taken away from you and the decision to sleep in a disorder has been made for you.)

9)Parasomnia Level I (This is the lesser of the two most severe experiences of parasomnia where 80% of your sleep is affected by multiple disorders resulting in fear of sleep, low daytime functioning, anxiety, nervousness, sweating, change in appetite all in daylight hours with direct correlation to the night time experience.)

10) Parasomnia Level II (This being the most severe level of parasomnia incorporating on a scale of 1-10 (1 being the least, 10 being the most) a 10+ for levels of fear, anxiety, physical and emotional pain, discomfort, irritability, cognitive functioning, mental alertness, daytime functioning, nervousness, sweating, change in appetite, and overall biological functioning at 50% or less.)

*Abbreviations (key) for parasomnia references:

NT-Night Terrors

Also known as sleep terrors, this occurs when a person is suddenly awakened and feels terrified and confused. A sleep terror usually lasts about 15 minutes but have been known to extend in rare cases for hours. Sleep terrors are most common in children at 6% and adults at 2%. Most people who experience sleep terrors do not remember the incident the following morning. The more a person has sleep terrors the more they remember upon waking over prolonged periods of time.

ND-Nightmare Disorder

These vivid events happen when a person is awakened suddenly from REM sleep by a dream that is causing fear or anxiety. A person who has had a nightmare often finds that it is hard to go back to sleep.

RLS-Restless Leg Syndrome

Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings. RLS sensations are often described by people as burning, creeping, tugging, or like insects crawling inside the legs. Often called paresthesias (abnormal sensations) or dysesthesias (unpleasant abnormal sensations), the sensations range in severity from uncomfortable to irritating to painful.

SW-Sleep Walking

Also known as somnambulism, sleepwalking occurs when a person moves around while they are sleeping. This parasomnia tends to run in families, and it can be dangerous because a sleepwalker is unaware of their actual surroundings.

EHS-Exploding Head Syndrome

A rare and relatively undocumented parasomnia event in which the subject experiences a loud bang in their head similar to a bomb exploding, a gun going off, a clash of cymbals or any other form of loud, indecipherable noise that seems to originate from inside the head. Contrary to the name, exploding head syndrome has no elements of pain, swelling or any other physical trait associated with it.

SE-Sleep Enuresis

Also known as bedwetting, this is when a person is unable to control their urinary functions while they are asleep.

SP-Sleep Paralysis

A person with this parasomnia experiences paralysis when going to sleep or waking up. They cannot move any part of their body, and this can be very frightening. Episodes of sleep paralysis usually last a very short time, and are often ended by a sound or the touch of someone else.

CA-Confusion Arousals

This happens when a person is awakened from a period of deep sleep during the early part of the night. When the person is awakened, they are often confused, move and react very slowly and sometimes have problems with their short-term memory.

NLC-Nocturnal Leg Cramps

This involves sudden, painful cramping of one or both calf muscles during sleep. The cramp can last for as many as 10 minutes, and the resulting pain from the cramp can last for much longer. This parasomnia tends to happen in adults.

SB-Sleep Bruxism

Also known as teeth grinding during sleep, sleep bruxism is when a person involuntarily grinds or clenches their teeth while sleeping. This can lead to teeth wear and jaw discomfort. The method for treating teeth grinding is usually a mouth guard that is worn during sleep.

REM-REM Sleep Behaviour Disorder

With this type of parasomnia, the person is in REM sleep and acts out violent dreams through body movements and sounds. This disorder generally occurs in older men, but can occur in others as well.

One response

  1. i am interested in following your blog

    July 17, 2011 at 4:43 pm

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