Nightmares and Sleep Terrors

What are nightmares and sleep terrors?

Nightmares are scary dreams filled with monsters or frightening events. Most people have nightmares sometimes, usually in the early morning hours. If they happen once in a while, it is usually not anything to worry about. People with a nightmare disorder have a severe problem with nightmares.

Sleep terrors are different from nightmares. During a night terror, you may:

be upset and restless but cannot wake up or be comforted
sit up, possibly screaming or talking wildly
not respond even though your eyes are wide open and staring.

In the morning, you cannot remember what happened. Night terrors are harmless and each episode will end on its own with deep sleep.

How do they occur?

Nightmares happen frequently in childhood, especially between the ages of 3 and 6. Most children outgrow them. In a few people, they continue into adulthood. Some people dream a different dream every time they have a nightmare, while others may have the same nightmare over and over again. Nightmares may be the result of taking certain medicines such as antidepressants or sleeping pills. They may also be a sign of post-traumatic stress disorder (PTSD) or panic disorder. Females are more likely than males to have nightmares.

Sleep terrors are not as common as nightmares. Sleep terrors usually begin between the ages of 4 and 12 in children and are usually outgrown. Adults may start having sleep terrors in their twenties. Sleep terrors occur more in young boys than girls, but affect about equal numbers of adult men and women.

While the cause is unknown, sleep terrors are often related to stress, tension, and conflict. People are more likely to have sleep terrors if they sleepwalk, or if someone else in their family has had sleep terrors.

What are the symptoms?

You may have a nightmare disorder if:

You wake up over and over with nightmares.
The dreams seem to last a long time and are very frightening.
The nightmares are about threats to your life, your security, or your self-image.
You remember the nightmares in detail.
The troubled sleep interferes with work, school, or social activities.

With sleep terrors:

You may wake up screaming or crying a few hours after going to sleep.
Your heart rate and breathing are rapid.
People tell you later that they could not seem to comfort you.
You do not remember the dream.
You will not remember the incident at all, unless other people tell you about it.

How are they diagnosed?

Your health care provider will ask you about:

your sleep patterns
use of caffeine, alcohol, medicine, and other drugs
eating and exercise habits
your mental and physical condition
your medical and mental health history, and your family's history
sources of stress.

After talking with you, your health care provider may give you a physical exam. A blood sample may be taken for lab tests.

Your health care provider may suggest that you sleep overnight in a sleep center. At the sleep center you may have a continuous, all-night recording of your breathing, eye movements, muscle tone, blood oxygen levels, heart rate and rhythm, and brain waves.

How are they treated?

Counseling and therapy often helps people with nightmare disorders. Sometimes medicine such as antidepressants or sleeping pills will help. Some sleeping pills can be addictive. Your provider will work with you to choose the right medicine for short-term or long-term use.

Violent shows or horror movies may cause bedtime fears and nightmares. Avoid these kinds of shows. Some children will not have a night terror if you purposely wake them (enough to sit up and respond) about an hour after they have been asleep.

Your health care provider may recommend relaxation techniques, changes in diet, and a healthy lifestyle that includes exercise. Talk to your provider for help with strategies for more restful sleep.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File BHV3344F.HTM Release 9.0/2006