Sleep terrors

Non-REM parasomnias have variable prevalence rates depending on patient age and different diagnoses. Sleep talking, brux-ism, sleepwalking, sleep terrors, and enuresis occur more frequently in childhood than in adulthood. Nightmares appear to occur with similar frequency in adults and children. REM behavior disorder (RBD), an REM-sleep parasomnia, has a reported prevalence of 0.5% and frequently is associated with concomitant neurologic conditions.16 Chronic RBD is more common in elderly men and may have a familial disposition. 

Sleep terrors are a type of sleep disorder known as a parasomnia (abnormal physical behavior during sleep) that... 

Sleep terrors—A sleep disturbance in which the person appears to wake up screaming and terrified and may cry inconsolably for several minutes. Although the person is not fully awake, the sufferer often shows several physical signs of fear, such as sweating, dilated pupils, and increased blood pressure. Also called night terrors. 

Sleep disturbance due to parasomnias, such as sleepwalking, sleep terrors, bruxism (teeth grinding), and enuresis (bedwetting). Note that family members may need to provide history about these behaviors, which are... 

Nightmare disorder Sleep terror disorder Sleepwalking disorder Parasomnia not otherwise specified Sleep disorders related to another mental disorder Insomnia related to another mental disorder Hypersomnia related to another mental disorder Other sleep disorders... 

Parasomnias are adverse events that either occur during sleep or are exaggerated by sleep. Many of these disorders are considered to be disorders of partial arousal from various sleep stages. Examples of parasomnias are sleepwalking disorder, sleep terror disorder, and nightmare disorder. 

Treatment of sleepwalking involves protecting the individual from harm by putting safety latches on doors and windows, removing hazardous objects from bedrooms, and covering glass doors with heavy curtains. Benzodiazepines, SSRls, or TCAs may be beneficial in adults. Benzodiazepines may also be helpful in curtailing sleep terrors in adults. ... 

Parasomnias are characterized by undesirable physical or behavioral phenomena that occur during sleep [e.g., sleepwalking, sleep talking, bruxism (grinding of teeth), enuresis, night terrors, and RBD]. RBD patients act out their dreams during sleep, often in a violent manner. 

Now Richard of Gloucester has used his cleverness to turn on his own kin. I know—I pray—that Louis is still free, but such hope as that gives me is a small, weak thing, and on its heels comes always fear for him. But chief of my terrors, waking and sleeping, are those for my boy Ned, who is my son in all but name. When I think of his head stooped under who knows what pain, my heart cramps my breath is stopped painfully by grief, as if I have been struck a blow in the throat. 

A native of England, Roy Bolbery, forty-two when interviewed, was ill throughout his childhood in London. At age six he had a severe adverse reaction to penicillin. His sleep frequently was interrupted by night terrors. And during the day he would suddenly feel ill for no apparent reason. The outcome of many medical tests was a diagnosis of mild epilepsy. His sister died in childhood of leukemia. His father suffered with tuberculosis. 

In order for dreaming to be contained in sleep, the brain must sharply demarcate its states. But it often fails to do so, as anyone who has awakened from a nightmare unable to move knows at first hand. The terror that prompted the awakening in the first place is not only unabated by the arousal, but it may be augmented as the return of waking consciousness takes account of the persistent sleep paralysis. 

Night terrors are pure emotional experiences that occur on awakening from sleep. Typically, they are associated with non-rapid eye movement (NREM) sleep, as are the recurrent dreams of post-traumatic stress. Together with the arousal from NREM sleep, there is intense activation of the heart, the breathing rate increases, and the blood pressure may rise to extremely high levels the person awakens drenched in sweat and terrified, and often has little dream recall whatsoever from these awakenings. 

What effect does trauma have on dreams There are two paradoxically contradictory answers to this question enormous impact and very little. We don t understand why, in some cases, the trauma is almost always dominant and, in others, it has such a small role to play in the shaping of dreams. One answer may be that victims of trauma, e.g. post-traumatic stress disorder patients who have had violent experiences in war, have a specific kind of awakening experience. Their sleep is interrupted by terrors akin to the night terrors of children, and, like in the night terrors of children, these do not occur in REM sleep when normal dreaming takes place. Instead, they occur in NREM sleep, the phase of sleep in which the brain is less completely activated, but in which powerful emotions can nevertheless make themselves felt. 

---