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Night terror

1. Signs and Symptoms of Night Terrors: – Night terrors are classified as NREM-related parasomnias. – Factors that may lead to night terrors include young […]

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1. Signs and Symptoms of Night Terrors:
– Night terrors are classified as NREM-related parasomnias.
– Factors that may lead to night terrors include young age, sleep deprivation, stress, fever, and intrinsic sleep disorders.
– Night terrors tend to happen during delta sleep.
– Night terrors can be mistaken for confusional arousal.
– Night terrors are less common than nightmares during childhood.

2. Prevalence and History of Night Terrors:
– Night terrors have been known since ancient times.
– The prevalence of sleep terrors in general is unknown.
– Night terrors are estimated to affect 36.9% of children at 18 months and 19.7% at 30 months.
– In adults, the prevalence of night terrors is lower, at 2.2%.
– Night terrors are closely linked to sleepwalking and frontal lobe epilepsy.

3. Causes and Diagnosis of Night Terrors:
– Evidence suggests a genetic predisposition to night terrors and parasomnias.
– Studies show a ten-fold increase in night terrors prevalence in first-degree biological relatives.
– Factors like sleep deprivation, fever, nocturnal asthma, and nasal passage issues contribute to night terrors.
– Night terrors may be linked to narcolepsy, with manifestations differing by age and gender.
– DSM-5 criteria for sleep terror disorder include abrupt waking with intense fear and autonomic arousal.

4. Treatment and Comorbidities of Night Terrors:
– Night terrors may respond to treatments addressing poor sleep quality or quantity.
– Night terrors in adults may be linked to hypoglycemia.
– Long-term intrathecal clonidine therapy may lead to night terrors in some adults.
– Psychiatric symptoms are prevalent in patients experiencing night terrors.
– Night terrors in adults can lead to violent actions, such as running out of the house.

5. Research, Differential Diagnosis, and Prognosis of Night Terrors:
– Studies have shown potential benefits of paroxetine and L-5-hydroxytryptophan.
– Night terrors can be distinguished from nightmares.
– Night terrors can evolve into sleepwalking in adolescence.
– The Diagnostic and Statistical Manual of Mental Disorders provides criteria for diagnosing sleep disorders.
– Night terrors have been explored in different age groups and populations.

Night terror (Wikipedia)

Night terror, also called sleep terror, is a sleep disorder causing feelings of panic or dread and typically occurring during the first hours of stage 3–4 non-rapid eye movement (NREM) sleep and lasting for 1 to 10 minutes. It can last longer, especially in children. Sleep terror is classified in the category of NREM-related parasomnias in the International Classification of Sleep Disorders. There are two other categories: REM-related parasomnias and other parasomnias. Parasomnias are qualified as undesirable physical events or experiences that occur during entry into sleep, during sleep, or during arousal from sleep.

Night terror
Other namesSleep terror, pavor nocturnus
SpecialtyPsychiatry, sleep medicine, clinical psychology
SymptomsFeelings of panic or dread, sudden motor activity, thrashing, sweating, rapid breathing, increased heart rate
Usual onsetEarly childhood; symptoms tend to decrease with age
Duration1 to 10 minutes
Differential diagnosisEpileptic seizure, nightmares

Sleep terrors usually begin in childhood and usually decrease as age increases. Factors that may lead to sleep terrors are young age, sleep deprivation, medications, stress, fever, and intrinsic sleep disorders. The frequency and severity differ among individuals; the interval between episodes can be as long as weeks and as short as minutes or hours. This has created a situation in which any type of nocturnal attack or nightmare may be confused with and reported as a night terror.

Night terrors tend to happen during periods of arousal from delta sleep, or slow-wave sleep. Delta sleep occurs most often during the first half of a sleep cycle, which indicates that people with more delta-sleep activity are more prone to night terrors. However, they can also occur during daytime naps. Night terrors can often be mistaken for confusional arousal.

While nightmares (bad dreams during REM sleep that cause feelings of horror or fear) are relatively common during childhood, night terrors occur less frequently. The prevalence of sleep terrors in general is unknown. The number of small children who experience sleep terror episodes (distinct from sleep terror disorder, which is recurrent and causes distress or impairment) are estimated at 36.9% at 18 months of age and at 19.7% at 30 months. In adults, the prevalence is lower, at only 2.2%. Night terrors have been known since ancient times, although it was impossible to differentiate them from nightmares until rapid eye movement was studied.

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