A Tale of Two Terrors: Night Terrors in Children and Adults
The parasomnia known as night terrors (also referred to as sleep terrors or pavor nocturnus) is generally discussed within the context of families. It’s commonly presumed that only children experience these disruptive episodes, but the fact is, adults are just as likely to experience them.
However, night terrors can be identified by distinctive behaviors depending upon the age group in which they occur. Let’s get one thing clear: Night terrors aren’t nightmares, even if they appear to be just as scary and disruptive. Distinctions between the two can be rendered using EEG and chin EMG data.
- Nightmares (and their calmer episodes, dreams) mostly occur during REM sleep and, as such, are considered REM-related parasomnias
- Night terrors occur during transitional sleep periods between or overlapping with deep Stage N3 sleep and lighter REM or non-REM stages of sleep, making them disorders of arousal under the non-REM (NREM) parasomnia umbrella.
Consider this: During REM sleep, the body is more or less paralyzed from the neck down as part of the brain’s effort to keep one from acting out the compelling—sometimes terrifying—content of dreams. Meanwhile, when muscle movements actively occur during REM, the more likely culprit, especially in adults, is REM sleep behavior disorder (RBD), another REM-related parasomnia.
This isn’t to say that children cannot also experience RBD. In fact, children with neurodevelopmental disabilities or narcolepsy, or who use certain kinds of medications, may also be diagnosed with RBD.
True to what we know about the foundations of sleep architecture, night terrors occur mostly during the first third of the night, when we’re more likely to experience longer periods of deep Stage N3 sleep. Meanwhile, nightmares happen in the second half of the night, during extended periods of REM sleep.
Another distinct feature of night terrors? The utter lack of memory following these episodes. Someone could be in the throes of a night terror that is so bad the witnesses who watch it happen may feel traumatized. Yet, in the morning, the person who underwent the horrifying experience may have zero memory of it.
Why? Stage N3 sleep allows for no imagery for the brain to process. If the same behavior occurred during a nightmare, there would be a visual memory of it for the person afterward, thanks to the visual images processed and stored as memories during REM sleep.
To learn more about night terrors in children and adults, read the full article in the A2Zzz Q3 2020 issue.