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Published June 16, 2013, 11:40 PM

Night terrors rare, but disturbing, for adults

FARGO – In the middle of the night, Erin Fallgatter tore her bed apart in a panic. Her heart raced, and she was convinced her newborn son was tangled in the sheets, suffocating. Her husband, Jeff, told her that baby Wyatt was in his crib, and she needed to go back to sleep.

By: Anna G. Larson, INFORUM

FARGO – In the middle of the night, Erin Fallgatter tore her bed apart in a panic.

Her heart raced, and she was convinced her newborn son was tangled in the sheets, suffocating. Her husband, Jeff, told her that baby Wyatt was in his crib, and she needed to go back to sleep.

“Sometimes, his firm voice would help me to pull back into reality, although it would take minutes for my heart to stop racing enough to relax again,” Erin says. “Most of the time, I had to continue my search of the bedding in order to calm down about it.”

The cycle would repeat four or five times some nights, while newborn Wyatt slept peacefully in his nursery.

“It’s alarming and incredibly confusing to feel such a heightened panic brought on out of a deep sleep for no reason other than your own brain working overtime,” Erin says.

She learned that the intense nighttime episodes she experienced were night terrors, or sleep terrors. About 2.2 percent of adults have night terrors, according to the American Academy of Sleep Medicine. They’re more common in children – 1 to 6.5 percent of children experience them.

Night terrors in adults haven’t been studied as extensively as night terrors in children, says sleep specialist Dr. Seema Khosla of the North Dakota Center for Sleep. Sleep medicine is a young but important field of study, she says.

“Your sleep is so crucial to your overall well-being,” Khosla says.

Nightmare or night terror?

Night terrors are characterized by their high intensity, and people are usually inconsolable during the episodes. Nightmares are very common in adults while night terrors are rare, Khosla says.

“Nightmares and night terrors fall under that same category of unpleasant things, things we don’t want to happen at night,” she says.

During a night terror, people typically act startled, and their heart is usually racing and pupils dilated. Their breathing is fast, and they appear frightened and might scream, says Dr. Samy Karaz of Sanford Health.

Because night terrors happen during non-REM sleep, or sleep that occurs in the first part of the night, people typically don’t remember them in the morning, he says.

It’s common for children to have night terrors because they get more non-REM sleep. Night terrors are more serious in adults since they can be violent, the Sleep Center’s Khosla says.

She recalls a patient who had such severe night terrors that she had to warn her neighbors in her apartment so they wouldn’t think she was being harmed.

Besides being violent, the bed partner or loved one might blame themselves for causing the terrors, or the person who has the night terrors might feel sad if they end up sleeping separately from their mate, she says. It can also lead to anxiety.

“That whole psychosocial side does have to be addressed,” Khosla says. “It’s uncomfortable to talk about sometimes, but I don’t think we’re doing anyone any favors by avoiding it either.”

Coping

Erin’s episodes subsided as she became used to being a mom, although they do occur from time to time. She avoids bad news involving children and anything else that might provoke her to feel stressed.

Treating night terrors is trial and error, Khosla says. They’re usually not treated with medications since many are addictive, like benzodiazepines.

Instead, Khosla encourages patients to de-stress and maintain a regular sleep schedule and calm sleep environment since sleep deprivation is a major cause of night terrors.

She’s also sent patients to behavioral therapists and psychiatrists to work through any issues that might be disturbing their sleep cycle.

Avoiding smoking three or four hours before bed, ideally all together, can also help with night terrors, as can avoiding alcohol and caffeine, Sanford’s Karaz says.

Sleep studies are only necessary if there’s a possible underlying condition like sleep apnea, both physicians say.

A clinical evaluation that involves speaking with the patient and bed partner or family is usually sufficient for figuring out the sleep disorder, Karaz says.

Since people with night terrors don’t usually remember their episodes, people around them are essential to figuring out a diagnosis, he says.

If a bed partner or someone else in a home witnesses a night terror, it’s important to make sure the person and onlooker are both safe, Khosla says.

She recommends directing the person experiencing the night terror back to bed in a soothing, comforting voice without trying to wake them. Trying to wake or hold them can exacerbate or prolong the night terror.

Both physicians say it’s important to seek help if night terrors disrupt daily life.

“I think sometimes the most important thing is to hear the whole story – physicians taking time to listen,” Khosla says. “If you don’t keep your eyes open for it, you’re never going to diagnose it.”

Readers can reach Forum reporter Anna G. Larson at (701) 241-5525

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