[Listen to an audio version of this blog HERE.]
A few weeks ago, a boatload of my running friends all ran through the Grand Canyon together. It was marvelous, they are marvelous, and life is a marvel. After our 50 mile journey, I fell asleep in a hotel room I shared with one of my friends. The next morning, he told me I woke him up (twice) because I was screaming in my sleep. This was news to me, and I didn't think much of it. Bad dream, probably.
But, a few days later, I asked my roommate if she had ever heard me scream, and she said yes, more than once. I was alarmed, she was alarmed, and life is (sometimes) alarming.
I told my therapist, who mentioned I could be having "night terrors," and told me to tell my doctor, which I haven't done because I don't even know who my doctor is. But I googled it, and now I'm writing about it, so here we are.
According to the all-knowing WebMD, While people talk about “night terrors,” it is not, in fact, a diagnosable condition per the Diagnostic and Statistical Manual fifth edition (DSM-V). Some diagnosable sleep conditions include nightmare disorder, REM sleep behavior disorder, and Non-Rapid Eye Movement (NREM) Sleep Arousal Disorder. "Night terrors" are what people who are not doctors call things that doctors have names for. Either way, I've been screaming in my sleep and I'm not entirely sure why, but I have learned that certain things can trigger screaming-in-one's-sleep, such as:
Depression or anxiety
Fever or sickness
Post-Traumatic Stress Disorder (PTSD)
Too much caffeine
Sleeping in a different place or away from home
Lack of sleep
Medications that affect the central nervous system (the brain)
Restless legs syndrome
Sleep problems like sleep apnea
Recent anesthesia for surgery
Night terrors are most common in children, but they can happen at any age. They usually stop without medical intervention and sleepwalking often accompanies them. I used to sleep walk, so this sort of makes sense. Night terrors also occur within the first few hours of sleep, also known as slow-wave sleep or non-REM. Nightmares, however, tend to happen during rapid eye movement sleep (REM), toward the end of the nights sleep. Sometimes, we're able to remember nightmares but usually have no recollection of night terrors.
So, what does a night terror episode look like? Some signs include:
screaming and shouting
sitting up in bed suddenly, or sleepwalking
heavy breathing, racing pulse, and profuse sweating
being hard to wake up
confusion upon waking
staring wide-eyed, as if awake, but not responding to stimuli
not remembering the event
Treatment for infrequent sleep terrors isn't usually necessary. Since it's only happened to me a handful of times, I probably don't need to explore any treatment options or take further action. However, if someone is injuring themselves or others, disrupting family members, or significantly impacting their sleep, treatment may be necessary.
Some treatment options include:
1. Addressing the underlying condition: If the sleep terrors are associated with an underlying medical or mental health condition or another sleep disorder, such as sleep apnea, treatment is aimed at the underlying problem. My therapist cited excessive exercise and/or anxiety and told me to continue therapy, which leads me to my next point:
2. Addressing stress: If stress or anxiety seems to be contributing to the sleep terrors, seek therapy such as cognitive behavioral therapy (CBT), hypnosis, biofeedback, or relaxation therapy.
3. Anticipatory awakening: This involves waking the person who has sleep terrors about 15 minutes before he or she usually experiences the event. This requires a second person, and usually helps children who experience night terrors.
4. Medication. Medication is rarely used to treat sleep terrors, particularly for children. Because night terrors are usually a side effect of an underlying issue, medications to address the underlying issue can sometimes help (i.e. antidepressants).
If sleep terrors are a problem for you or your loved ones, there are some things you can do to help that are free and easy to implement at home.
1. Get adequate sleep. Fatigue can contribute to sleep terrors. If you're sleep deprived, try an earlier bedtime and a more regular sleep schedule. Sometimes a short nap may help. Avoid noises (like TV) or other stimuli that could interrupt sleep.
2. Establish a regular, relaxing routine before bedtime. Put down your phone and engage in quiet, calming activities such as reading books or taking a warm shower before bed. Meditation or relaxation exercises may help, too.
3. Make your environment safe. To help prevent injury, close and lock all windows and exterior doors at night. When I was young, my family even put an alarm on the door. Move tripping hazards or sharp/fragile objects. Sometimes people simply scream, but often they become physical as well.
4. Put stress in its place. Identify the things in your life that are causing stress or anxiety and address the underlying issue. Mental health affects every aspect of life, especially sleep. Seeking professional help can greatly improve your quality of life (take it from someone who has gone to therapy a lot, it never hurts).
If you're around someone having a night terror, or sleepwalking, don't try to wake them. They will likely awake confused, thrash out at you, and find it hard to go back to sleep.
P.S. Read how to help a child who may be experiencing night terrors here, watch an old movie called Night Terror here, or watch a video from Mount Sinai explaining night terrors in half-hearted detail here.