Sleep terror

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By Federica Provini MD

Sleep terrors are also known as or subsume Night terrors. -ed.

Sleep terrors consist of abrupt arousals out of sleep stage 3 NREM, primarily in the first third of the night, with disordered motor agitation, screaming, fear, and autonomic activation. Sleep terrors affect between 1% to 6% of prepubertal children with a peak incidence between 5 and 7 years of age and a strong familial clustering. Sleep terrors are usually benign and tend spontaneously to decrease in frequency or cease during adolescence. In this update, the author addresses the latest clinical and polygraphic criteria for the differential diagnosis between sleep terrors and other motor phenomena occurring during sleep, focusing on nocturnal frontal lobe epilepsy, in which the differential diagnosis poses particular problems.

Key Points

  • Sleep terrors are sudden, partial awakenings from deep non-REM sleep, associated with intense motor behavior and strong autonomic responses.
  • Sleep terrors are mainly a childhood phenomenon, with peak prevalence at 5 to 7 years of age.
  • During the episodes, children have a terrified expression but do not respond to family members trying to console them.
  • Sleep terrors are usually benign with a tendency for spontaneous resolution during adolescence.
  • Safety measures are of primary importance to protect the patient from injury, but treatment with medications is not usually necessary.

In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Pathogenesis and pathophysiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
References cited