Nightmares and night terrors are two distinct but related sleep disorders. Both these conditions occur mostly in children but adults may be affected too.
Nightmares are basically nothing more than bad dreams. It is an unpleasant dream that can cause a strong emotional response like fear, anxiety, and sadness.
Where in the sleep cycle is that we dream?
We do our dreaming when we are in REM stage of our sleep. Do we have a memory of our dream? Yes. That’s the difference between nightmares and night terrors.
Nightmares increase during times of stress, anxiety, fever or when we sleep in an uncomfortable place or position.
About 50% of the population tends to have nightmares. And if you have them in the night you might not remember them in the morning so that’s a usually a good thing.
Since nightmares occur in the REM (Rapid Eye Movement) stage of the sleep, so Tricyclic antidepressants are used to treat nightmares since TCAs are REM suppressants.
Night terrors or sleep terrors:
A night terror is nothing more than a child (especially boys) waking up in the middle of the night panic-stricken. They scream, they yell and then what happens. They go right back to sleep. When you asked them in the morning “what was that about?” they don’t remember anything. That is a night terror.
Night terrors are common in children between 3 and 12 years of age and usually stop during adolescents.
During night terror bouts, people are usually described as “bolting upright” with their eyes wide open and a look of fear and panic on their face. In some cases, individuals are likely to have even more elaborate motor activity, such as a thrashing of limbs—which may include punching, swinging, or fleeing motions. There is a sense that the individuals are trying to protect themselves and/or escape from a possible threat of bodily injury.
So the difference between the two is the timings and memory of the events.
The specific DSM-5 criteria for NREM sleep arousal disorder, sleep terror type, are as follows:
- Recurrent episodes of abrupt terror arousals from sleep, usually beginning with a panicked scream; intense fear and signs of autonomic arousal
- Relative unresponsiveness to efforts to comfort the individual during the episode
- Little or no recall of dream imagery
- Amnesia for the episode
- Significant distress or impairment in social, occupational or other areas of functioning
- The symptoms cannot be explained by another mental disorder, medical condition, or the effects of a drug of abuse or medication
Night terrors occur in stage 3 and 4 of the sleep, nightmares occur in REM sleep. We remember nightmares, whereas night terrors are not remembered.
Treatment is not required for night terrors but benzodiazepines may be considered in rare cases.
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