Institute for Continuing Education

Night Terrors

Course Objectives

Upon successful completion of this module, you will be able to:

• Classify parasomnias according to ICSD-3 categories (NREM arousal disorders, REM parasomnias, other parasomnias), distinguishing sleep terrors, sleepwalking, and confusional arousals as disorders of arousal from slow-wave sleep with shared pathophysiology and epidemiology.
• Explain the pathophysiology of NREM arousal disorders including dissociated arousal states, genetic predisposition, developmental factors, and common triggers (sleep deprivation, stress, fever, medications, sleep-disordered breathing).
• Differentiate sleep terrors from nightmares, nocturnal panic attacks, nocturnal seizures, REM sleep behavior disorder, and psychogenic episodes using clinical features, timing, recall patterns, and sleep stage of origin.
• Apply clinical assessment methods including detailed event history, sleep diaries, validated questionnaires, and determining when polysomnography with video-audio monitoring is indicated versus when clinical diagnosis is sufficient.
• Recognize characteristic polysomnographic findings in NREM arousal disorders including events from slow-wave sleep in the first third of night, partial arousal patterns, autonomic activation, and absence of REM atonia or epileptiform activity.
• Implement evidence-based management strategies including safety measures, behavioral interventions (sleep hygiene, scheduled awakening), pharmacological options for severe cases, treatment of precipitating conditions, and family education.
• Communicate effectively with patients and families about parasomnia etiology, expected course and prognosis, safety planning, treatment options, and appropriate scope of practice for sleep technologists in parasomnia evaluation and management.

Course Information

Night Terrors are a medical ailment and not demon possession. (Contrary to what others may tell you.) Sleep labs across the United States and Canada have shown through sleep studies, that Night Terrors happen due to increased brain activity.

The common thought among researchers is that a chemical trigger in the brain causes your brain to “misfire” and cause a Night Terror. These misfires can be caused by many factors such as stress and various other medical ailments.

People who have night terrors are often misdiagnosed. The most common one is a simple nightmare. Any of you who have had a night terror can say they aren’t even close! Another common misdiagnosis (especially among veterans) is PTSD or Post Traumatic Stress Disorder. For this reason I have included a description of the difference between nightmares and night terrors.