Understanding night terrors and insomnia

Q:  I sleep walk and am prone to night terrors.  Sometimes I wake up in the night screaming, other times I find myself running out of my bedroom yelling.  I rarely remember any details about my dreams, but these terror episodes seem to be worse when I am stressed.  Do you have any suggestions?

A:  Night terrors can be absolutely frightening, but rest assured there are effective treatments

First, it’s important to understand the difference between nightmares and night terrors.

Nightmares are a form of REM dreaming.  While dreaming is thought to be a continuous process throughout the night, our most vivid dreams typically occur during REM.  When the emotional content of a REM dream is very negative, we might call it a nightmare.

Night terrors are qualitatively different than nightmares.  Night terrors typically occur during the deeper NREM sleep stages that normally precede REM sleep.  NREM is also known as deep or slow wave sleep.

Children are most prone to night terrors, but typically outgrow them during adolescence.  Adults can also experience night terrors, but most of us can usually just them go safely unless they become overly disruptive, dangerous, or they have lingering negative effects that overlap into daytime waking hours.

If you feel overwhelmed by the experience of night terrors, a visit to your doctor is in order.  A primary care doctor may refer you to a physician specializing in sleep medicine, or to a sleep clinic where you may have an overnight sleep study.  This will help you either treat or rule out any underlying medical issues.

Night terrors are often worsened by stress and anxiety.  So it stands to reason that reducing levels of stress and anxiety will also help manage night terrors.

Counseling is one way to learn effective methods to control stress and anxiety.  By understanding the recurring negative thought patterns that underlie stress and anxiety, it’s possible to manage them permanently, and without drugs.

If you are the self-help type, you can find many books and online resources about stress management and control of anxiety.  In particular cognitive behavioral therapy (CBT) is very useful, and there are CBT programs specifically designed to help train adults to sleep better.  These methods might help you better manage night terrors while improving your overall sleep.

In addition, you will help yourself by having a better understanding of what dreams really are, including night terrors, and what they are not.

What they are not is real.

By themselves, night terrors or nightmares cannot hurt you.  Even if they are terrifying or the content is disturbing, they are still only dreams.

Regardless of emotional content, what dreams and night terrors really are is a function of sleep.  A night terror by definition means you are experiencing deep sleep, which is normally the most refreshing stage.  A nightmare experienced during REM sleep means you are still benefiting from all the preceding deeper most refreshing stages of sleep.

While the psychological function of dreams is still not completely understood, they may be a way to purge yourself of excessive anxiety, fears, or prior trauma you may have experienced.   In that sense, dreams, including nightmares, are healthy.

So we suggest it’s OK for most of us to just let these negative dreams go.  Most of us can do so safely.

Explore posts in the same categories: Fear, Health, Insomnia, Nightmares, sleep

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One Comment on “Understanding night terrors and insomnia”


  1. […] What you are experiencing could be just a bad dream, or it could be a night terror.  In either case these thoughts can be intensely disturbing or even frightening,  but they are […]


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