Sleep terrors (night terrors): what they are, causes and what to do

A sleep terror is an episode of apparent intense fear that occurs during sleep. The NHS explains that during a night terror you may talk and move about but you are asleep, and it is rare to remember having had one. In contrast, a nightmare is a bad dream that you wake up from and can recall, with strong feelings of fear.

The NHS says night terrors and nightmares happen at different stages of sleep. Night terrors happen in the early part of the night, sometimes more than once, and last up to 15 minutes, while nightmares happen later in the night. This timing and the lack of memory are the features that most often separate the two.

Sleep terrors sit alongside sleepwalking among behaviours that happen during sleep. The NHS says sleepwalking happens when you partly wake from deep sleep so that you can move but your brain is not fully awake, and notes that night terrors are more common in people with family members who sleepwalk. Both are more common in children.

The NHS describes a person having a night terror as screaming, shouting, thrashing about or jumping out of bed, with eyes open but not awake. It is a frightening thing to witness, particularly for parents, but the person is not in the distress that they appear to be and has no memory of the episode afterwards.

• Screaming, shouting or crying out, often suddenly.

• Thrashing about, sitting up or leaving the bed.

• Eyes open but the person does not respond normally and cannot be comforted.

• No memory of the episode the next morning.

• Episodes early in the night, lasting up to 15 minutes.

The NHS lists common causes of night terrors and nightmares: being very tired or unwell, sudden noises at night or needing to pee during the night, which can affect deep sleep, and something that has frightened or stressed you, such as watching a scary film. They can also be caused by certain medicines such as antidepressants, conditions that affect sleep such as restless legs syndrome or sleep apnoea, mental health conditions such as generalised anxiety disorder, conditions that affect the brain such as Parkinson's disease, and a severe injury, after which sleep may be disturbed for 4 to 6 weeks.

Night terrors are more common in people with family members who have had night terrors or who sleepwalk. The NHS sleepwalking page adds that not getting enough sleep, being unwell with a high temperature, stress and alcohol can also be linked to this kind of sleep behaviour.

The NHS says that during a night terror you should stay calm and wait for the person to calm down. You should not talk to them or try to stop them moving about, unless there is a risk they could hurt themselves or someone else. Do not try to wake them: they may not recognise you and may become more upset if you try to comfort them.

Safety is the main priority. As for sleepwalking, the NHS suggests keeping floors clear, closing doors and windows, using stair gates for children, locking away sharp objects and not letting a child who sleepwalks sleep in the top of a bunk bed. These measures reduce the chance of injury during an episode.

For most people night terrors get better on their own. The NHS suggests a relaxing bedtime routine, keeping a sleep diary, including how long you or your child sleep for, how long it takes to fall asleep and how you feel the next day, to help identify causes, and dealing with things that may be causing stress or anxiety.

If night terrors happen at the same time every night, the NHS suggests waking the person 15 minutes before the night terror every night for 2 weeks, which may stop them happening. The NHS sleepwalking page also recommends enough sleep, regular bedtimes and rising times, avoiding naps during the day and avoiding caffeine and alcohol in the evening.

The NHS advises seeing a GP if your child continues having night terrors after the age of 12, or starts having night terrors after the age of 5. It also advises seeing a GP if your child continues to have nightmares after the age of 6, is having frequent nightmares or nightmares caused by an upsetting event, or if you have regular nightmares that are affecting your sleep and everyday life.

The NHS sleepwalking page adds that a GP should be seen if it disrupts sleep, if you are worried about accidents or injuries, or if you have other symptoms such as feeling very tired during the day or breathing stopping and starting during sleep, which can point to sleep apnoea.

The NHS says treatment for night terrors and nightmares depends on the cause. Psychological therapies such as CBT can help children and adults who have frequent nightmares, and CBT may also help with conditions such as anxiety or insomnia that can cause night terrors or nightmares. If nightmares are caused by a traumatic event, a GP may recommend psychological treatment such as counselling, and if a condition affecting sleep is responsible, treatment usually involves managing that condition better.

For sleepwalking, which can overlap, the NHS says a GP might refer to a sleep clinic when there is a risk of accidents or severe sleep disruption, and that medicines such as clonazepam or antidepressants may be used if other things have not worked. Do not stop prescribed medicines without talking to a GP.

The GP or health visitor is the usual first point of contact on the NHS, with referral to a sleep clinic or paediatric service if needed.

Some families see a private sleep specialist or child psychologist for persistent problems. Whichever route you choose, a sleep diary makes any consultation more productive, and the GP should be told about any medicines or sleep-disordered breathing symptoms.