Night Terrors: Causes, Age Range & When to Seek Help

What Are Night Terrors?

Night terrors (sleep terrors) are NREM parasomnias featuring abrupt arousal from slow-wave sleep with intense fear, screaming, tachycardia, tachypnea, and autonomic arousal. The child is inconsolable, amnestic, and difficult to awaken fully.

Epidemiology

• Peak onset: 1.5–3 years.
• Most frequent: Ages 4–12.
• Prevalence: 1–6% of children.
• Resolution: Majority remit by adolescence; <5% persist into adulthood.

Triggers

• Sleep deprivation, irregular schedule
• Fever, illness
• Medications (sedatives, antihistamines)
• Stress, anxiety
• Sleep-disordered breathing (OSA)
• Genetic predisposition (family history)

Management

• Do NOT wake the child – may prolong episode.
• Ensure safety (pad floor, gates on stairs).
• Gentle verbal reassurance; wait for return to sleep.
• Address triggers: consistent bedtime routine, adequate sleep, treat OSA.
• Scheduled awakenings (15 min before typical episode) can break cycle.

When to Consult a Specialist

• Frequency >2×/week or increasing
• Injury during episodes
• Daytime sleepiness/behavioral changes
• Onset >12 years or persistence into adulthood
• Suspected seizure (video EEG may be needed)