NIGHT TERRORS
 
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NIGHT TERRORS

 

DEFINITION:

A sleep disorder characterized by the sudden awakening of the child at night in a terrified state.

EPIDEMIOLOGY:

  • incidence: 1-4% of children
  • age of onset:
    • begin in preschoolers; peak between ages 5-7 years
  • risk factors:
    • familial pattern
    • M > F

PATHOGENESIS:

1. Etiology

  • unknown, but occur with arousal from stage 4 (non-REM) sleep or during stage 3-4 of slow-wave sleep
  • may be related to a:
    • specific developmental conflict
    • precipitating traumatic event
    • febrile illness
    • emotional disorder

CLINICAL FEATURES:

1. Features of Night Terrors

  • sudden onset usually between midnight and 0200
  • screams, appears frightened, little or no verbalization, may thrash violently, cannot be consoled, unaware of parents or surroundings
  • autonomic activity during episode
    • dilated pupils, hyperventilating, sweating, tachycardia
  • 1/3 of these children experience somnambulism
  • disoriented for several minutes
  • sleep follows in a few minutes and total amnesia in the morning
  • no awareness of content of dream causing the night terror

INVESTIGATIONS:

1. EEG

  • normal

MANAGEMENT:

1. Supportive

  • parental support, reassurance, and encouragement
  • may use nightlight, leave door open, or let child sleep in sibling's room temporarily

2. Medical

  • a short course of diazepam or imipramine may be beneficial

3. Psychotherapy

  • for prolonged night terrors to investigate for an emotional disorder

4. Prognosis

  • a self limited and short lived sleep disorder

 

 

 

Pediatric Database - NIGHT TERRORS

 

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