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Sleep Terror Disorder

When a person awakens from a dream crying or screaming, they may be experiencing sleep terror disorder. Usually the person is difficult to wake-up and the episode may last several minutes. Once awakened, the individual is confused and finds it difficult to relay the detail of his/her dream. Sleep terror usually only occurs once per night. Sometimes the person experiencing a sleep terror will attempt to punch or swing his/her fists at others. Main characteristics are:

On numerous occasions, the patient awakens abruptly, usually during the first third of sleep and usually beginning with a scream of panic.

During each episode the patient shows evidence of marked fear and autonomic arousal, such as rapid breathing, rapid heartbeat and sweating.


During the episode, the patient responds poorly to the efforts of others to provide comfort.

The patient cannot recall any dream in detail at the time and cannot recall the whole episode later.

These symptoms cause clinically important distress or impair work, social or personal functioning.

These symptoms are not directly caused by a general medical condition or substance use, including medications and drugs of abuse.

Associated Features:

Other characteristics that can occur with sleep disorders include depression, decreased concentration, fatigue, anxiety, and irritability. People with chronic sleep problems tend to have other illnesses such as stomach problems, muscle aches, and headaches.

Differential Diagnosis:

Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Seizure Disorder.
Nightmares.

Cause:

Sleep problems frequently occur around periods of stress in a person's life and can occur at any age. However, sleep problems increase with increasing age.

Treatment:
    
In many cases, comfort and reassurance are the only treatment required. Psychotherapy or counseling may be appropriate in some cases.
   
Counseling and Psychotherapy [ See Therapy Section ]:

Sleep disorder clinics often are able to help people restore normal sleeping patterns through various techniques. Night terrors may also be treated with hypnosis and guided imagery techniques.
    
Pharmacotherapy [ See Psychopharmacology Section ] :
     
Benzodiazepine medications (such as diazepam) used at bedtime will often reduce the incidence of night terrors; however, medication is not usually recommended to treat this disorder. A safe over-the-counter drug, Benadryl elixir (diphenhydramine), given 1 hour before bedtime may reduce the incidence of night terror.

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Page Updated
20th July 2003