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.
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.
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.
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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Sleep
Disorders
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