Nightmares and What to Do about Them

In children, this disorder is technically referred to as pavor nocturnus, from Latin words meaning "night terror" Night terrors are considered to be a disorder of partial arousal. The episode begins in a state of very deep sleep (stage 4). Instead of moving gradually upward through lighter stages of sleep (stages 3 and 2) into a dream period (stage 1, or REM), the child is catapulted suddenly awake. The rapid shift of consciousness brings with it an overwhelming sense of dread.

Experts think that night terrors are the result of an immature nervous system, but we do not yet know exactly why they occur. Sometimes, however, high fevers, head injuries, or other physical trauma has triggered attacks. Emotional stress, fatigue, or a sudden external stimulus may also precipitate an attack. Researchers have produced an attack experimentally in some susceptible people by startling them awake with a loud buzzer; others remain unaffected.

Most experts say that this disorder upsets parents and spouses more than the victim, who usually does not remember the event. Night terrors in children almost always disappear without treatment.

Although night terrors are not usually thought to be related to emotional disturbance in children, adults who suffer from them say that emotional upsets intensify the experience. Experts are still debating how much influence the psychological component has in this disorder.

From one to five percent of all children have at least one attack of night terrors. (Figures vary from expert to expert.) These attacks are most common between the ages of three and seven years old, but they occur in all age ranges. Night terrors are more frequent in males, and since boys mature later, attacks last a longer time for them. Fortunately, most children outgrow night terrors by adolescence.

In adults, the equivalent experience to night terrors is called "incubus," from a Latin word meaning, "to lie upon." This term is based on the ancient notion that a demon or evil spirit possesses the victim during the night.

Adults who suffer from night terrors report feelings of overwhelming dread; an impression of being crushed or having great pressure on the chest; and they may sometimes experience muscle paralysis or difficulty breathing. Like children, most adults do not recall the attack by morning.

For adults, the attack may be a malfunction of the sleep process. Two-thirds of all adults report having had at least one night terror. As many as six percent say they have one attack a week, and some unhappy people experience attacks three or four times a week.

An acquaintance of mine, a prominent opera singer, tells me that she has such experiences almost every night. Since she has a powerful voice, her shrieks awaken everyone within hearing distance, and her wild flailing has occasionally wounded her bed partner, to say nothing of startling him awake.

Several adult victims of night terrors have said that the attacks started during a major life change. Many (75 percent)) attest that emotional strain intensifies the experience; some (15 percent) state that fatigue, too, affects the vividness of the experience. Victims of night terrors often have relatives who suffer from the same disorder; 14 percent of first-degree relatives also had attacks. Many people who have other disorders of arousal also have night terrors; for instance, 33 percent of sleepwalkers and 16 percent of bed-wetters also experience night terrors. Similarly, 94 percent of people with night terrors also walk in their sleep.