The Matt Walker Podcast

#97 - Night Terrors

May 5, 2025

Discover the intriguing world of night terrors, which are distinct from nightmares and mainly affect children. Learn about the dramatic symptoms like screaming and confusion following abrupt awakenings. Explore the rarity of adult cases, often linked to anxiety and sleep disorders. Uncover the multifactorial causes, including genetics and stress, alongside management strategies to improve sleep hygiene. Finally, dive into ongoing research aimed at unraveling the mysteries of this perplexing phenomenon and potential treatments.

25:52

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Quick takeaways

Night terrors are distinct from nightmares, occurring in deep non-REM sleep and leaving individuals with no memory of the episodes.

While primarily affecting children, adult night terrors are rarer and often linked to stress, sleep deprivation, or comorbid conditions.

Deep dives

Understanding Night Terrors

Night terrors, also known as sleep terrors, are a form of parasomnia occurring during deep non-REM sleep and are characterized by intense episodes of fear or distress. Unlike nightmares, which are connected to REM sleep and involve dream recollection, individuals experiencing night terrors often have no memory of the event. Symptoms may include screaming, sweating, rapid heartbeat, and confusion upon awakening, leading to significant distress for both the person experiencing them and their family. Night terrors primarily affect children, with a prevalence of 1-6% and peak occurrences between the ages of three and five, while they become less common in adulthood.

Intro

8min

Understanding Adult Night Terrors and Their Symptoms

3min

Understanding Night Terrors: Symptoms and Diagnosis

5min

Exploring Nighttime Sleep Quality and Daytime Drowsiness

3min

Understanding Night Terrors: Causes, Treatments, and Future Research

7min

Matt takes the opportunity this week to explore the perplexing sleep phenomenon of night terrors (sleep terrors). Matt clarifies that these are distinct from nightmares, defining them as parasomnias arising from abrupt arousals out of deep Non-REM sleep, not REM sleep where dreaming occurs. He details the often dramatic symptoms – intense fear, screaming, sweating, rapid breathing, confusion, sometimes thrashing or sleepwalking – emphasizing the typical lack of memory of the event afterward. Matt discusses prevalence, noting night terrors primarily affect children (1-6%, peaking ages 3-5) and are usually outgrown, while adult cases (<1%) are rarer and often linked to other factors.

Our host delves into the multifactorial causes, including potential genetic predispositions, stress, sleep deprivation, and, in adults, comorbid conditions like anxiety or sleep apnea, as well as alcohol use. He contrasts the impact on children versus adults and notes that diagnosis involves history and observation, sometimes supplemented by polysomnography (sleep studies). Management strategies discussed include optimizing sleep hygiene, managing stress (mentioning CBT-I for related anxiety), scheduled awakenings, and, rarely, medication as a last resort. Matt concludes by touching on ongoing research into the underlying mechanisms and potential future treatments.

Please note that Matt is not a medical doctor, and none of the content in this podcast should be considered medical advice in any way, shape, or form, nor prescriptive in any way.

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As always, if you have thoughts or feedback you’d like to share, please reach out to Matt on Instagram.

Matt: Instagram @drmattwalker or on X @sleepdiplomat

YouTube https://www.youtube.com/@sleepdiplomatmattwalker9299