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Treatment for sleep terrors isn’t usually necessary. If your child has a sleep terror, simply wait it out. You might gently restrain your child and try to get him or her back into bed. Speak softly and calmly. Shaking your child or shouting may make things worse.

If the sleep terrors are associated with an underlying medical or mental health condition or another sleep disorder, treatment is aimed at the underlying problem. If stress or anxiety seems to be contributing to the sleep terrors, your doctor may suggest meeting with a therapist or counselor. Cognitive behavior therapy, hypnosis, biofeedback and relaxation therapy may help.

Medication is rarely used to treat sleep terrors, particularly for children. If necessary, however, use of benzodiazepines or some antidepressants may help reduce sleep terrors.

For children, sleep terrors tend to decrease by the time they’re adolescents. However, if you have concerns about safety or underlying conditions for you or your child, you may want to consult your or your child’s doctor, who may refer you to a sleep specialist.

It’s a good idea to prepare for your appointment. Here’s some information to help you.

What you can do
•Keep a sleep diary. Keeping a sleep diary for two weeks before your appointment can help your doctor understand what’s causing the sleep terrors. In the morning, you record as much as you know of your or your child’s bedtime ritual, quality of sleep, and so on. At the end of the day, you record behaviors that may affect your or your child’s sleep, such as caffeine consumption and any medications taken.
•Write down any symptoms you or your child is experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
•Write down key personal information, including any major stresses or recent life changes.
•Make a list of all medications, vitamins or supplements you or your child is taking.
•Bring a family member or friend along, if possible. Someone who accompanies you can help you remember what the doctor says.
•Write down questions to ask your doctor.

Preparing a list of questions for your doctor will help you make the most of your time together. For sleep terrors, some basic questions to ask your doctor include:
•What is likely causing my or my child’s symptoms or condition?
•Other than the most likely cause, what are other possible causes for the symptoms or condition?
•What kinds of tests are needed?
•Is the condition likely temporary or chronic?
•What is the best course of action?
•What are the alternatives to the primary approach you’re suggesting?
•Are there any restrictions that that need to be followed?
•Do you recommend seeing a specialist?
•Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

Don’t hesitate to ask other questions that occur to you.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:
•When did the sleep terrors begin?
•How often do the sleep terrors occur?
•Have there been sleep problems in the past?
•Does anyone else in your family have sleep problems?

COMPLICATIONS:

Sleep terrors aren’t necessarily a concern, but regularly disrupted sleep can be. It can cause excessive daytime sleepiness, which can lead to difficulties at school or work, or problems with everyday tasks such as driving.

Harming oneself or others is another possible, rare complication during sleep terrors.

TEST & DIAGNOSIS

Sleep terrors are usually self-diagnosed. Your doctor may do a physical or psychological exam to identify any conditions that may be contributing to the sleep terrors. In some cases, a sleep study in an overnight sleep lab may be recommended.

Sleep studies

To participate in a sleep study, also known as a polysomnogram, usually requires spending the night in a sleep lab. Sensors that send electrical signals are placed on various parts of the body, and a chip will be attached to a finger. A video camera will record your sleep. Throughout the night, the sensors will record your:
•Heartbeat
•Brain waves
•Breathing
•Eye movements
•Leg movements
•Muscle tension
•Blood oxygen level

Your doctor will review the information to determine whether you or your child have any sleep disorders.

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Sleep terrors differ from nightmares. The dreamer of a nightmare wakes up from the dream and remembers details, but a person who has a sleep terror episode remains asleep. Children usually don’t remember anything about their sleep terrors in the morning. Adults may recall a dream fragment they had during the sleep terrors.

Like sleepwalking and nightmares, sleep terrors are a parasomnia — an undesired occurrence during sleep. Sleep terrors usually occur during the first third of the sleep period.

During a sleep terror episode, a person might:
•Sit up in bed
•Scream or shout
•Kick and thrash
•Sweat, breathe heavily and have a racing pulse
•Be hard to awaken
•Be inconsolable
•Get out of bed and run around the house
•Engage in violent behavior (more common in adults)
•Stare wide-eyed

When to see a doctor

Occasional sleep terrors aren’t usually a cause for concern. If your child has sleep terrors, you can simply mention them at a routine well-child exam.

Consult your doctor if your or your child’s sleep terrors:
•Become more frequent
•Routinely disrupt sleep or the sleep of other family members
•Cause you or your child to fear going to sleep
•Lead to dangerous behavior or injury
•Appear to follow the same pattern each time

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DEFINITION:

Sleep terrors are episodes of fear, flailing and screaming while asleep. Also known as night terrors, sleep terrors often are paired with sleepwalking.

Although sleep terrors are more common in children, they can affect adults. A sleep terror episode usually lasts from seconds to a few minutes.

Sleep terrors are relatively rare, affecting only a small percentage of children — often between ages 4 and 12 — and a smaller percentage of adults. However frightening, sleep terrors aren’t usually a cause for concern. Most children outgrow sleep terrors by adolescence.

CAUSES:

Various factors can contribute to sleep terrors, including:
•Sleep deprivation
•Fatigue
•Stress
•Anxiety
•Fever (in children)
•Sleeping in unfamiliar surroundings
•Lights or noise

Sleep terrors sometimes are associated with underlying conditions that affect sleep, such as:
•Sleep-disordered breathing — a group of disorders characterized by abnormal breathing patterns during sleep, the most common of which is obstructive sleep apnea
•Migraines
•Head injuries

In other cases, use of alcohol, illegal drugs or certain medications — including some antihistamines, sedatives and sleeping pills — can trigger sleep terror episodes.

Experts aren’t entirely sure how biofeedback works. But if biofeedback is successful for you, it may help you control symptoms of your condition or reduce the amount of medication you take. Eventually, you can practice the biofeedback techniques you learn on your own. You may need to continue with standard treatment for your condition, though.

On the downside, learning biofeedback can take a lot of time and, if it’s not covered by your health insurance, it can be personally expensive. In some cases, biofeedback may be no more effective than other simpler, less expensive relaxation techniques, such as yoga.

During a biofeedback session, a therapist attaches electrical sensors to different parts of your body. These sensors monitor your body’s physiological state, such as brain waves, skin temperature or muscle tension. This information is fed back to you via cues, such as a beeping sound or a flashing light. The feedback teaches you to change or control your body’s physiological reactions by changing your thoughts, emotions or behavior. In turn, this can help the condition for which you sought treatment.

For instance, biofeedback can pinpoint tense muscles that are causing headaches. You then learn how to invoke positive physical changes in your body, such as relaxing those specific muscles, to reduce your pain. The ultimate goal with biofeedback is to learn to use these techniques at home on your own.

A typical biofeedback session lasts 30 to 60 minutes. The length and number of sessions are determined by your condition and how quickly you learn to control your physical responses. You may need a series of 10 sessions or as many as 50, which can make it more expensive and time-consuming. Biofeedback is often not covered by insurance.

Types of biofeedback

Your therapist may use several different biofeedback techniques. Determining the technique that’s right for you depends on your health problems and goals. Biofeedback techniques include:
•Electromyography (EMG) biofeedback. This type gives you information about your body’s muscle tension so that you can practice relaxation.
•Temperature (thermal) biofeedback. Sensors attached to your fingers or feet measure your skin temperature. Because your temperature often drops when you’re under stress, a low reading can prompt you to begin relaxation techniques.
•Galvanic skin response training. Sensors measure the activity of your sweat glands and the amount of perspiration on your skin, alerting you to anxiety.
•Heart rate variability biofeedback. This type of biofeedback helps you control your heart rate in an effort to improve blood pressure, lung function, and stress and anxiety.

Biofeedback devices

You can receive biofeedback training in physical therapy clinics, medical centers and hospitals. But a growing number of biofeedback devices and programs are being marketed for home use. Some of these are hand-held portable devices, while others connect to your computer. You can try different devices until you find one that works for you, or ask your doctor for advice. Check with your health insurance company to see what costs, if any, associated with biofeedback devices are covered.

Be aware that some products marketed as biofeedback devices may not be, and that not all biofeedback practitioners are reputable. If a manufacturer or biofeedback practitioner claims that a biofeedback device can assess your organs for disease, find impurities in your blood, cure your condition or send signals into your body, check with your doctor before using it, as it may not be legitimate.

You don’t need special preparation for biofeedback.

To find a biofeedback therapist, start by asking your doctor or another health professional with knowledge of biofeedback therapy to recommend someone who has experience treating your condition. Many biofeedback therapists are licensed in another area of health care, such as nursing or physical therapy, and might work under the guidance of a doctor. But state laws regulating biofeedback practitioners vary. Some biofeedback therapists choose to become certified to show their extra training and experience in the practice.

Ask a potential biofeedback therapist questions before starting treatment, such as:
•Are you licensed, certified or registered?
•If you aren’t licensed, are you working under the supervision of a licensed health care professional?
•What is your training and experience?
•Do you have experience providing feedback for my condition?
•How many biofeedback sessions do you think I’ll need?
•What’s the cost, and is it covered by health insurance?
•Can you provide a list of references?

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RISKS:

Biofeedback is generally safe. Biofeedback may not be appropriate for everyone, though. Be sure to discuss it with your doctor first.

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DEFINITION:

Biofeedback is a technique you can use to learn to control your body’s functions, such as your heart rate. With biofeedback, you’re connected to electrical sensors that help you receive information (feedback) about your body (bio). This feedback helps you focus on making subtle changes in your body, such as relaxing certain muscles, to achieve the results you want, such as reducing pain.

In essence, biofeedback gives you the power to use your thoughts to control your body, often to help with a health condition or physical performance. Biofeedback is often used as a relaxation technique.

Why it’s done:

Biofeedback, sometimes called biofeedback training, is used to help manage many physical and mental health issues, including:
•Anxiety or stress
•Asthma
•Chemotherapy side effects
•Chronic pain
•Constipation
•High blood pressure
•Incontinence
•Irritable bowel syndrome
•Raynaud’s disease

Biofeedback appeals to people for a variety of reasons:
•It’s noninvasive.
•It may reduce or eliminate the need for medications.
•It may be a treatment alternative for those who can’t tolerate medications.
•It may be an option when medications haven’t worked well.
•It may be an alternative to medications for some conditions during pregnancy.
•It helps people take charge of their health.