From the Guidelines
Night terrors are best treated by ensuring safety and waiting for the episode to pass without waking the person, as waking them can cause confusion and disorientation. For children experiencing night terrors, parents should maintain a consistent sleep schedule, reduce stress, and ensure adequate sleep as these episodes often occur during transitions between sleep stages when a child is overtired 1. Creating a relaxing bedtime routine and addressing any underlying anxiety can help reduce frequency.
Key Considerations
- Ensuring the child's safety during an episode is crucial, as they may engage in harmful behaviors without being aware of their surroundings.
- Scheduled awakenings may help - wake the child about 15-30 minutes before the typical time of night terrors for several nights.
- Medication is rarely needed but in severe cases affecting quality of life, short-term use of certain medications might be considered under medical supervision.
Medication Options
- Although the provided evidence does not directly address the treatment of night terrors, it discusses pharmacologic treatment options for nightmare disorder, which may be considered in severe cases of night terrors affecting quality of life, such as nitrazepam, prazosin, and triazolam 1.
- It's essential to note that the evidence provided focuses on nightmare disorder, and the treatment of night terrors should prioritize non-pharmacological approaches, with medication considered only in severe cases under medical supervision.
Management and Prognosis
- Most children outgrow night terrors by adolescence, and treatment focuses on management rather than elimination.
- Addressing any underlying sleep disorders like sleep apnea is important as these can trigger night terrors in both children and adults.
From the Research
Treatment Options for Night Terrors
- Hypnosis has been used as a treatment for night terrors, with a case study showing success in a 10-year-old boy who had not had a recurrence of night terrors after approximately 2 years 2.
- Good sleep hygiene and an appropriate sleeping environment are important in managing night terrors, as sleep deprivation can predispose to sleep terrors 3.
- Anticipatory awakening, performed approximately half an hour before the child is most likely to experience a sleep terror episode, is often effective for the treatment of frequently occurring sleep terrors 3.
- Clonazepam may be considered on a short-term basis at bedtime if sleep terrors are frequent and severe or are associated with functional impairment, such as fatigue, daytime sleepiness, and distress 3.
- Reassurance and parental education are often the only treatment needed, as most children outgrow the disorder by late adolescence 3.
- Underlying conditions should be treated if possible, and precipitating factors should be avoided 3.
Non-Pharmacological Treatments
- Counseling and reassurance of the parents are indicated for children with sleep terrors, as well as for sleepwalking, nightmares, and enuresis 4.
- Psychotherapy may be necessary in the treatment of adults with sleep terrors, sleepwalking, and nightmares 4.
Pharmacological Treatments
- Prazosin has been shown to be effective in treating nightmare disorder, which may be related to night terrors 5.
- Clonazepam may be used to treat sleep terrors, but its use should be limited to short-term basis 3.
Note: There is no relevant information in reference 6 to assist in answering this question about the treatment of night terrors.