Treatment of Night Terrors

Critical Distinction: Night Terrors vs. Nightmares

• Night terrors are distinct from nightmares, occurring during deep non-REM sleep with autonomic hyperactivity and complete amnesia for the event, whereas nightmares occur during REM sleep with full recall, according to the American Academy of Sleep Medicine 1
• The American Academy of Sleep Medicine notes that night terrors and nightmares are different conditions, with night terrors typically occurring in the first third of the night and nightmares happening during REM sleep 2

Management Approach for Night Terrors

Pharmacological Treatment (Reserved for Severe Cases Only)

• The American Academy of Sleep Medicine recommends considering pharmacological intervention, such as clonazepam, only when night terrors are frequent, severe, or associated with functional impairment, such as daytime fatigue or significant distress 1

Common Pitfalls to Avoid

• The American Academy of Sleep Medicine advises against confusing night terrors with nightmares, as treatments differ significantly, and medications like prazosin have no role in night terrors 1
• The American Academy of Sleep Medicine suggests that pharmacological intervention should only be considered when episodes are occurring multiple times per week, there is significant risk of injury, daytime functioning is impaired, or the family is experiencing severe distress 1

When to Consider Medication

• The American Academy of Sleep Medicine recommends considering medication when night terrors are frequent, severe, or associated with functional impairment, such as daytime fatigue, sleepiness, or significant distress, and when sleep hygiene measures and anticipatory awakening have failed 1