what causes night terrors in adults?
Dreams

Why Did I Wake Up in The Middle of The Night Screaming?

Last Updated on October 3, 2023 by Louise Carter

Sleep heals, preparing the body and mind for the next day. Night screaming adversely affects the sleep quality of partners, people living in the house, and even neighbors.

Nightmares and night terrors are common during childhood but less so in adulthood. Most of us have the occasional nightmare, but for some people, they’re a regular occurrence.

If you’ve recently begun screaming at night, you’ll want to know what suddenly brought it on.

What Are Night Terrors?

If you frequently scream yourself awake, you may be having night terrors. These are also called sleep terrors, or by their Latin name, “pavor nocturnus.”

They’re a parasomnia recognized in the Diagnostic and Statistical Manual of Mental Disorders.

According to the DSM, night terrors are most common among children aged 3-12. About 1 – 6% of children experience them, compared to less than 1% of adults.

Usually, night terrors aren’t standalone experiences. Unlike dreams, night terrors don’t occur during rapid eye movement (REM) sleep. Instead, they begin during deep (slow-wave) sleep.

When a night terror starts, the individual will appear to have awoken from sleep, and their eyes will usually be open. However, in reality, they’re still sleeping.

To an observer, the person is experiencing extreme fear and can’t be consoled. They might:

  • Scream, cry, or shout.
  • Breathe rapidly or heavily.
  • Stare wide-eyed.
  • Sit upright in bed or get up and run around.
  • Display aggression if restrained.
  • Have dilated pupils and a fast heartbeat.

Night terrors aren’t harmful in themselves, so the only danger may arise from the activity carried out by the sleeping person, like falling downstairs.

What Are the Causes of Night Terrors?

Many factors contribute to someone experiencing night terrors:

  • A twin study in the Pediatrics journal discovered that night terrors could be hereditary. If your mother or father experiences night terrors, you’re more likely to do so.
  • Children are far more likely to have night terrors than adults. Although adults can experience them, most night terror episodes pass by adolescence.
  • You’re more likely to have a night terror if you experience a lack of sleep. The more tired you are, the longer you spend in deep sleep, which is when night terrors occur.
  • Certain medications, especially those that affect the brain.
  • Fever and illness can trigger parasomnias like sleepwalking, sleep talking, and night terrors.
  • Stress and anxiety are triggers for various disorders, including parasomnias. If you’re going through a stressful period, you’re more likely to have night terrors, perhaps due to past trauma.
  • Medical conditions like sleep apnea, epilepsy, and restless leg syndrome often occur alongside night terrors. They can also occur alongside mental illnesses like depression and personality disorders.

Night terrors can occur for no discernable reason, and some people are more prone to them than others.

night terrors in adulthood

What Are the Treatments for Night Terrors?

Night terrors often subside when you practice good sleep habits. If you train your brain to know when to sleep, you’re less likely to wake up at night or experience sleep disorders.

Before visiting a doctor, try the following:

  • Before bedtime, relax the mind by having a warm shower. Don’t use screens because the blue light can trick your brain into thinking it’s daytime.
  • Sleep at the same time each night. Regardless of whether it’s a workday or a day off, go to bed and wake up at the same time, as this will help your body learn when it’s time to rest.
  • Exercise to tire yourself sufficiently to sleep at night. However, don’t become overtired because this can make sleep terrors more likely. For example, take a brisk walk before bedtime.
  • Aim for 7-9 hours of sleep per night if over 18. Adolescents need 8-10 hours of sleep.

Consult a sleep therapist if you believe night terrors are due to a past traumatic event because they may be able to offer counseling to help you deal with your past.

A study in the American Journal of Psychotherapy found that psychotherapy is an effective tool for reducing and eliminating the occurrence of night terrors.

Doctors rarely prescribe medication for night terrors unless they severely impact the patient’s life.

According to the Canadian Family Physician, benzodiazepines (sleeping pills) can reduce the frequency of night terrors. However, they’re not a long-term solution.

What Are Nightmares?

If you wake up screaming and terrified, you may be experiencing nightmares.

You may have heard the terms “nightmares” and “night terrors” used interchangeably. However, although they can cause screaming at night, they’re entirely different things.

Like night terrors, nightmares occur during sleep. However, they’re not classified as sleep disorders or parasomnia. Instead, they’re a type of bad dream.

Unlike night terrors, most of us experience nightmares occasionally. Research in the journal Sleep found that about 40% of adults have a nightmare sometimes.

Nightmares occur during REM sleep. Bad dreams trigger strong emotional responses, including fear, anxiety, and sadness.

Nightmares usually involve an uncomfortable or frightening scenario that causes the dreamer to panic. Common themes include falling and being chased by someone or something.

Someone having a nightmare might:

  • Thrash or toss and turn in their sleep.
  • Talk, scream or shout in their sleep (somniloquy).
  • Have a concerned or panicked look on their face.
  • Be sweating or have a rapid heartbeat.
  • Wake suddenly in fear.
  • Describe their nightmare once it’s over.

Once the dreamer has awakened, they’ll be lucid but may find it difficult to return to sleep.

Though the occasional nightmare is normal, it isn’t usual to experience them frequently. If someone has nightmares at least weekly, they may be diagnosed with nightmare disorder (recurring nightmares).

For diagnosis, the nightmares must cause significant distress and impact some areas of daily life, like work or socialization. Around 4% of adults experience frequent nightmares.

What Causes Frequent Nightmares?

Like night terrors, frequent nightmares can be triggered by the following:

  • Gender. In adults, women report having nightmares more frequently than men. In children, the incidence rate is about the same for both sexes.
  • Lifestyle. People who lead stressful lives are more likely to have nightmares. In particular, you may experience more nightmares when unemployed, have a lower household income or are divorced/widowed. Nightmares are also associated with lower life satisfaction.
  • Sleep duration. Nightmares are correlated with a lack of sleep. You’re most at risk of nightmares if you sleep less than 5 hours per night or have insomnia.
  • Medications. These include painkillers, sedatives, hypnotics, and antidepressants.
  • Medical conditions. High blood pressure, angina, and heart failure elicit frequent nightmares. Also, a mental health condition, like depression, increases the incidence of nightmares.

Everyone has a nightmare occasionally. Infrequent nightmares are often spontaneous, so some people experience nightmares for no reason.

What Are The Treatments for Nightmares?

If you only experience nightmares occasionally, there is no need for treatment. Nightmares are normal, so nothing can be done to stop you from having nightmares.

There are treatment options available for individuals who have frequent nightmares. A doctor will need to determine if there’s an underlying cause of nightmares.

Nightmares may result from a psychological condition like depression, anxiety, or post-traumatic stress disorder (PTSD). If this is the case, therapy could be beneficial.

A particularly useful solution is cognitive-behavioral therapy (CBT). A study published in Cognitive Therapy and Research found CBT effective in treating many mental illnesses.

Also, you can change your lifestyle by making the following adjustments:

  • For adults, a healthy amount is between 7 – 9 hours per night.
  • Go to sleep and wake up at the same time each day.
  • Address any stressors in your life, like an unsatisfying job or personal relationship.
  • Practice yoga or meditation to relieve stress and clarify your mind.
  • Regular exercise can help you de-stress and get more restful sleep.

Night Terror vs. Nightmare in Adults

Night terrors and nightmares can seem quite similar, but they’re distinct.

Here’s how to recognize a night terror versus a nightmare:

Time it Occurs

Night terrors usually occur early at night, around 1.5 hours to 3 hours after falling asleep.

When we first fall asleep, we go through a period of light sleep, then transition to deep (slow-wave) sleep. Night terrors occur when we transition from stage 3 to 4 of deep sleep, often early at night.

Nightmares are more likely to occur later at night, usually during the early morning hours. If you wake up screaming only a few hours before your alarm goes off, it’s likely a nightmare.

That’s because nightmares are dreams produced during REM sleep. At the start of the night, REM sleep stages are quite short. As we sleep for longer, REM stages get longer as well.

The longest periods of REM sleep occur after we’ve been asleep for many hours.

Duration

A night terror lasts 1-2 minutes, while the most severe night terrors can last up to 30 minutes.

Throughout a night terror, the person experiencing it is fast asleep, although they appear awake. After an episode, the individual will return to a peaceful sleep or wake up.

If someone is having a nightmare, they’ll appear asleep, usually with their eyes closed. They may move around or make noise in their sleep, but not always.

Nightmares can vary significantly, lasting from five minutes to an hour. According to research by the University of Mannheim, a person having a nightmare will almost always wake up naturally.

Unlike a night terror, when the individual is awake, they’ll be alert and present. Also, they may have difficulty returning to sleep.

Arousability

According to research in the Tzu Chi Medical Journal, it’s not easy to interrupt night terrors because they occur during the deepest stage of sleep.

Someone having night terrors may not recognize the person comforting them and won’t be consoled. Talking to or touching someone with night terrors won’t wake them and could worsen things.

If the individual does wake up, they’ll be confused and disoriented, unaware that they were screaming or what they were afraid of.

Nightmares occur during the transition between REM and light sleep, so waking someone up from a nightmare is easy. This can be done by gently touching their arm or calling their name.

They’ll usually wake up straight away and can be consoled. Once they awaken, they’ll know they’ve had a nightmare and will be able to describe the nightmare to some extent.

yelling in sleep meaning

Memory

As night terrors occur in the deepest sleep stage, they’re episodes of spontaneous fear. Though the person having the night terror appears frightened and threatened, they won’t remember this later.

If the individual wakes up due to a night terror, they’ll seem confused by what has happened.

Upon waking up in the morning, they’ll likely be unable to recall the episode. If you’re screaming during sleep and unable to recall it later, it’s likely to be a night terror.

By contrast, nightmares are almost always remembered because they’re a dream. Nightmares are usually vivid and occur in one of the lighter sleep stages.

When a person wakes up from a nightmare, they can almost always explain their dreams. In the morning, they’ll usually remember that they experienced a nightmare with some missing information.

How To Help Someone Having A Nightmare or Night Terror

If a loved one has a nightmare or night terror, you may wonder how to assist them. If you’re the one screaming in your sleep, give the following advice to your partner or family member:

Night Terror Help

  • Don’t try to wake the person. It’s almost impossible to wake someone having a night terror, and attempting to do so may confuse or distress them further.
  • Avoid talking to or touching them because this won’t soothe or reassure them.
  • Don’t restrain them from moving unless they’re endangering themselves.
  • Sit near them until their night terror has passed to ensure they don’t hurt themselves.
  • Reassure them if they wake up, even if they don’t understand what’s happened.

Nightmare Help

  • Reassure the person by softly talking to or touching them. It’s safe to wake someone having a nightmare, and they’ll likely appreciate it.
  • Comfort and reassure them when they awaken. People are often distressed after waking up from a nightmare, so explain that it was a dream and they’re completely safe.
  • Talk with them afterward to take their mind off things. They may find it beneficial to tell you about their nightmare or to talk about something entirely unrelated.

When Should I Seek Medical Help?

Most of the time, nightmares and night terrors don’t require medical intervention because they go away and don’t cause long-term mental or physical harm.

It may be wise to get a medical consultation if the following apply:

  • Nightmares or night terrors occur frequently and prevent you from sleeping well.
  • They affect your emotions during the day, making you angry.
  • You experience other symptoms, like headaches or behavioral changes.
  • Night terrors or nightmares came on suddenly with no previous history.
  • You suspect they’re related to past trauma, which you’d like to address with an expert.

A doctor will ask questions about your life and experiences with nightmares or night terrors. Also, they may conduct a sleep study to better understand your issues.

A doctor may offer you medication or therapy and recommend lifestyle changes.