Night Terrors Vs Nightmares
Night terrors are often mistaken for nightmares, but doctors warn parents that there are telltale signs that can help distinguish the two. Nightmares often occur during the second half of the night when dreaming is most intense during REM sleep. They are “horrific dreams that we recall after awakening, and originate from dream sleep, so dream images are vivid and specific,” says Dr. Peter Fotinakes, medical director of St. Joseph Hospital's Sleep Disorders Center in Orange County, Calif. Night terrors on the other hand, are often not remembered on waking. That’s because in most cases, non-REM dreams (such as night terrors) primarily consist of brief, fragmented impressions that, compared to REM-state dreams (such as nightmares), are less emotional and less likely to involve visual images.
Despite the common belief that children just “grow out of it,” sleep terrors can persist well into adulthood. Dennis Palumbo, a psychotherapist in Los Angeles, Calif., has several adult patients who report night terrors. He believes more adults are suffering from chronic fatigue and emotional fatigue, which may account for the upsurge in sleep episodes he’s seen in his private practice. Anxiety suppressed during work life, or deep-seeded issues, takes a toll on a patient’s sleep quality.
The literature on night terrors in adults is scarce since the parasomnia is commonly associated with children. The American Academy of Sleep Medicine estimates 6.5 percent of all children are affected by night terrors, followed by 2.2 percent of adults, while it remains a rare occurrence for those over the age 65. In adulthood, the sleeping disorder is suspected to be triggered by a strong genetic and family link, but there has yet to be clear empirical evidence to establish this link.
A 2014 study published in the journal Sleep found although nightmares and night terrors are a normal part of childhood development, it may also be an early indicator of mental health issues in adolescence. Children who have a frequency of nightmares before age 12 are about four times more likely to have psychotic experiences during adolescence, while those who have experienced night terrors in this group double the risk of these problems, according to the study. The researchers suggest nightmares or night terrors that occur over a prolonged period of time that persist into adolescence can be an early indicator of something more significant later in life, but that has yet to be known.
Dennis Palumbo is now a licensed psychotherapist and author. His mystery fiction has appeared in Ellery Queen’s Mystery Magazine, The Strand and elsewhere, and is collected in From Crime to Crime (Tallfellow Press). His acclaimed series of crime novels (Mirror Image, Fever Dream, Night Terrors and the latest, Phantom Limb) feature psychologist Daniel Rinaldi, a trauma expert who consults with the Pittsburgh Police.