There is some evidence that suggests that night terrors can occur if the individual does not eat a proper diet, does not get the appropriate amount or quality of sleep (e.g., because of sleep apnea), or is enduring stressful events. Adults who have experienced sexual abuse are more likely to receive a diagnosis of sleep disorders, including night terrors. Overall, though, adult night terrors are much less common and often respond best to treatments that rectify causes of poor quality or quantity of sleep. Diagnosis
The DSM-5 diagnostic criteria for sleep terror disorder requires:
Recurrent periods where the individual abruptly but not completely wakes from sleep, usually occurring during the first third major period of sleep. The individual experiences intense fear with a panicky scream at the beginning and symptoms of autonomic arousal, such as increased heart rate, heavy breathing, and increased perspiration. The individual cannot be soothed or comforted during the episode. The individual is unable or almost unable to remember images of the dream (only a single visual scene for example). The episode is completely forgotten. The occurrence of the sleep terror episode causes clinically significant distress or impairment in the individuals functioning. The disturbance is not due to the effects of a substance, general medical condition or medication. Coexisting mental or medical disorders do not explain the episodes of sleep terrors. Differential diagnosis
Night terrors are distinct from nightmares. In fact, in nightmares there are almost never vocalization or agitation, and if there are any, they are less strong in comparison to night terrors.
In addition, nightmares appear ordinarily during REM sleep in contrast to night terrors, which occur in NREM sleep. Finally, individuals with nightmares can wake up completely and easily and have clear and detailed memories of their dreams.A distinction between night terrors and epileptic seizure is required. Indeed, an epileptic seizure could happen during the night but also during the day. To make the difference between both of them, an EEG can be done and if there are some anomalies on it, it would rather be an epileptic seizure. Assessment
The assessment of sleep terrors is similar to the assessment of other parasomnias and must include:
When the episode occurs during the sleep period
Age of onset
How often these episodes occur (frequency) and how long they last for (duration)
Description of the episode, including behavior, emotions, and thoughts during and after the event
How responsive the patient is to external stimuli during the episode
How conscious or aware the patient is, when awakened from an episode
If the episode is remembered afterwards
The triggers or precipitating factors
Sleep–wake pattern and sleep environment
Daytime sleepiness
Other sleep disorders that might be present
Family history for NREM parasomnias and other sleep disorders
Medical, psychiatric, and neurological history
Medication and substance use historyAdditionally, a home video might be helpful for a proper diagnosis. A polysomnography in the sleep laboratory is recommended for ruling out other disorders, however, sleep terrors occur less frequently in the sleep laboratory than at home and a polysomnography can therefore be unsuccessful at recording the sleep terror episode.