When a person
awakens from a dream crying or screaming, they may be experiencing
sleep terror disorder. Usually the person is difficult to wake-up
and the episode may last several minutes. Once awakened, the individual
is confused and finds it difficult to relay the detail of his/her
dream. Sleep terror usually only occurs once per night. Sometimes
the person experiencing a sleep terror will attempt to punch or swing
his/her fists at others. Main characteristics are:
On numerous occasions, the patient awakens abruptly, usually during
the first third of sleep and usually beginning with a scream of panic.
During each episode the
patient shows evidence of marked fear and autonomic arousal, such as
rapid breathing, rapid heartbeat and sweating.
During the episode, the
patient responds poorly to the efforts of others to provide comfort.
The patient cannot recall
any dream in detail at the time and cannot recall the whole episode
later.
These symptoms cause clinically
important distress or impair work, social or personal functioning.
These symptoms are not
directly caused by a general medical condition or substance use, including
medications and drugs of abuse.
Other characteristics
that can occur with sleep disorders include depression,
decreased concentration, fatigue, anxiety,
and irritability. People with chronic sleep problems tend to have
other illnesses such as stomach problems, muscle aches, and headaches.
Differential
Diagnosis:
Some disorders
have similar or even the same symptoms. The clinician, therefore,
in his/her diagnostic attempt has to differentiate against the following
disorders which need to be ruled out to establish a precise diagnosis.
Seizure
Disorder.
Nightmares.
Sleep problems
frequently occur around periods of stress in a person's life and can
occur at any age. However, sleep problems increase with increasing
age.
Treatment:
In
many cases, comfort and reassurance are the only treatment required.
Psychotherapy or counseling may be appropriate in some cases.
Counseling
and Psychotherapy
Sleep disorder clinics often are able to help people restore normal
sleeping patterns through various techniques. Night terrors may also
be treated with hypnosis and guided imagery techniques.
Pharmacotherapy
Benzodiazepine
medications (such as diazepam) used at bedtime will often reduce the
incidence of night terrors; however, medication is not usually recommended
to treat this disorder. A safe over-the-counter drug, Benadryl elixir
(diphenhydramine), given 1 hour before bedtime may reduce the incidence
of night terror.
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