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Episodes may seem quite intense, with the child screaming and thrashing without being aware of their surroundings. Children may exhibit symptoms of heightened autonomic activity, including rapid heart rate, rapid breathing, dilated pupils, and excessive perspiration. In certain instances, enuresis may also manifest.It is common for children to not respond to verbal cues, attempts to comfort them, or efforts to awaken them. Waking these children during an episode can be quite challenging. These episodes typically last for about 10 to 20 minutes before the child suddenly goes back to sleep. Many children do not remember the episodes. | Episodes may seem quite intense, with the child screaming and thrashing without being aware of their surroundings. Children may exhibit symptoms of heightened autonomic activity, including rapid heart rate, rapid breathing, dilated pupils, and excessive perspiration. In certain instances, enuresis may also manifest.It is common for children to not respond to verbal cues, attempts to comfort them, or efforts to awaken them. Waking these children during an episode can be quite challenging. These episodes typically last for about 10 to 20 minutes before the child suddenly goes back to sleep. Many children do not remember the episodes. | ||
- | ===== Etiology | + | === Etiology === |
The precise cause is uncertain, however there are significant associations with fever and illness, extreme physical exertion, excessive use of coffee or alcohol, sleep deprivation and fatigue, and emotional strain. | The precise cause is uncertain, however there are significant associations with fever and illness, extreme physical exertion, excessive use of coffee or alcohol, sleep deprivation and fatigue, and emotional strain. | ||
=== Epidemiology === | === Epidemiology === | ||
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=== Management === | === Management === | ||
- | Comforting the child is the primary approach for addressing night terrors, as there is no targeted treatment available. | + | * Sleep studies are not usually necessary as night terrors generally have a positive outlook and resolve on their own. |
- | + | * Comforting the child is the primary approach for addressing night terrors, as there is no targeted treatment available. | |
- | If a child is experiencing high levels of stress or conflict, a combination of therapy and coping techniques can be suggested to help reduce the frequency of episodes. Medications are not necessary and avoiding their use is highly recommended.Clonazepam may be considered on a short-term basis at bedtime if sleep terrors are frequent and severe or are associated with functional impairment, such as fatigue, daytime sleepiness, and distress[(: | + | * Provide |
- | )].There are also sporadic case reports of melatonin use in night terrors[(: | + | |
- | + | * Medications are not necessary and avoiding their use is highly recommended. | |
- | It is uncommon for a sleep study to be necessary as night terrors generally have a positive outlook and resolve on their own. Nonetheless, | + | * Clonazepam may be considered on a short-term basis at bedtime if sleep terrors are frequent and severe or are associated with functional impairment, such as fatigue, daytime sleepiness, and distress[(: |
+ | * Anticipatory awakening, performed approximately half an hour before the child is most likely to experience a sleep terror episode, is often effective for the treatment of frequently occurring sleep terrors. | ||
+ | * L-5 Hydroxy Tryptophan (L -5-HTP) administered (2 mg/kg per day) at bedtime has been reported to modulate the arousal level in children and to induce a long-term improvement of sleep terrors[(: | ||
+ | )]. | ||
+ | * There are also sporadic case reports of melatonin use in night terrors[(: | ||
+ | | ||
=== Differential Diagnosis === | === Differential Diagnosis === | ||
- | + | The differential diagnosis for night terrors can include: | |
- | The differential diagnosis for night terrors can include | + | |
* Seizures. Patients with nocturnal frontal lobe epilepsy can present in a similar fashion. | * Seizures. Patients with nocturnal frontal lobe epilepsy can present in a similar fashion. | ||
* Somnambulism (also known as sleepwalking): | * Somnambulism (also known as sleepwalking): | ||
* Nightmares: A disorder that occurs during REM stage of sleep that is characterized extreme fear, horror, distress or anxiety | * Nightmares: A disorder that occurs during REM stage of sleep that is characterized extreme fear, horror, distress or anxiety | ||
- | * Narcolepsy: An adolescent age chronic sleep disorder consisting of excessive daytime drowsiness | + | * [[Narcolepsy]]: An adolescent age chronic sleep disorder consisting of excessive daytime drowsiness |
* Sleep Apnea Hypersomnia: | * Sleep Apnea Hypersomnia: | ||
- | * Breath-holding spells: These occur most often between the ages of six to eighteen months in which some irritating stimuli trigger a voluntary episode of apnea or alteration in consciousness. It is not uncommon for these children to become cyanotic during the episodes. | + | * [[Breath-holding spells]]: These occur most often between the ages of six to eighteen months in which some irritating stimuli trigger a voluntary episode of apnea or alteration in consciousness. It is not uncommon for these children to become cyanotic during the episodes. |
* Syncope | * Syncope | ||
- | * Benign sleep myoclonus: A self-limited episode of sudden jerking of the extremities in the early stages of sleep | + | * [[Benign sleep myoclonus]]: A self-limited episode of sudden jerking of the extremities in the early stages of sleep |
- | * Shuddering attacks: A whole body attacks that resemble an essential tremor | + | * [[Shuddering attacks]]: A whole body attacks that resemble an essential tremor |
* Gastroesophageal reflux: An arching or dystonic posturing (Sandifer' | * Gastroesophageal reflux: An arching or dystonic posturing (Sandifer' | ||
- | * Psychogenic Nonepileptic Seizures (PNES) | + | * [[Psychogenic Nonepileptic Seizures]] (PNES) |
=== References === | === References === | ||