Sleep Terror Disorder

The essential feature of Sleep Terror Disorder is the repeated occurrence of sleep terrors, that is, abrupt awakenings from sleep usually beginning with a panicky scream or cry.

Sleep terrors usually begin during the first third of the major sleep episode and last 1–10 minutes. The episodes are accompanied by autonomic arousal and behavioral manifestations of intense fear.

During an episode, the individual is difficult to awaken or comfort.

If the individual awakens after the sleep terror, no dream is recalled, or only fragmentary, single images are recalled. On awakening the following morning, the individual has amnesia for the event.

The sleep terror episodes must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Sleep Terror Disorder should not be diagnosed if the recurrent events are due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

During a Typical Episode

Sleep terrors are also called "night terrors" or pavor nocturnus. During a typical episode, the individual abruptly sits up in bed screaming or crying, with a frightened expression and autonomic signs of intense anxiety (e.g., tachycardia, rapid breathing, flushing of the skin, sweating, dilation of the pupils, increased muscle tone). The individual is usually unresponsive to the efforts of others to awaken or comfort him or her. If awakened, the person is confused and disoriented for several minutes and recounts a vague sense of terror, usually without dream content.

Although fragmentary vivid dream images may occur, a storylike dream sequence (as in nightmares) is not reported. Most commonly, the individual does not awaken fully, but returns to sleep, and has amnesia for the episode on awakening the next morning. Some individuals may vaguely recall having an "episode" during the previous night, but do not have detailed recall. Usually only one episode will occur on any one night, although occasionally several episodes may occur at intervals throughout the night.

Diagnostic criteria summarized from:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.