The pavor nocturnus or night terror is a frightening experience that occurs during sleep and, unlike a nightmare, has nothing to do with dreams. The person involved has sunk into a deep phase 4 sleep from which he suddenly awakens in great dismay, which is often accompanied by screaming, crying, rapid breathing and sweating. He can actively resist attempts at calming others by kicking and hitting as if to ward off an imaginary evil.
Usually he does not wake up fully, but sets sail again without remembering anything about the episode the next morning. If you do wake up during pavor nocturnus, you will feel confused and disoriented.
A pavor nocturnus will mainly occur at the beginning of the night, when one sleeps the deepest. Usually there is no connection with any dream content or nightmare. This phenomenon occurs most often in children: 6% of all children suffer from it at some point, compared to less than 1% of adults. The problem usually begins between the ages of four and 12 and resolves itself during adolescence.
Diagnosis according to DSM IV
- According to the diagnostic manual, you have a real problem with pavor nocturnus if the following occurs:
- It often happens that you suddenly wake up with a scream and various signs of extreme anxiety (such as a racing pulse, wheezing and sweating).
- Unlike nightmares, you don’t remember a bad dream when you wake up and you forget the incident the next morning.
- You (or your family) find these episodes so distressing that you seek professional help.
Sleepwalking
Sleepwalking involves repetitive episodes, usually lasting a few minutes to half an hour, in which the person concerned walks around while asleep, sits down, talks or eats something. A sleepwalker appears to be unaware of his surroundings, has an infinity view and does not respond to attempts by others to wake him. This may involve getting out of bed, going downstairs, eating something, visiting the toilet or even leaving the house.
The patient’s speech is poorly articulated and difficult to understand. Although only simple actions are usually performed during sleepwalking, complex activities such as driving a car or operating machinery are sometimes also performed.
Strange things sometimes happen: for example, people pee in the kitchen or crawl into someone else’s bed. Sometimes the sleepwalker may give the impression of running away from something, as if fleeing an approaching danger. If he is woken up (which is extremely difficult), he loses his mind for a moment and then returns to a normal waking state. When he then goes back to bed and continues to sleep, he sometimes remembers nothing about what happened in the morning.
This can be annoying if you wake up somewhere other than where you originally went to sleep, and you have no idea how or why you got there. Sleepwalking usually occurs in stage 3 or REM sleep, usually early in the night. Such episodes can be triggered by alcohol or substance use in a predisposed person.
Sleepwalking is common in childhood: 20 to 30% of children have sleepwalked at least once. But it is more common in just under 5%. It normally starts between the ages of four and eight and disappears on its own during adolescence. A child who sleepwalks often does not want to stay with friends or go to camp out of embarrassment about this problem.
