Sleep terror disorder: a case report

Guzman, Carlos Simón; Wang, Yuan‐Pang

doi:10.1590/s1516-44462008000200016

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…Psychological factors are not frequent in children with sleep terrors but are common in adults with this disorder [ 1 , 2 ]. There is an association between psychiatric disorders and sleep terrors in youths and adults, but not in young children [ 21 , 22 , 25 , 48 , 52 , 53 ]. Very rarely, a thalamic lesion, disrupting the arousal system, may provoke sleep terrors [ 54 ].…”

Section: Etiologymentioning

confidence: 99%

“…For sporadic sleep terrors, reassurance that the child will outgrow the disorder will often allay parental anxiety [ 11 , 17 , 22 , 25 ]. Parental education and support cannot be over-emphasized.…”

Section: Managementmentioning

confidence: 99%

“…Melatonin (N-acetyl-5-methoxytryptamine) has also been found to be useful [ 17 , 76 , 80 - 82 ]. Tricyclic antidepressants (such as imipramine, amitriptyline), selective serotonin reuptake inhibitors (such as paroxetine, fluoxetine), mirtazapine, and ramelteon have also been used for the treatment of sleep terrors with varying success [ 25 , 57 , 65 , 83 - 88 ]. 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 [ 9 , 22 , 42 , 57 , 65 , 76 ].…”

Section: Managementmentioning

confidence: 99%

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Sleep Terrors: An Updated Review

Leung

Wong

et al. 2020

CPR

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Background: Sleep terrors are common, frightening, but fortunately benign events. Familiarity with this condition is important so that an accurate diagnosis can be made. Objective: : To familiarize physicians with the clinical manifestations, diagnosis, and management of children with sleep terrors. Methods: A PubMed search was completed in Clinical Queries using the key terms " sleep terrors" OR " night terrors". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article. Results: It is estimated that sleep terrors occur in 1 to 6.5% of children 1 to 12 years of age. Sleep terrors typically occur in children between 4 and 12 years of age, with a peak between 5 and 7 years of age. The exact etiology is not known. Developmental, environmental, organic, psychological, and genetic factors have been identified as a potential cause of sleep terrors. Sleep terrors tend to occur within the first three hours of the major sleep episode, during arousal from stage three or four non-rapid eye movement (NREM) sleep. In a typical attack, the child awakens abruptly from sleep, sits upright in bed or jumps out of bed, screams in terror and intense fear, is panicky, and has a frightened expression. The child is confused and incoherent: verbalization is generally present but disorganized. Autonomic hyperactivity is manifested by tachycardia, tachypnea, diaphoresis, flushed face, dilated pupils, agitation, tremulousness, and increased muscle tone. The child is difficult to arouse and console and may express feelings of anxiety or doom. In the majority of cases, the patient does not awaken fully and settles back to quiet and deep sleep. There is retrograde amnesia for the attack the following morning. Attempts to interrupt a sleep terror episode should be avoided. As sleep deprivation can predispose to sleep terrors, it is important that the child has good sleep hygiene and an appropriate sleeping environment. Medical intervention is usually not necessary, but 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. Conclusion: Most children outgrow the disorder by late adolescence. In the majority of cases, there is no specific treatment other than reassurance and parental education. Underlying conditions, however, should be treated if possible and precipitating factors should be avoided.

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Section: Etiologymentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

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Sleep Terrors: An Updated Review

Leung

Wong

et al. 2020

CPR

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Childhood Sleep Terror and Mirtazapine

Hoşoğlu

Hergüner

2016

Journal of Child and Adolescent Psychopharmacology

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S leep terror (ST) is defined as a partial arousal disorder, which usually occurs during the first third of the sleep. It is characterized by intense fear, motor agitation, screaming, and prominent autonomic activity (e.g., mydriasis, tachycardia, and tachypnea). The child is typically unresponsive to the external stimulus during the attack and does not recall the episode in the morning. ST is reported to have a higher prevalence in childhood than in adulthood, affecting 3% of children. Although its etiology is mostly unknown, several factors such as sleep deprivation, fever, stress, and drugs (e.g., lithium) were described as triggers in susceptible individuals. Its management includes parental reassurance, psychoeducation, and behavioral interventions (e.g., scheduled awaking). However, pharmacotherapy may be necessary in some cases (e.g., when the child has high risk of injury or frequent night terror) (Howell 2012).In this report, we present a pediatric case with ST successfully treated with mirtazapine. CaseA 7-year-old boy was admitted to the child and adolescent psychiatry out-patient clinic with complaints of vomiting and night-time awakenings. According to his parents, 1-2 hours after falling asleep, he was screaming, crying agitatedly, vomiting, and sweating profusely. He appeared frightened and unresponsive to his parents' attempts to communicate. All these were continuing for nearly 5 minutes and then he fell asleep. In the morning he had no memory of this experience. Parents reported that these episodes had started 5 months ago and were evident nearly every night.His other complaint was vomiting during daytime that was generally induced by a stressor (e.g., going to school) and occurred usually in the morning for nearly every day. His vomiting episodes started when he was 4 years old and affected his daily functioning negatively.Neurology and gastroenterology consultations were requested to rule out organic causes for his night-time awakenings and vomiting. His neurological examination and extensive work-up were normal. He was diagnosed as having ST and functional vomiting, and we decided to initiate mirtazapine 15 mg/day treatment. On his second visit 1 month later, his complaints of ST and vomiting improved completely. During a 6-month follow-up, he had only two episodes of ST and no episode of vomiting. No adverse effect of mirtazapine was reported during this period.

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Comments on "sleep terror disorder: a case report"

Borgio

Pradella-Hallinan

2009

Rev. Bras. Psiquiatr.

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Sleep terror disorder: a case report

Cited by 4 publications

References 5 publications

Sleep Terrors: An Updated Review

Sleep Terrors: An Updated Review

Childhood Sleep Terror and Mirtazapine

Comments on "sleep terror disorder: a case report"

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