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Night Terrors, Sleep Talking, and Other Odd Nighttime Events

Unusual events occur sometimes at night. These events are intriguing, sometimes funny and other times scary. They are mostly harmless and weird phenomena that we understand only partially and study them, as they represent some kind of a naturally occurring experiment that can teach us a lot.

Night terrors, Sleep talking and Sleep walking are all events that originate in DEEP SLEEP, mostly during the first third of the night. They are frequent during childhood and usually their prevalence decreases with age, although a small percentage of adults experience this kind of events. It appears that there is a genetic component to these phenomena. There is no underlying basic disorder and usually no treatment is needed, unless they are very frequent and interfere with the night routine of those sleeping in the same room, house, or environment. The only reason to perform a sleep test may be to rule out epileptic seizures during the night. The sleep environment has to be proofed so the person who has such an episode does not get hurt.

Night terror is frequent in children; they start screaming, crying, being terribly agitated and frightened, they are disconnected from the environment, inconsolable, and any trial to wake them or to comfort them makes things worse. There is no memory to the event, no sleep disruption, and when they are awake at the end of an episode there is no report of any dreamlike content. Sleep talking and quiet to agitated

Sleep walking is an additional spectrum of disorders arising from DEEP Sleep in the first third of the night. There is talking and complex motor behavior from quiet to very agitated, and rarely a person can leave the house during an episode. There is no memory of the event in the morning and no sleep disruption. Treatment is not needed if the episodes are not frequent, but the sleep environment has to be safe. The episodes start in late childhood and usually fade out in the late teens, though for some they persist into adulthood.

Nightmares are just bad dreams; usually they occur during the last part of the night, and upon awakening from the episode there is a report of a frightening dream.

Sleep paralysis occurs when someone wakes up suddenly from REM sleep, but is unable to move because the REM related muscle inhibition is still on. It may be frightening, it is harmless, may be sporadic or recurring in family clusters. Sometimes it is an isolated phenomenon, and other times it occurs as one of the symptoms of Narcolepsy.

REM behavioral disorder presents with agitated motor activity that appears during REM sleep, activity can cause injury to the patient or to the bed partner. It appears when the muscle inactivation during REM is lost, and people behave violently during sleep. A sleep study can easily diagnose the disorder. It usually originates in neurological brain problem, sometimes preceding Parkinson’s disease by many years.