When night terrors occur in adulthood

4 a.m. Anna* wakes up in a place that seems unknown to her. She feels a presence and screams. The seconds, or perhaps the minutes, go by. After this moment, the outline of the obscure shapes around her becomes clearer. Her heart rate goes down, and she understands that all this time, she was in the comfort of her room. “I hadn’t realised where I was. As if, once awake, my nightmare continued.”

This is not the first time that the thirty-year-old has experienced an episode of “night terror”, a phenomenon that is well known among children, but less documented in adults, who are also concerned. Geoffroy Solelhac is a doctor working with the Center for Investigation and Research on Sleep at CHUV and confirms: “In my consultation, I often see young adults. In some cases, night terrors persist after childhood.”

Night terrors are part of parasomnias, or behavioural disorders during sleep. In this category, we find sleepwalking or even sleep paralysis. "A person affected by night terrors may suffer from other parasomnias," explains Geoffroy Solelhac.

The forms that this type of terror can take vary from one person to another. Barbara, also in her thirties, explains living with them for about ten years. For her, it’s always the same scenario: she wakes up in a state of anguish and thinks she sees, in the back of the room, a man’s silhouette. “It’s not easy to talk about it to my surroundings. People don’t understand, or sometimes think that I have a problem. It is quite something to wake up screaming at the top of your lungs. I was even told that I happened to speak in this state of awakening, although I am not conscious.”

Different from a nightmare

The confusion between nightmare and night terror is common, but it is misleading. “You can remember a nightmare. You are conscious and oriented when awakening, says Geoffroy Solelhac. During a nocturnal terror, the person is in a state between waking and sleeping. (S)he experiences a scene of anguish, sometimes extreme, without being able to control it. (S)he can feel intense fear, have visual hallucinations, like a falling ceiling or insects. Often, (s)he doesn’t keep any clear memory of the episode.”

Anna has already experienced a particularly memorable scene: “I was sleeping at my in-law’s with my partner, when I woke up screaming, without managing to understand where I was. The next day, I was embarrassed, I didn’t know how to explain my screams.”

There is a genetic predisposition that explains night terrors. "We see cases of parasomnia in brothers, sisters, or parents, but we have not found the responsible gene," comments Geoffroy Solelhac. Beyond the innate factors, the environment in which the person suffering from this kind of parasomnia finds themselves plays a role, insists the specialist. “The life context matters, if the individual is stressed, anxious, if (s)he lacks sleep or has to sleep in an environment that is noisy or too hot: all this promotes the occurrence of night terrors”.

A precise analysis thanks to polysomnography 

The detection of night terrors is primarily based on a clinical evaluation. In rare cases, a polysomnography – a complete recording of sleep – can be performed at the hospital or at home to refine the analysis. The care, however, relies mainly on non-medicinal approaches. "Today, we prefer alternative therapies, such as medical hypnosis or therapeutic education, which have shown promising results in the parasomnia of non-REM sleep," explains the doctor.

When night terrors are accompanied by somnambulism, there are certain risks. “The person may suddenly stand up, bump into furniture, or open a window, which exposes them to accidental injuries.” However, night terrors are not worrying in themselves. “Nothing proves that there is a direct link between the parasomnias and possible psychiatric or neurological disorders, reassures the specialist. If it disrupts sleep or leads to severe fatigue, it is important to consult a doctor. Otherwise, if the person lives their situation well, there is no need to worry.”

For Anna, addressing the issue with a specialist helped her. “Talking about night terrors to my psychologist allowed me to break a certain isolation. When they happen frequently, I now know that it reflects a more anxious period for me.” Her testimony echoes what the specialist on the ground observed. “It is true that night terrors affect many young adults. They are often more intense at a time of transition, such as during a new job, a break-up, or an exam period.”

*Pseudonym