Pavor Nocturnus

Pavor nocturnus is also known as night terrors, is a sleep disorder involving abrupt awakening from sleep in a terrified state.

It occurs approximately 90 minutes after sleep during stage 3 or 4 NREM sleep.

Pavor nocturnus usually occur in children three to eight years of age. They need to be distinguished from nightmares. They are more likely to happen during times of stress or weariness.

As frightening as they are, parents and children generally only need to be reassured that they are normally self-limiting. Attempts should be made to lessen whatever stress may be going on in the child's environment and to ensure that the child is getting enough rest.

In children for whom pavor nocturnus are not self-limiting or are especially troublesome, diazepam (Valium) has been used with some success.

Causes Of Pavor Nocturnus

The normal sleep cycle involves different stages from light drowsiness to deep sleep. During REM (rapid eye movement) sleep, the eyes move rapidly and vibrant dreaming is most common. Each night there are several cycles of non-REM and REM sleep.

Pavor nocturnus (night terror) occurs during Stage 3 and Stage 4 sleep (deep sleep). The cause is unknown but Pavor nocturnus are commonly related with periods of emotional tension, stress, or argument.

Pavor nocturnus is similar to nightmares except that nightmares usually occur during REM sleep and include horrible or frightening dreams. Nightmares are most common in the early morning.

Pavor nocturnus happen usually in the first half of the night heralded by a shout. The child does not usually remember the details of the fright. Nightmares are normal on occasion, especially after frightening movies/TV shows or emotional situations.

Pavor nocturnus happens most often in preadolescent boys, although it can happen in girls and in adults. It is quite common in children 3 to 5 years old, and much less common after that. Pavor nocturnus may run in families. It can happen in adults, especially with emotional worry and/or the use of alcohol.

Symptoms Of Pavor Nocturnus

• Constant fear or terror that occurs at night
• Sweating
• Shouting at night
• Fast heart rate
• Unable to explain what happened
• Abrupt awakening from sleep
• Unable to fully wakeup
• Confusion
• May have a unclear sense of frightening images
• Difficult to relieve
• No memory of the event on awakening the next day

Events are most common in the first third of the night. They may last 10 to 20 minutes, then normal sleep returns.

Pavor Nocturnus Treatment

In many cases, ease and encouragement are the only treatment required. Psychotherapy or counseling may be suitable in some cases.

Benzodiazepine medications (such as diazepam) used at bedtime will often reduce the occurrence of pavor nocturnus; however, medication is not generally suggested to treat this disorder.

A safe over-the-counter drug, Benadryl elixir (diphenhydramine), given 1 hour before bedtime may reduce the occurrence of pavor nocturnus.