Further Outpatient Care
Routine follow-up and developmental assessment is indicated for all children, including those affected by sleep terrors.
Continued support and reassurance can be helpful for affected families. Surveillance for deviation from classic sleep terror characteristics or increasing severity of behavior during episodes may prompt reconsideration of the diagnosis or increased protective interventions.
Efforts during an episode should focus on protecting the individual from harming self or others. These efforts can be supported by removing hazardous objects from the sleep area, securing windows, and impeding exit from the sleep area. Affected children are typically resistant to interference in the midst of a sleep terror event, but patient surveillance to avert injury as permitted may be all that is required. When the episode has terminated, parents should assist the child back to bed. Discussion of the event immediately or the following day is usually not helpful as the experience is either not remembered or only vaguely recalled.
Scheduled awakenings is a process proposed to help reduce sleep terror occurrences.[12]
Prognosis
Most children with sleep terrors experience resolution before adolescence. No increased occurrence of psychiatric diagnoses is found in children. Adults who experience sleep terrors have an increased occurrence of other psychiatric conditions, particularly posttraumatic stress disorder, generalized anxiety, and dependent, schizoid, and borderline personality disorders.[6, 13]
Patient Education
Families and individuals must understand that sleep terrors are fundamentally benign, self-limited events. Safety measures including sleep environment modification to afford increased patient protection, securing windows and assuring limitation of access to potentially harmful situations.
Because the affected individual is generally unresponsive to outside interventions, aggressive attempts to intervene should be discouraged. Improvement of sleep hygiene and avoidance of potential triggers may reduce the frequency or severity of events.[9]
For excellent patient education resources, visit eMedicine's Sleep Disorders Center. Also, see eMedicine's patient education articles Night Terrors, Disorders That Disrupt Sleep (Parasomnias), and REM Sleep Behavior Disorder.
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