Sleep Terrors Medication
- Author: Eve G Spratt, MD, MSc; Chief Editor: Caroly Pataki, MD more...
Medications rarely are indicated for sleep terrors and usually provide no long-term help to patients. They should be prescribed only for severe symptoms that affect waking behavior (eg, school performance and peer or family relations) and only after behavioral interventions have failed. Pharmacologic therapy should be administered only as a temporary measure.
Tricyclic antidepressants decrease deep delta sleep and arousal between sleep stages.
In limited studies, imipramine has stopped the disorder when administered at bedtime for 8 weeks.
Amitriptyline has been effective in the treatment of REM sleep disorder behaviors.
Some studies suggest that long-term management with low dose clonazepam is effective for adults with severe sleep terrors involving violence or self-injurious behaviors.[25, 26]
Long-acting benzodiazepine that increases the presynaptic GABA inhibition and reduces the monosynaptic and polysynaptic reflexes. It has been used off-label for REM and nonREM sleep behavior disorders.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association; 2000.
Fialho LM, Pinho RS, Lin J, et al. Sleep terrors antecedent is common in adolescents with migraine. Arq Neuropsiquiatr. 2013 Feb. 71(2):83-6. [Medline].
Bruni O, Ferri R, Miano S, Verrillo E. L -5-Hydroxytryptophan treatment of sleep terrors in children. Eur J Pediatr. 2004 Jul. 163(7):402-7. [Medline].
Nguyen BH, Perusse D, Paquet J, et al. Sleep terrors in children: a prospective study of twins. Pediatrics. 2008. 122(6):e1164-e1167.
Hublin C, Kaprio J. Genetic aspects and genetic epidemiology of parasomnias. Sleep Medicine Reviews. 2003. 7(5):413-421.
Lecendreux M, Mayer G, Bassetti C, et al. HLA association in sleepwalking. Mol Psychiatry. 2003. 8:114-7.
Bisulli F, Vignatelli L, Naldi I, et al. Increased frequency of arousal parasomnias in families with nocturnal frontal lobe epilepsy: A common mechanism?. Epilepsia. 2010. 51(9):1852-1860.
Petit D, Pennestri MH, Paquet J, Desautels A, Zadra A, Vitaro F, et al. Childhood Sleepwalking and Sleep Terrors: A Longitudinal Study of Prevalence and Familial Aggregation. JAMA Pediatr. 2015 Jul. 169 (7):653-8. [Medline].
Guilleminault C, Palombini L, Pelayo R, Chervin RD. Sleepwalking and sleep terrors in prepubertal children: what triggers them?. Pediatrics. 2003 Jan. 111(1):e17-25. [Medline].
Mindell JA & Owens JA. A Clinical Guide to Pediatric Sleep: Diagnosis and Management ofSleep Problems. Philadelphia: Lippincott Williams & Wilkins; 2003.
Pressman, M. Factors that predispose, prime and precipitate NREM parasomnias in adults: clinical and forensic implications. Sleep Med. Rev. 2007. 11:5-30.
DiMario FJ Jr, Emery ES 3rd. The natural history of night terrors. Clin Pediatr (Phila). 1987 Oct. 26(10):505-11. [Medline].
Ohayon MM, Guilleminault C, Priest RG. Night terrors, sleepwalking, and confusional arousals in the general population: their frequency and relationship to other sleep and mental disorders. J Clin Psychiatry. Apr 1999. 60(4):268-76.
Thünker J, Pietrowsky R. Effectiveness of a manualized imagery rehearsal therapy for patients suffering from nightmare disorders with and without a comorbidity of depression or PTSD. Behav Res Ther. 2012 Sep. 50(9):558-64. [Medline].
Pressman MR. Disorders of arousal from sleep and violent behavior: the role of physical contact and proximity. SLEEP. 2007. 30(8):1039-1047.
[Guideline] Paruthi S, Brooks LJ, D'Ambrosio C, Hall W, Kotagal S, Lloyd RM, et al. Recommended Amount of Sleep for Pediatric Populations: A Statement of the American Academy of Sleep Medicine. J Clin Sleep Med. 2016 May 25. [Medline]. [Full Text].
Carter KA, Hathaway NE, Lettieri CF. Common sleep disorders in children. Am Fam Physician. 2014 Mar 1. 89 (5):368-77. [Medline].
Moore M, Allison A, and Rosen CL. A review of pediatric nonrespiratory sleep disorders. Chest. 2006. 130(4):1252-1262.
Cornaggia CM, Beghi M, Giovannini S, Boni A, Gobbi G. Partial seizures with affective semiology versus pavor nocturnus. Epileptic Disord. 2010 Mar. 12 (1):65-8. [Medline].
Weber P, Jüngling F, Datta AN. Differential diagnoses of nocturnal fear and movement paroxysm: a case report. Eur J Pediatr. 2012 Sep. 171 (9):1309-15. [Medline].
Williams SG, Correa D, Lesage S, Lettieri C. Electroencephalographic hypersynchrony in a child with night terrors. Sleep Breath. 2013 May. 17 (2):465-7. [Medline].
Frank NC, Spirito A, Stark L, and Owens-Stively A. The use of scheduled awakenings to eliminate childhood sleep walking. Journal of Pediatric Psychology. 1997. 22:345-353.
Lask B. Novel and non-toxic treatment for night terrors. BMJ. 1988 Sep 3. 297 (6648):592. [Medline].
Ferri R, Zucconi M, Marelli S, Plazzi G, Schenck CH, Ferini-Strambi L. Effects of long-term use of clonazepam on nonrapid eye movement sleep patterns in rapid eye movement sleep behavior disorder. Sleep Med. 2013 May. 14 (5):399-406. [Medline].
Schenck CH, Mahowald MW. Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults. Am J Med. 1996 Mar. 100 (3):333-7. [Medline].