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Sleep Disorder: Night Terrors: Treatment & Medication

Author: Kevin P Connelly, DO, Clinical Assistant Professor, Department of Pediatrics, Division of General Pediatrics and Emergency Care, Virginia Commonwealth University; Medical Director, Paws for Health Pet Visitation Program
Contributor Information and Disclosures

Updated: Feb 25, 2008

Treatment

Medical Care

  • Management consists of educating the family about the disorder and reassuring them that episodes are not harmful. See Patient Education for more information on this subject.

Medication

Medications rarely are indicated and usually provide no long-term help to patients. Prescribe medications only for severe symptoms that affect waking behavior such as school performance and peer or family relations. Administer medications only as a temporary treatment.

Tricyclic antidepressants

These agents decrease deep delta sleep and arousal between sleep stages.


Imipramine (Janimine, Tofranil, Tofranil-PM)

Stopped disorder in limited studies when administered at bedtime for 8 wk.

Adult

Pediatric

<6 years: Not established
>6 years: 25-50 mg PO qhs; not to exceed 8 wk

Possible added effects when coadministered with other CNS depressants; not for concomitant use with MAOIs; increases toxicity of sympathomimetic agents such as isoproterenol and epinephrine by potentiating effects and inhibiting antihypertensive effects of clonidine

Documented hypersensitivity; ECG changes reported in children receiving twice recommended maximum daily dose; hypersensitivity to sulfites, in formulations containing sulfites; do not use in patients taking MAOIs or fluoxetine or in patients who used these drugs in the previous 2 wk

Pregnancy

D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus

Precautions

May mask symptoms rather than treat disease; tolerance occurs frequently; possible rebound effect upon discontinuation, with worsening of episodes; reports of sudden death in small number of children; possible stomach upset; administer with food
Caution with urinary retention, angle-closure glaucoma, hyperthyroidism, or other conditions in which anticholinergic activity aggravates condition; caution with seizure disorders; eliminate possibility of underlying cardiac disease based on ECG and physician's judgment

More on Sleep Disorder: Night Terrors

Overview: Sleep Disorder: Night Terrors
Differential Diagnoses & Workup: Sleep Disorder: Night Terrors
Treatment & Medication: Sleep Disorder: Night Terrors
Follow-up: Sleep Disorder: Night Terrors
References
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References

  1. DiMario FJ Jr, Emery ES 3d. The natural history of night terrors. Clin Pediatr (Phila). Oct 1987;26(10):505-11. [Medline].

  2. Dahl RE. The pharmacologic treatment of sleep disorders. Psychiatr Clin North Am. Mar 1992;15(1):161-78. [Medline].

  3. Guilleminault C, Palombini L, Pelayo R, Chervin RD. Sleepwalking and sleep terrors in prepubertal children: what triggers them?. Pediatrics. Jan 2003;111(1):e17-25. [Medline].

  4. Pesikoff RB, Davis PC. Treatment of pavor nocturnus and somnambulism in children. Am J Psychiatry. Dec 1971;128(6):778-81. [Medline].

  5. Siegel JM. Why we sleep. Sci Am. Nov 2003;289(5):92-7. [Medline].

  6. Wise MS. Parasomnias in children. Pediatr Ann. Jul 1997;26(7):427-33. [Medline].

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Further Reading

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Keywords

night terrors, night-terrors, sleep terrors, night frights, parasomnia, pavor nocturnus, autonomic arousal, sleep disruption, rapid eye movement, REM, nonrapid eye movement, non-REM, tachycardia, diaphoresis, disrupted sleep pattern, night terror disorder, sleep deprivation

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Contributor Information and Disclosures

Author

Kevin P Connelly, DO, Clinical Assistant Professor, Department of Pediatrics, Division of General Pediatrics and Emergency Care, Virginia Commonwealth University; Medical Director, Paws for Health Pet Visitation Program
Kevin P Connelly, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Osteopathic Pediatricians, and American Osteopathic Association
Disclosure: Nothing to disclose.

Medical Editor

Chet Johnson, MD, Medical Director, Child Development Unit, Department of Pediatrics, Professor, University of Kansas Medical Center
Chet Johnson, MD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

CME Editor

Carrie Sylvester, MD, MPH, Director of Education in Child and Adolescent Psychiatry, Professor, Departments of Psychiatry and Pediatrics, Northwestern University Medical School
Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Medical Women's Association, American Psychiatric Association, and American Society for Adolescent Psychiatry
Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD, Professor of Clinical Psychiatry, Department of Psychiatry and Biobehavioral Sciences, Division Chair of Child and Adolescent Psychiatry, Director of Training, Child and Adolescent Psychiatry Residency Program, University of Southern California Keck School of Medicine
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
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