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Night terrors occur in NREM-3. Nightmares are unpleasant dreams that one can remember when woken while sleep terrors involve feelings of intense fear, screaming, and thrashing during sleep

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Not as many people have experienced sleep terrors, but about 10 percent will have one in their lifetime. Sleep terrors tend to affect kids more than adults, according to The Mayo Clinic. Almost 40 percent of children will experience sleep terrors, but most outgrow them by their teen years.

According to the Mayo Clinic, a few things can trigger sleep terrors including sleep deprivation, stress, fevers, and changes in sleep schedule (like travel or jet lag). Sleep apnea, restless leg syndrome, and alcohol use can also increase the likelihood of sleep terrors.

Sleep terrors are more common in people with mood or anxiety disorders, including PTSD. They're also more prevalent in people who sleep walk and/or talk. This is because sleep terrors, sleep walking, and sleep talking are thought to have similar underlying mechanisms in the brain during sleep; they also tend to occur during the same stages of sleep.

There are a few ways you can try to prevent nightmares and night terrors.

For mild cases of nightmares, I recommend something called image rehearsal therapy. It works by desensitizing the nightmare so it's less scary. During the day, write out your nightmare, remembering the early details. But near the end of the story, during the most frightening part, create a non-scary ending. Now you have a story that starts out like your nightmare, but has a safe ending. Visualize this story a few times a day. When the story appears in your nightmare, the ending should change to be more like the one you've created. This may extinguish the nightmare over time.

Sleep terrors are treated differently. I recommend mapping the timing of sleep terrors and setting an alarm before they strike. Part of this rests on your bed partner, because they're the ones that know when your sleep terrors happen. Ask them to keep track of the time of events so you know when to set the alarm. Wake up with the alarm and go back to sleep. In some cases, I'll have a patient do an overnight study in a sleep lab, where your behavior will be videotaped and your brain waves, breathing, and heart rate will be monitored.

In more serious cases, sleep terrors can include getting out of bed (sleep walking), which can lead to physically harming yourself. If you're having a combination of sleep walking and sleep terrors, it's most definitely time to see your doctor. They will give you additional advice to make the bedroom safe, like sleeping on the floor, using a sleeping bag, or setting alarms on doors and exits.

Remember that someone having a sleep terror may not be reassured by another's presence. So don't confront someone having a sleep terror, as they could get violent. Once a sleep terror starts, there isn't much you can do to stop it. Instead, clearing the environment of dangerous objects is the best you can do until it's over.

If you're experiencing frequent, troublesome nightmares, or you're just not feeling like you're getting restful sleep, it may be time to see a sleep doctor.

Even though nightmares are common, it's time to see a doctor when they start to affect you during the day. Are you feeling sleepy during the day because the nightmares are keeping you up, or because you're avoiding sleep due to bad dreams? Are you having a hard time focusing at work? Then, yes, it's time to see your doctor.

Using how you feel during the day as a signal to see your doctor works for sleep terrors too, especially because you won't always know that you've had one. If you're sleepy during the day, unfocused, or have trouble functioning normally, it's time to talk to your doc. You might also notice unexplained injuries or bruises from thrashing around during a sleep terror-another sign that you should see your doctor.

Serious cases of nightmare disorder, a type of parasomnia, require specialized help like cognitive behavioral therapy. Your doctor will work with you to tackle the source of the nightmares, including trauma, stress or anxiety, alcohol or drugs, or other underlying sleep disorders, according to the Mayo Clinic.

Sleep is one of the body's most important processes, and nightmares and sleep terrors can majorly mess it up. So if you're experiencing either and they aren't going away on their own, talk to your doctor. You won't be stuck in a cycle of bad dreams forever.
Nitun Verma, M.D. is a sleep medicine physician trained at Stanford University. He's a spokesperson for the American Academy of Sleep Medicine and practices at Crossover Health in the San Francisco Bay Area. Related: You May Also Like: 10 Ways You're Sabotaging Your Sleep Without Realizing It

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What's the Difference Between Nightmares and Sleep Terrors?

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Not as many people have experienced sleep terrors, but about 10 percent will have one in their lifetime. Sleep terrors tend to affect kids more than adults, according to The Mayo Clinic. Almost 40 percent of children will experience sleep terrors, but most outgrow them by their teen years.

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- medication
- hypnosis
- time
(all sources from the Mayo Clinic)

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Moving, talking, or getting out of bed while unconscious.
lasting 5-20 minutes.
repeating actions such as putting on pajamas or brushing teeth

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Sleepwalking occurs during deep sleep and causes the person to have repeated episodes of rising from bed during sleep and walking around. Sleepwalking episodes begin during any stage of NREM sleep, most commonly during slow wave sleep and therefore most often occurring during the first third of the night.

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Sleepwalking occurs during deep sleep and causes the person to have repeated episodes of rising from bed during sleep and walking around. Sleepwalking episodes begin during any stage of NREM sleep, most commonly during slow wave sleep and therefore most often occurring during the first third of the night.

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- Difficulty falling asleep or staying asleep
- Feeling sleep deprived
- Cannot focus
- Irritability, Anxiety

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This disorder can make it hard to fall asleep, hard to stay asleep or both, even though you have the chance for enough sleep. It can drain your energy.

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- Medication--sleep aid, perhaps for anxiety/depression.
- Behavioral therapy--can help overcome bedtime anxiety, just nightmares can't hurt a person.
- Hypnotherapy-can help overcome bedtime anxiety, just nightmares can't hurt a person.

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Sleepwalking is when you move unconsciously, usually lasting 5-20 minutes and easily being returned to bed. Happens mostly in smaller children and decreases as you grow older.

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Nightmare disorder happens in the REM stage of sleep while a night terror happens in Non-REM sleep. Nightmares are vividly remembered, but night terrors are harder to remember.

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- Major distress
- Enhanced anxiety
- Bedtime anxiety
- Persistent fear
- Problems with concentration and memory

Greatly impairs social, occupational, and bodily functions.

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- Prescription sleeping pills, such as Zaleplon
(Negative: Can be habit forming)
- Stimulus Control Therapy
- Changing sleep habits
(regular sleep time, relaxing activities like medication)
- Cognitive Behavioral Therapy

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Diagnosis

Depending on your situation, the diagnosis of insomnia and the search for its cause may include:

Physical exam. If the cause of insomnia is unknown, your doctor may do a physical exam to look for signs of medical problems that may be related to insomnia. Occasionally, a blood test may be done to check for thyroid problems or other conditions that may be associated with poor sleep.

Sleep habits review. In addition to asking you sleep-related questions, your doctor may have you complete a questionnaire to determine your sleep-wake pattern and your level of daytime sleepiness. You may also be asked to keep a sleep diary for a couple of weeks.

Sleep study. If the cause of your insomnia isn't clear, or you have signs of another sleep disorder, such as sleep apnea or restless legs syndrome, you may need to spend a night at a sleep center. Tests are done to monitor and record a variety of body activities while you sleep, including brain waves, breathing, heartbeat, eye movements and body movements.

Treatment

Changing your sleep habits and addressing any issues that may be associated with insomnia, such as stress, medical conditions or medications, can restore restful sleep for many people. If these measures don't work, your doctor may recommend cognitive behavioral therapy, medications or both, to help improve relaxation and sleep.

Cognitive behavioral therapy for insomnia

Cognitive behavioral therapy for insomnia (CBT-I) can help you control or eliminate negative thoughts and actions that keep you awake and is generally recommended as the first line of treatment for people with insomnia. Typically, CBT-I is equally or more effective than sleep medications.

The cognitive part of CBT-I teaches you to recognize and change beliefs that affect your ability to sleep. It can help you control or eliminate negative thoughts and worries that keep you awake. It may also involve eliminating the cycle that can develop where you worry so much about getting to sleep that you can't fall asleep.

The behavioral part of CBT-I helps you develop good sleep habits and avoid behaviors that keep you from sleeping well. Strategies include, for example:

Stimulus control therapy. This method helps remove factors that condition your mind to resist sleep. For example, you might be coached to set a consistent bedtime and wake time and avoid naps, use the bed only for sleep and sex, and leave the bedroom if you can't go to sleep within 20 minutes, only returning when you're sleepy.

Relaxation techniques. Progressive muscle relaxation, biofeedback and breathing exercises are ways to reduce anxiety at bedtime. Practicing these techniques can help you control your breathing, heart rate, muscle tension and mood so that you can relax.

Sleep restriction. This therapy decreases the time you spend in bed and avoids daytime naps, causing partial sleep deprivation, which makes you more tired the next night. Once your sleep has improved, your time in bed is gradually increased.

Remaining passively awake. Also called paradoxical intention, this therapy for learned insomnia is aimed at reducing the worry and anxiety about being able to get to sleep by getting in bed and trying to stay awake rather than expecting to fall asleep.

Light therapy. If you fall asleep too early and then awaken too early, you can use light to push back your internal clock. You can go outside during times of the year when it's light outside in the evenings, or you can use a light box. Talk to your doctor about recommendations.

Your doctor may recommend other strategies related to your lifestyle and sleep environment to help you develop habits that promote sound sleep and daytime alertness.

Prescription medications

Prescription sleeping pills can help you get to sleep, stay asleep or both. Doctors generally don't recommend relying on prescription sleeping pills for more than a few weeks, but several medications are approved for long-term use.

Examples include:

Eszopiclone (Lunesta)

Ramelteon (Rozerem)

Zaleplon (Sonata)

Zolpidem (Ambien, Edluar, Intermezzo, Zolpimist)

Prescription sleeping pills can have side effects, such as causing daytime grogginess and increasing the risk of falling, or they can be habit-forming, so talk to your doctor about these medications and other possible side effects.

Over-the-counter sleep aids

Nonprescription sleep medications contain antihistamines that can make you drowsy, but they're not intended for regular use. Talk to your doctor before you take these, as antihistamines may cause side effects, such as daytime sleepiness, dizziness, confusion, cognitive decline and difficulty urinating, which may be worse in older adults.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

No matter what your age, insomnia usually is treatable. The key often lies in changes to your routine during the day and when you go to bed. These tips may help.

Basic tips:

Stick to a sleep schedule. Keep your bedtime and wake time consistent from day to day, including on weekends.

Stay active. Regular activity helps promote a good night's sleep. Schedule exercise at least a few hours before bedtime and avoid stimulating activities before bedtime.

Check your medications. If you take medications regularly, check with your doctor to see if they may be contributing to your insomnia. Also check the labels of OTC products to see if they contain caffeine or other stimulants, such as pseudoephedrine.

Avoid or limit naps. Naps can make it harder to fall asleep at night. If you can't get by without one, try to limit a nap to no more than 30 minutes and don't nap after 3 p.m.

Avoid or limit caffeine and alcohol and don't use nicotine. All of these can make it harder to sleep, and effects can last for several hours.

Don't put up with pain. If a painful condition bothers you, talk to your doctor about options for pain relievers that are effective enough to control pain while you're sleeping.

Avoid large meals and beverages before bed. A light snack is fine and may help avoid heartburn. Drink less liquid before bedtime so that you won't have to urinate as often.

At bedtime:

Make your bedroom comfortable for sleep. Only use your bedroom for sex or sleep. Keep it dark and quiet, at a comfortable temperature. Hide all clocks in your bedroom, including your wristwatch and cellphone, so you don't worry about what time it is.

Find ways to relax. Try to put your worries and planning aside when you get into bed. A warm bath or a massage before bedtime can help prepare you for sleep. Create a relaxing bedtime ritual, such as taking a hot bath, reading, soft music, breathing exercises, yoga or prayer.

Avoid trying too hard to sleep. The harder you try, the more awake you'll become. Read in another room until you become very drowsy, then go to bed to sleep. Don't go to bed too early, before you're sleepy.

Get out of bed when you're not sleeping. Sleep as much as you need to feel rested, and then get out of bed. Don't stay in bed if you're not sleeping.

Alternative medicine

Many people never visit their doctor for insomnia and try to cope with sleeplessness on their own. Although in many cases safety and effectiveness have not been proved, some people try therapies such as:

Melatonin. This over-the-counter (OTC) supplement is marketed as a way to help overcome insomnia. It's generally considered safe to use melatonin for a few weeks, but no convincing evidence exists to prove that melatonin is an effective treatment for insomnia, and the long-term safety is unknown.

Valerian. This dietary supplement is sold as a sleep aid because it has a mildly sedating effect, although it hasn't been well-studied. Discuss valerian with your doctor before trying it. Some people who have used high doses or used it long term may have had liver damage, although it's not clear if valerian caused the damage.

Acupuncture. There's some evidence that acupuncture may be beneficial for people with insomnia, but more research is needed. If you choose to try acupuncture along with your conventional treatment, ask your doctor how to find a qualified practitioner.

Yoga or tai chi. Some studies suggest that the regular practice of yoga or tai chi can help improve sleep quality.

Meditation. Several small studies suggest that meditation, along with conventional treatment, may help improve sleep and reduce stress.

Caution regarding herbal and dietary sleep aids

Because the Food and Drug Administration does not mandate that manufacturers show proof of effectiveness or safety before marketing dietary supplement sleep aids, talk with your doctor before taking any herbal supplements or other OTC products. Some products can be harmful and some can cause harm if you're taking certain medications.

Preparing for your appointment

If you're having sleep problems, you'll likely start by talking to your primary care doctor. Ask if there's anything you need to do in advance, such as keep a sleep diary. Take your bed partner along, if possible. Your doctor may want to talk to your partner to learn more about how much and how well you're sleeping.

What you can do

Prepare for your appointment by making a list of:

Any symptoms you're experiencing, including any that may seem unrelated to the reason for the appointment.

Personal information, including new or ongoing health problems, major stresses or recent life changes.

All medications, over-the-counter medications, vitamins, and herbal or other supplements that you're taking, including dosages. Let your doctor know about anything you've taken to help you sleep.

Questions to ask your doctor to make the most of your appointment time.

Basic questions to ask your doctor include:

What is likely causing my insomnia?

What's the best treatment?

I have these other health conditions. How can I best manage them together?

Should I go to a sleep clinic? Will my insurance cover it?

Are there any brochures or other printed material that I can have?

What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor may ask you several questions, such as those below.

About your insomnia:

How often do you have trouble sleeping, and when did the insomnia begin?

How long does it take you to fall asleep?

Do you snore or wake up choking for breath?

How often do you awaken at night, and how long does it take you to fall back to sleep?

What is your response when you can't sleep?

What have you tried to improve your sleep?

About your day:

Do you feel refreshed when you wake up, or are you tired during the day?

Do you doze off or have trouble staying awake while sitting quietly or driving?

Do you nap during the day?

What do you typically eat and drink in the evening?

About your bedtime routine:

What is your bedtime routine?

Do you currently take any medications or sleeping pills before bed?

What time do you go to bed and wake up? Is this different on weekends?

How many hours a night do you sleep?

About other issues that may affect your sleep:

Have you experienced any stressful events recently?

Do you use tobacco or drink alcohol?

Do you have any family members with sleep problems?

What medications do you take regularly?

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Insomnia is a disorder that can make it hard to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep.

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Anxiety and depression can cause adult nightmares. PTSD also commonly causes people to experience chronic, recurrent nightmares.

- Occurs during REM sleep

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Difficulty going to Sleep
Difficulty staying asleep
Difficulty Re falling asleep
Must occur 3 times a week and must be present for 3 Months

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It is a dream anxiety disorder characterized by frequent nightmares that jeopardizes their life or personal safety. It happens in the REM stage of sleep.

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causes:
- underlying stress, anxiety, or depression
- doesn't come from: psychological effects of drug abuse or medication
- coexisting mental or medical disorders do not explain the occurrence of night terrors

treatments:
- nocturnal sleep study - overnight study in which sensors are placed on the body and monitor/record brain waves, oxygen levels, heart rate, and breathing
- can visit counselors/doctors to reduce stress in turn lessening night terrors.
- anticipatory awakenings can also be applied in which the patient is woken 15 minutes before a night terror usually occurs
- medication is rare, but can use benzodiazepines/antidepressants

“Sleep Terrors (Night Terrors).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 9 Mar. 2018, https://www.mayoclinic.org/diseases-conditions/sleep-terrors/diagnosis-treatment/drc-20353529.

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rapid breathing, sweating, little or no dream remembered, amnesia, distress in social, occupational, and other functioning areas,

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are ongoing episodes that result in terror arousal during sleep. Usually begins from a scream. Hard to comfort a person through an episode.
Occur in NREM-3

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The main causes of this disorder are Anxiety, stress, and depression. Also imsomnia can actually amplify these affects. Other causes are anger, worry, grief, bipolar disorder, and trauma.

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Insomnia: Symptoms, Causes, and Treatment - HelpGuide.org

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Having trouble sleeping? Find tips and simple strategies that can help you beat insomnia for good.

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- A condition which is characterized by an extreme tendency to fall asleep wherever in relaxing conditions.
- "Sleep attacks" and sudden muscles weakness several times a week.
-  Caused by a lack of a brain chemical called hypocretin , which regulates sleep.
- Occurs in the REM Phase.
- Roughly affects 1 in every 3000 people.

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Persistent inability to fall asleep or stay asleep.

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- Symptoms: hallucinations, sleep paralysis, memory problems, disturbed nighttime sleep, lose control of muscles, fall asleep 3 times a week in 3 months
- Treatment: stimulants and antidepressants

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Definition: a sleep disorder characterized by temporary cessations of breathing during sleep and repeated momentary awakenings.

What is it? When your breathing starts and stops over and over again, causing you to snore.

Symptoms: loud snoring, snorting or gasping, waking up with dry/sore throat, morning headaches

Treatment: C-pap machine (delivers constant and steady pressure to your airways to help breathing)

How often can this happen?
Has to happen 15 or more times an hour to be considered a disease.

Causes:
Obesity, smoker, structure of the airway

Severities:
mild: less than 15 times per hour
moderate: 15-30 times per hour
severe: greater than 30 times per hour

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For additional detail, have at least one person refer to the DSM-5 (linked in title):

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For additional detail, have at least one person refer to the DSM-5 (linked in title):

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Sleep Disorder (p. # in DSM-5)
Sleepwalking Disorder (Somnambulism) p.399
Insomnia p.362
Sleep apnea p.378
Narcolepsy p.372
Nightmare Disorder p.404
Sleep Terror Disorder p.399

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Be sure to also address what stage of sleep this occurs in. 

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Be sure to also address what stage of sleep this occurs in. 

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Be sure to address what stage of sleep nightmares occur in/how this is different than Night Terror Disorder. 

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Be sure to address what stage of sleep nightmares occur in/how this is different than Night Terror Disorder. 

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Be sure to address what stage of sleep Night Terrors occur in/how this is different than Nightmare Disorder. 

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Be sure to address what stage of sleep Night Terrors occur in/how this is different than Nightmare Disorder. 

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Be sure to also address how many times per night a person stops breathing. 

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Be sure to also address how many times per night a person stops breathing. 

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Be sure to also address what stage of sleep a person falls into. 

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Be sure to also address what stage of sleep a person falls into. 

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Be sure to also address what makes this a disorder, and not just normal, occasional trouble falling asleep. 

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Be sure to also address what makes this a disorder, and not just normal, occasional trouble falling asleep. 

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1. Each table selects a sleep disorder. (Insomnia, Narcolepsy, Sleep Apnea, Night Terrors Disorder, Nightmare Disorder, Sleepwalking) pp.238-240.
2. Read about it in the textbook and add information to the class Padlet.  Information to include in post:  Description of the disorder, Causes of the disorder, Symptoms of the disorder, and Treatment of the Disorder.  You will probably have to look up causes and treatment outside of the textbook. Any sources outside of the textbook used, cite in APA format.  Citation Machine is a great tool to help you.  To add a post, just double-click.

3. Select one person to present the information to the class.