sleep terror disorder

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Related to sleep terror disorder: Sleepwalking disorder


a period of rest for the body and mind, during which volition and consciousness are in partial or complete abeyance and the bodily functions partially suspended. Sleep has also been described as a behavioral state marked by characteristic immobile posture and diminished but readily reversible sensitivity to external stimuli.

NREM and REM Sleep. Prior to the discovery and reporting of rapid eye movements during sleep, it was thought that sleep was a single state of passive recuperation in which the central nervous system was deactivated. Studies concerned with the measurement of central and autonomic activities during sleep have led to its division into two types: non–rapid eye movement (NREM) sleep, also called orthodox or synchronized (S) sleep; and rapid eye movement (REM) sleep (so called because of the rapid eye movements during this stage), also called paradoxical or desynchronized (D) sleep.

On the basis of electroencephalographic (EEG) criteria, NREM sleep is subdivided into four stages. Stage 1 is observed immediately after sleep begins or after momentary arousals and is characterized by low-voltage, mixed-frequency EEG tracing, with predominantly theta-wave activity (four to seven hertz, that is, cycles per second). Stage 2 is characterized by intermittent waves of 12 to 16 hertz, known as sleep spindles.Stages 3 and 4 consist of relatively high voltage EEG tracings with a predominance of delta wave activity (one to two hertz).

The EEG patterns of NREM sleep suggest that this is the kind of apparently restful state that supports the recuperative functions assigned to sleep. NREM sleep is increased after physical activity and has a relatively high priority among humans in the recovery sleep following extended periods of wakefulness.

Within 90 minutes after sleep begins, an adult progresses through all four stages of NREM sleep and then proceeds into the first of a series of REM periods of sleep. Brief cycles of about 10 to 30 minutes of REM sleep recur throughout the night, alternating with various stages of NREM sleep. With each cycle, NREM sleep decreases and REM sleep increases so that by the end of the night most of the sleep is REM sleep, which is when dreams occur. While everyone dreams every night, many do not remember dreaming; most people are aware, however, that they dream more just before rising.

In addition to the rapid eye movements that can be observed through closed eyelids, REM sleep can be recognized by complete relaxation of the lower jaw. Convulsions, myocardial infarction, and cardiac arrhythmias are more likely to occur during REM sleep. This is probably because of increased autonomic activity, irregular pulse, and fluctuations in blood pressure, which are all typical of REM sleep.
Patterns of Sleep. Although the average adult spends approximately 25 percent of total accumulated sleep in REM sleep and 75 percent in NREM sleep, the cyclic changes vary with individuals. The pattern of sleep, in addition to the REM and NREM states, also includes the periods of sleep and wakefulness within a 24-hour period.

Factors affecting the total sleep pattern include age, state of physical health, psychological state, and certain drugs. Newborns follow a pattern of several hours of sleep followed by a period of wakefulness. REM sleep occurs at the onset of sleep in infants; it rarely does in adults. As the child matures there is an increasing tendency toward longer periods of nocturnal sleep. Elderly persons sometimes return to the shorter periods of sleep that are typical of infants.
Benefits of Sleep. Sleep requirements vary greatly among individuals. Infants usually require 16 to 20 hours of total sleep during a 24-hour period, and the amount decreases as the child matures. An adult usually requires 6 to 9 hours of total sleep, and requirements continue to decrease with aging.

Most theorists agree that sleep has value as a recuperative and adaptive function in the lives of humans. The relatively high metabolic needs of mammals and birds to maintain a constant body temperature in a wide range of environmental temperatures suggests that the periodic decreases in metabolic rate and body temperature that occur in NREM sleep allow for recuperation and restitution of body tissues. For example, even though the function of stage 2 NREM sleep is not clear, approximately half of human sleep time is spent in this stage. It is also theorized that REM sleep provides a period of recuperation of mental activities and preparation for wakefulness. During REM sleep it is believed that there is increased metabolic activity in the brain so that during waking hours it is more receptive to new information and can assimilate it more easily.
sleep apnea syndrome episodes of apnea (cessation of breathing) occurring at the transition from NREM to REM sleep, with repeated wakening and excessive daytime sleepiness; it occurs most often in middle-aged, obese males and is thought to have several causes, one being collapse or obstruction of the airway with the inhibition of muscle tone that characterizes REM sleep. The condition is arbitrarily defined as more than five cessations of airflow for at least 10 seconds each per hour of sleep.
sleep disorders chronic disorders involving sleep; primary sleep disorders are classified as dyssomnias or parasomnias. Among the minor disorders are sleepwalking, sleeptalking, enuresis, bruxism (tooth grinding), and nightmares. Sleepwalking is not considered serious if it occasionally occurs in childhood. It should be considered pathological, however, if it persists into adulthood. Sleeptalking is common to many persons and, while it may annoy others whose sleep it may disturb, it is not considered pathological.

A sleep disorder occurring in early childhood, and not to be confused with nightmares, is sleep terror disorder. The child awakens with a scream, is in panic and cannot be consoled, and often is incoherent; the following morning, there is poor recall of the event. Treatment usually involves reassurance of the parents. Adults who experience night terrors often have some psychological problem requiring treatment. More serious disorders of sleep include persistent insomnia, narcolepsy, and chronic hypersomnia. Hypersomnia can occur with central nervous system damage or may be secondary to some physical and mental illnesses, particularly depression.
sleep terror disorder a sleep disorder of the parasomnia group, consisting of repeated episodes of pavor nocturnus (sleep terrors).

night ter·rors

(nīt' ter'ŏrz),
A childhood disorder in which a child awakes screaming with fright, the distress persisting for a time during a state of semiconsciousness.

sleep terror disorder

Etymology: AS, slaepan + L, terrere, to frighten
a condition occurring during stage 3 or 4 of nonrapid eye movement sleep. It is characterized by repeated episodes of abrupt awakening, usually with a panicky scream, accompanied by intense anxiety, confusion, agitation, disorientation, unresponsiveness, marked motor movements, and total amnesia concerning the event. The disorder usually occurs in children, is more common in boys than in girls, and is extremely variable in frequency but is more likely to occur if the individual is fatigued or under stress or has been given a tricyclic antidepressant or neuroleptic at bedtime. Compare nightmare. See also pavor nocturnus.

sleep terror disorder

Night terror, pavor nocturnus Sleep disorders An abrupt awakening from sleep with behavior consistent with terror–panic, sweating, tachycardia, confusion, and poor recall for the event; STD occurs during stage 3/4 (deep) sleep, and is associated with emotional stress or conflict, especially in preadolescent boys and, in adults, is associated with alcohol use. See Sleep disorder. Cf Nightmare.