Insomnia and poor sleep quality are common symptoms of perimenopause, which can last for several years before your period completely stops. Night terrors, however, are not a common symptom of menopause.
Night terrors are most common in children, but they can persist into adulthood. Also known as sleep terrors, these episodes affect about 2 percent of adults. Night terrors sometimes begin in adulthood, including during menopause, but this is uncommon.
These are terrifying events that happen in your mind while you sleep. If you have a night terror episode, you may scream, flail about, or jump out of bed while you’re sill asleep.
Night terrors are not the same as nightmares. If you have a nightmare, you may wake suddenly, and you may remember details or fragments of your disturbing dream. Night terrors usually don’t wake people up, and people don’t remember having them.
This may be because night terrors occur at a different point in the sleep cycle than nightmares. Like all dreams, nightmares occur during REM sleep. REM, which stands for rapid eye movement, is a period of time when the brain is very active.
Night terrors, on the other hand, occur during deep sleep, also known as slow-wave sleep. Slow-wave sleep is the deepest stage of non-REM sleep. Night terrors may also occur during the transitional period from non-REM to REM sleep.
Nightmares are common throughout childhood and adulthood. Many people of all ages have nightmares on occasion, especially during stressful or challenging times.
Night terrors affect around 15 percent of children and are most common in kids under age 7. Children who have night terrors typically outgrow them by the time they are teens.
Most of the symptoms of night terrors are noticed by partners and other members of the household. The person experiencing the night terror typically remains asleep for the entire episode – even while they’re sitting up, walking around, and yelling.
People often have no recollection of their night terrors. They may just be unusually tired the next day or wake up with unexplained cuts and bruises.
During a night terror episode, you may:
- appear to be experiencing extreme terror
- scream or shout
- flail your arms, kick your legs, or move about
- sit upright in bed
- open your eyes wide, even though you’re asleep
- have dilated pupils
- sweat profusely and look flushed
- breathe or pant heavily
- have a racing pulse
- sleepwalk
- become violent or unruly
- be hard to awaken
- be inconsolable and hard to soothe by others
Night terrors can be short or last as long as 20 minutes. After the episode, you may enter REM sleep without any recollection of the event. You may also wake up with feelings of intense confusion.
Night terrors are not triggered or caused by menopause or perimenopause. Common triggers in adults include stress, alcohol, and caffeine.
Night terrors are a form of parasomnia. Parasomnia conditions involve undesirable physical or verbal behaviors during sleep that are not under the sleeper’s voluntary control. Sleepwalking, known as somnambulism, is another form of parasomnia, and it can accompany night terrors.
In addition to night terrors, parasomnia includes:
- Confusional arousal. This is when a sleeping person seems to be awake but acts oddly.
- Sleepwalking. A sleeping person may do anything from taking a few steps to driving a car while they’re sleepwalking. They may even eat (sleep-eating) while sleepwalking
- Sleep-talking. This is when a sleeping person may say a few words or have a full conversation.
Certain substances and medications may trigger parasomnia in some people. These can include:
- alcohol
- caffeine
- beta-blockers
- statins
- nicotine replacement therapy drugs
- selective serotonin reuptake inhibitors (SSRIs)
Certain health conditions and mental health disorders may also make adults more likely to have night terrors. These include:
- Parkinson’s disease
- depression
- anxiety
- post-traumatic stress disorder (PTSD)
- bipolar disorder
Changes in sleeping patterns and quality are common during and after the menopause transition. Around
Sleep apnea
Sleep apnea is a sleep disorder that causes your breathing to stop and start during sleep. Sleep apnea is a potential cause of night terrors.
People with this condition may:
- snore
- feel tired, even after a full night’s sleep
- wake up with a dry mouth
- wake up with a headache
Progesterone and estrogen may help protect against sleep apnea. These hormones decline during menopause, making sleep apnea more likely to occur.
Night sweats
Night sweats are drenching sweats that soak your bedclothes and bedding. They’re associated with hot flashes and the reduction in estrogen production that happens during perimenopause.
Night sweats occur when the blood vessels expand and suddenly contract. This causes an intense and sudden feeling of heat throughout the body, which causes you to sweat profusely. Your heartbeat may also accelerate.
Night sweats are sometimes followed by cold chills.
Insomnia
Night sweats, hot flashes, and mood changes can all cause insomnia or make it worse.
People in menopause can experience several symptoms of insomnia, including:
- difficulty falling asleep
- difficulty staying asleep
- early awakening
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Declining and fluctuating hormones, including estrogen, are at the root of many sleep issues during menopause. Estrogen continues to drop for several years after the last menstrual period has occurred. Once estrogen has stabilized, sleep disorders improve in many people.
Melatonin is another hormone that can affect sleep quality. Melatonin supports regulation of the sleep-wake cycle, also known as your circadian rhythm. This cycle helps your body know when to go to sleep and when to wake up.
Melatonin levels gradually decrease as menopause approaches. This may also play a role in menopause-related sleep disturbances.
If you experience frequent night terrors, talk with your doctor. This is especially important if night terrors expose you to danger or if they’re affecting your ability to stay awake during the day.
Your doctor will give you a physical exam and looks for signs of issues like sleep apnea. They will talk with you about your symptoms and ask about your family history of parasomnia. If you have a consistent sleep partner, your doctor may ask them what they’ve observed.
Your doctor may recommend that you participate in a sleep study. During this overnight test, sensors will be placed on your body to record:
- brain wave activity
- blood oxygen level
- respiration
- heart rate
- leg movements
- eye movements
Treatments for night terrors vary and may be based on the underlying causes of your condition. For example, if you have sleep apnea, your doctor may recommend that you lose weight or use a CPAP machine.
Since night terrors can lead to insomnia, creating a healthy sleep routine may be beneficial. This includes avoiding caffeine and alcohol in the evening and limiting screen time.
If you drink alcohol in excess, reducing or eliminating it completely may help lessen night terrors.
Anticipatory awakening therapy may also be an option. This involves being woken up around 15 minutes before night terror episodes typically occur. You then make yourself stay awake for several minutes before falling back asleep. You can use a partner or an alarm to wake yourself up.
Mental health concerns — including bipolar disorder, emotional trauma, depression, and anxiety — may be addressed with therapies such as:
- talk therapy
- cognitive behavioral therapy
- medication
- deep breathing techniques
- relaxation techniques, including meditation
Night terrors can be scary and disruptive for your entire household. But partners and other household members shouldn’t try to wake you during a night terror.
They should, however, take precautions to keep you safe from harm. This includes eliminating your ability to use the stairs, leave the house, or gain access to a vehicle.
Working with a mental health professional may help you learn to manage stress and reduce night terrors.
Establishing a healthy nighttime routine may also be beneficial. Meditating before bed, reading a book, or doing other relaxing activities such as taking a warm bath may help. And eliminate stressful triggers, such as reading work emails.
Night terrors are a type of sleep disorder that is most common in children. They differ from nightmares, and people often don’t remember the episodes.
Menopause is not a direct cause of night terrors, but it is associated with several sleep concerns. Sleep concerns common during menopause include sleep apnea, night sweats, and insomnia.
Factors that increase your risk of night terrors include stress, alcohol, and certain medications.
