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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/04/20 16:31:38」(JST)

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For other uses, see Night Terror (disambiguation).

"Pavor nocturnus" redirects here. For the Sanctuary episode, see Pavor Nocturnus (Sanctuary).

A night terror, also known as a sleep terror, incubus attack, or pavor nocturnus, is a parasomnia disorder, causing feelings of terror or dread, and typically occurring in the first few hours of Sleep during stage 3 or 4 Non-rapid eye movement NREM sleep.^[1] However, they can occur during slow-wave sleep periods or even daytime naps. ^[2] Night terrors should not be confused with nightmares, which are bad dreams that cause the feeling of horror or fear. According to the American Academy of Child and Adolescent Psychiatry, nightmares are relatively common during childhood.^[3] However, night terrors may occur less frequently. An estimated 1%-6% of children and less than 1% of adults will experience a night terror episode within their lifetime. ^[4] Sleep terrors begin between ages 4 and 12 years and then usually dissipates during adolescence. The most common age for sleep terrors in adults are ages 20 and 30 years which are chronic in severity and frequency with the episodes waning over time. Though the frequency varies between individuals the episodes can occur in intervals of days or weeks, but can also occur over consecutive nights. ^[2]

According to the American Academy of Child and Adolescent Psychiatry, nightmares are relatively common during childhood.^[3] However, night terrors may occur less frequently.

Associated Features of Night Terrors

Children who have night terrors are usually described as 'bolting upright' with their eyes wide open and a look of fear and panic on their face, and they will often scream. Further, they will usually sweat, exhibit rapid respiration, and have a rapid heart rate (autonomic signs). In some cases, individuals are likely to have even more elaborate motor activity, such as a thrashing of limbs -- which may include punching, swinging, or fleeing motions. There is a sense that the individual is trying to protect themselves and/or escape from a possible threat which can lead to physical injury of the individual. ^[2] Although it seems like children are awake during a night terror, they will appear confused, be inconsolable and/or unresponsive toward attempts to communicate with them, and may not recognize others familiar to them.

During lab tests, subjects are known to have very high voltages of Electroencephalography (EEG) delta activity, an increase in muscle tone, and a doubled increase in heart rate, if not more. Brain activities during a typical episode show theta and alpha activity when using an EEG. It is also common to see abrupt arousal from NREM sleep that does not progress into a full episode of a night terror. These episodes can include tachycardia.

There is a close association with psychopathology or mental disorders in adults that suffer from Sleep Terror Disorder. There may be an increased occurrence of Sleep Terror Disorder particularly with those that have suffered from Post-traumatic stress disorder or PTSD and Generalized Anxiety Disorder. It is also likely that some Personality Disorders may occur in individuals with Sleep Terror Disorder, such as Dependent, Schizoid, and Borderline Personality Disorders. There have been some symptoms of depression and anxiety that have increased in individuals that have suffered from Sleep Terror Disorder. ^[2]

Genetic and Cultural Features of Night Terrors

There is some evidence that a predisposition to night terrors and other parasomnia disorders can be congenital. Individuals frequently report that past family members have had either episodes of sleep terrors or sleepwalking. In some studies, a 10-fold increase in the prevalence of the disorder in first-degree biological relatives has been observed -- however, the exact link to inheritance is not known.^[2] In addition, some laboratory findings suggest that sleep deprivation and having a fever can increase the likelihood of a night terror episode occurring. ^[5] Special consideration must be used when the subject suffers from narcolepsy, as there may be a link between the disorders. There have been no findings that show a cultural difference between manifestations of Sleep Terror Disorder, though it is thought that the significance and cause of sleep terrors differ within cultures. Also, older children and adults provide highly detailed and descriptive images associated with their sleep terrors than younger children, who either cannot recall or only vaguely remember. Sleep terrors in children are also more likely to occur in males than females; in adults, the ratio between sexes are the same. ^[2]

Though the symptoms of night terrors in adolescents and adults are similar, the Etiology, Prognosis, and treatment are qualitatively different. There is some evidence that suggests that night terrors can occur if the sufferer does not eat a proper diet, does not get the appropriate amount or quality of sleep (e.g. Sleep apnea), or is enduring stressful events in his or her life. Adult night terrors are much less common, and often respond best to treatments that rectify causes of poor quality or quantity of sleep. There is no scientific evidence of a link between night terrors and mental illness. There is some evidence of a link between adult night terrors and hypoglycemia.^[6] According to Carranza and Dill (2004), some adult night terror sufferers share some characteristics with depressed individuals, e.g., "inhibition of aggression, self-directed anger, passivity, anxiety, impaired memory, and the ability to ignore pain."^[7]

DSM-IV-TR Diagnosis

The DSM-IV-TR diagnostic criteria for Sleep Terror Disorder requires recurrent periods where the individual abruptly wakes from sleeping with a scream (Criterion A), the individual experiences intense fear and symptoms of autonomic arousal (see Autonomic nervous system) such as increased heart rate, heavy breathing, and increased perspiration, (Criterion B), the individual cannot be soothed or comforted during the episode (Criterion C), the individual is unable to remember details of the dream or details of the episode (Criterion D), the occurrence of the sleep terror episode causes clinically significant distress or impairment in the individual's functioning (Criterion E), and the disturbance is not due to the effects of a substance or general medical condition (Criterion F). ^[8]

Treatment

There is some indication that night terrors can result from being overtired, in which case interventions such as creating a bedtime schedule can increase the chances of restful sleep. If the night terrors are more chronic, however, some evidence suggests that the sufferer should be awakened from sleep just before the time when the terrors typically occur to interrupt the sleep cycle. In some cases, a child who has night terrors will require additional comfort and reassurance during the day and before bedtime. Psychotherapy or counseling can be helpful in many cases. Benzodiazepine medications (such as Diazepam) used at bedtime will often reduce the occurrence of night terrors; however, medication is rarely recommended to treat this disorder.^[9]

References

^ Hockenbury, Don H. Hockenbury, Sandra E. (2010). Discovering psychology (5th ed. ed.). New York, NY: Worth Publishers. pp. 157. ISBN 978-1-4292-1650-0.
^ ^a ^b ^c ^d ^e ^f Association, published by the American Psychiatric (2000). DSM-IV-TR : diagnostic and statistical manual of mental disorders. (4TH ED. ed.). United States: AMERICAN PSYCHIATRIC PRESS INC (DC). ISBN 9780890420256.
^ ^a ^b American Academy of Child and Adolescent Psychiatry. "Facts for Families No. 34: Children's Sleep Problems". AACAP. http://www.aacap.org/cs/root/facts_for_families/childrens_sleep_problems. Retrieved Dec. 20, 2011.
^ American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision). Washington, DC: Author.
^ American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision). Washington, DC: Author.
^ Blog from Fountia, “Things You Didn’t Know About Night Terrors”
^ Carranza, C. R., Dill, J.R. (2004). Banishing night terrors and nightmares: A breakthrough program to heal the traumas that shatter peaceful sleep. New York: Kensington Publishing Corp.
^ American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision). Washington, DC: Author.
^ Kaneshiro, Neil. "Night Terror". A.D.A.M.. http://www.nlm.nih.gov/medlineplus/ency/article/000809.htm. Retrieved July 20, 2011.

External links

Night Terror Resource Center
National Institutes of Health, Medline Plus: Night Terrors
National Library of Medicine - Medical Subject Headings: Night Terrors

UpToDate Contents

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1. 小児における夢遊およびその他の錯眠 sleepwalking and other parasomnias in children
2. 思春期および成人における非てんかん性痙攣疾患 nonepileptic paroxysmal disorders in adolescents and adults
3. 小児における非てんかん性発作性疾患 nonepileptic paroxysmal disorders in children
4. 睡眠障害の分類 classification of sleep disorders
5. 小児における睡眠生理学 sleep physiology in children

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