Attacks of Pavor Nocturnus (a.k.a. Sleep Terrors, Night Terrors, Incubus Attacks)
Are They Affecting You or Your Children?

Written by Anthony Degani and Kevin Morton with contributions from the Stanford Sleep Book, Winter 2010

Why Do They Occur? | In Children | In Adults | Awake or Not? | Treatment | Your Stories

What's In A Name?

Pavor nocturnus, sleep terror, night terror, incubus attack? Why so many names??

Well, "pavor nocturnus" is literally Latin for "sleep terror"--so those phrases are just saying the exact same thing in two separate languages. In addition, "pavor nocturnus" is used most commonly to refer to sleep terrors in children.

On the other hand, the phrase "incubus attacks" is commonly used to refer to sleep terrors in adults. The word "incubus" (from the Latin in: upon, & cubare: to press) reflects the medieval belief that sleep terrors are caused by a devil pressing on the chest of the sleeper, although this cause is scientifically yet to be proven ;-)

Since pavor nocturnus episodes also occur during naps, the term "sleep terror" is preferred over "night terror" to be technically correct.

Sleep terrors have also been referred to as nightmares, but don't confuse this with the REM nightmare that you usually think of with this word!

In a characteristic pavor nocturnus (or sleep terror) episode, the sleeper sits up suddenly in bed and screams out in fear. Eyes wide open, pupils dilated, and breathing fast, he or she appears to be in a state of great terror, autonomically awake but clearly distanced. Throughout the episode, communication is difficult (and sometimes downright impossible), and the victim can typically neither be consoled nor comforted.

A sleep terror is a common sleep complication that affects both children and adults. (Do you experience sleep terrors? Let us know and share your experiences.)

Sleep terrors are a sleep disorder, though often just a temporary one. Since they involve abnormal physical behaviors during sleep they are classified as a parasomnia (learn about the different types of sleep disorders). Episodes typically last several minutes and end rather spontaneously.

Dr. Dement

Dr. D's Sleep Book Says...

Also known as incubus attacks or pavor nocturna, sleep terrors often involve individuals screaming in the middle of the night, ostensibly in a state of panic. Sleep terrors typically last several minutes and resolve themselves. Attacks are more frequent in children and can occur throughout the lifespan, although they occur less frequently with age.

When and Why Do Sleep Terrors Occur?

Polysomnographic sleep recordings that have captured pavor nocturnus episodes have shown that they mainly occur during arousals from slow wave sleep (SWS, or NREM stages 3 & 4), which occurs predominantly during the first third of the night. When several sleep terror episodes occur during the course of the same night, they may also occur in NREM stage 2, or even stage 1.

Creating A Sleep Terror

In subjects who are predisposed to episodes, attacks can be elicited experimentally by forced arousal during SWS, suggesting that the transition out of this deep slumber is an important component (albeit not a standalone one) of a sleep terror.

It is not likely for someone to have multiple sleep terrors in one night, as frequent attacks occur in only 3 percent of children and less than 1 percent of adults, but some have reported as much as 40! The majority of people who experience the sleep terror disorder have, on average, one to four episodes per month.

Sleep terrors sometimes run in the family and are associated with increased incidence of sleepwalking and confusional arousals in the person affected and/or other family members.

Some factors like sleep deprivation (sleep debt), sickness or fevers, and stress can contribute to the triggering of a sleep terror episode, but no one factor acts independently and it is as of now at least a leap of faith to name a specific mechanism that causes sleep terrors.

Dr. Dement

Dr. D's Sleep Book Says...

In making a correct identification, sleep terrors must be distinguished from nightmares. The latter typically occur in the last (rather than the first) third of the night; they do not have the same intensity of terror, autonomic arousal, or motor activity; and they are not followed by such intense mental confusion. Moreover, a person who has had a nightmare typically recalls an organized dream in which evolving events became frightening and personally threatening.

Sleep Terrors in Children

As mentioned above, sleep terrors in children are sometimes referred to as pavor nocturna, or pavor nocturnus in the singular (which is just Latin for sleep terror).

Childhood Sleep Disorders

Many sleep disorders tend to present themselves predominantly in childhood, before the patiend grows out of them later in life. Sleep terrors is typically one of them, and you can explore more about the other sleep disorders in children here.

The attacks can occur from early childhood on, are more common in males than in females, and many children experience the occasional episode. Frequent attacks occur in only about 3 percent of children (as mentioned above) and tend to disappear before adolescense.

A good way to tell if your child has pavor nocturnus is if you ever notice him or her wake up with expressions of extreme fear with symptoms like rapid heartbeat, sweating, or quick breathing. Often the person experiencing the sleep terror will be jolted into motion and sit up suddenly in bed, scream, cry, or have a very frightened facial expression.

Does your child experience this? Share your thoughts, questions, or concerns with us and we will respond back.

Sleep Terrors In Adults

While psychopathology (mental conditions) in children experiencing pavor nocturnus is very rare, it is commonly associated with sleep terrors in adults. Common associated conditions include anxiety and post-traumatic disorders. That said, sleep terrors themselves are much less common in adults, and this is not to say that having sleep terrors as an adult necessitates any kind of mental condition. (Browsing our visitor-submitted stories of adult sleep terrors is testament to that.

If present in adulthood, incubus attacks typically are most frequent in the 20- to 30-year-old range and less frequent in old age. Due to the link with psychopathology, it would seem that one would not have to have experienced pavor nocturna as a child in order to have sleep terrors as an adult.

Sleep terrors in adults are not normal, and if they are occurring on a frequent basis (more than a few times a week) and/or resulting in injuries to the individual or another, or significant stress, the individual should consult a sleep specialist.

Are you an adult who experiences sleep terrors? Share your thoughts, questions, and concerns with us.

Are You Awake During A Sleep Terror Episode?

While it has been mentioned above that sleep terrors occur mostly during arousals from slow wave sleep, these arousals are quite autonomic, meaning that an individual is not fully awake by any means. This, despite the fact that he or she will often have eyes wide open with pupils dilated and will be screaming or talking in a fearful flurry.

In fact, while an episode is going on victims can be almost impossible to wake up to a coherent state or even to comfort, and this can be very hard on most parents. While parents should know that many individuals in a pavor nocturnus episode may respond violently to attempts to help or restrain them, it is understandable of course to console them. Parents may also take solace in the fact that many children will have no recollection at all of their episode when they wake up in the morning.

For some subjects though, once awake they will often remember having difficulty breathing but will very rarely recall detailed mental activity at the time of the episode. Instead, if memory is present of what happened it will often just consist of a static scene like a single photograph, rather than the progressive storyline of images that accompanies a dream.

Treatment for Sleep Terrors

Treatment is often unneccessary when episodes of pavor nocturnus are rare, whether in children or adults. For children, Dr. Dement's words below should calm the minds of most parents:

Dr. Dement

Dr. D's Sleep Book Says...

Parents of young patients must be reassured that these dramatic episodes have no psychopathological implications, that they seldom cause injury, and are almost always outgrown.

However, for frequently occuring episodes of sleep terrors, especially those occuring in adults, or for episodes that cause injury or significant anxiety, a sleep specialist should definitely be consulted.


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Do You Or Your Child Experience Sleep Terrors?

Have you ever experienced (or been told you have experienced) the bloodcurdling screams of a pavor nocturnus? Do you or your child currently experience them? Share your stories, questions, concerns, or insights with us below. We would really love to hear about them and look forward to being able to respond to your writing.

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Read Other Stories About Sleep Terrors

Click on the links below to read other pavor nocturnus stories, thoughts, and questions. They were all written by other visitors to this page, just like you.

10 Year Old Son-I'm Guessing These Are Sleep Terrors... 
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Wakes Up The Whole House 
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5 Y.O. Son Started Having Sleep Terrors Running From His Room to the Living Room In Sleep 
About a month ago (July 2011) my son had woken up crying his head off and rubbing his knees repeatedly... After about 5 min. of me being in tears in fear …

33 Yr Old Experiencing Frequent (3-4) Times A Week 
I also experienced these as a child when running a high fever and was unwakable and unable to be comforted by my parents. As a young adult I became, or …

Intense Episode Last Night Led To Internet Diagnosis Today: Night Terror! 
Last night around midnight about 1 1/2 hours after going to sleep I felt like the building was collapsing around me everything was tilting and I jumped …

Sleep Terrors Every Night About My Baby--PPD or Anxiety? 
I had my first child in the end of February and he is now 15 weeks old. About 3 weeks ago I started having a few night terrors a week. What happens is …

Night Terrors Every Night For All My Life. I Have Tried Everything. Please Help 
I am a 27 yr old, educated, multilingual, emotionally stable, happily committed (to a boyfriend, not an institution) woman. I have night terrors AND …

Adult Sleep Terrors Every Night 
Hi to all. What a relief to know that I'm not the only one to experience adult night terrors . My experiences are very disturbing to me and are getting …

7-Year-Old Daughter With Sleep Terrors Nightly 
My son has periodic sleep terrors, but they are getting fewer and fewer and we have learned to counteract them. My daughter has had a few throughout …

Sleep Terrors When I Was 4 and 8, Now 17 and Fear Sleep 
I had night terrors when i was 4 and 8 when I moved from house to house. About 6 to 10 episodes that i know of but my parents don't tell me when i get …

Scream In Sleep 5-6 Nights Per Week 
I often scream during a dream during the first few hours of sleep. The scream awakens me, often my wife reassures me, and I fall back to sleep. I have …

Cluster Episodes Of Sleep Terrors With Injuries 
I am a 29 y/o female that has been having sleep issues for approx. 8 years. My terrors seem to come in clusters. I will go for quite awhile without having …

SLEEP TERRORS IN OUR 3 YEAR OLD, EVERY DAY FOR SEVERAL WEEKS 
MY HUSBAND AND I HAVE BEEN DEALING WITH OUR SON ADAM'S SLEEP TERRORS FOR AT LEAST 18 MONTHS. HE IS TURNING 4 IN JANUARY. WATCHING HIM GO THROUGH THESE …

20 Month Old Baby Son Has Been Having Sleep Terrors For Months 
My son has been having sleep terrors on and off for the past 6 months or so. The last few have lasted about 20 minutes. Is there a way that I can wake …

Frequent Night Terrors With Sleep Paralysis 
I have had night terrors all my life, many of the times they are your "normal night terrors", but some of the times when I start waking up from an episode, …

3 Sleep Terror Experiences I've Been Told About 
the 1st I know of was in my bed at my parents. I dreamt there were 2 men in my doorway. One of them stepped closer to me. I felt trapped in my covers. …

Sleep Terrors in Clumps 
I am an adult female, 56 yrs old, experiencing sleep terrors more frequently during times of extreme stress, yet sometimes experiencing them for no apparent …

Sleep Terrors: When I Sleep I Dream Of Demons  
The following is a visitor-submitted story of a sleep terror experience | Read more stories here When I sleep I dream of demons. Demons in little …

Are My Night Visions Night Terrors? 
I am a 59 Y.O female and for the past few years have been having what I call night visions. In the past few weeks they have increased to the point of …

Adult Night Terrors: Experiencing Phobic Episodes 
I'm a 27-year-old woman. I share a bed with my boyfriend. Every so often I am jolted awake and I see an imagined spider in the room. I am terribly phobic …

Sleep Abnormalities & Terrors Since I Was A Child!! 
Hi, I have suffered with night terrors for as long as I can remember (I am 33 now). The abnormalities range from sleepwalking, sleep talking/shouting, …

Severe Sleep Terrors At Irregular Intervals And Increasing Intensity 
Hi I am Simon, My first night terror occurred in my early teens. The previous night I was sharing a bunk bed with my brothers and they all decided …

Frequent Sleep Terrors In My Partner, Sometimes Violent 
My partner experiences frequen sleep terrors. He does not fall under the normal parameters of this condition as he is 47 years old. When he experiences …

My Daughter Has Multiple Sleep Terrors In One Night 
I have a two year old daughter that moves around a lot (tosses and turns), I mean a lot, when she sleeps. Almost all the time she will whine in her sleep …

Click here to write your own.

My Partial Cure For Night Terrors 
As an adolescent, I frequently sleep-walked. Night terror dreams began in my late 20'and I still experience them in my late 50's, although not so severely. …

Sleep Terrors: Is There A Way To Stop the Fear? 
I am a 45-yr-old female. I was so excited to read about others who suffer from this! I went to bed thinking I will be able to manipulate my dream to …

Neighbours Rang The Police Due To My Screams 
I had an incident this year which I thought I'd share. Early hours of the morning there was a loud banging on my door with a yell "POLICE OPEN UP" which …

Night Terrors On And Off For About 5 Years 
My husband told me, that I had 3 night terrors last night. I am a 70 year old women who also has sleep apnea and uses a CPAP machine. These events …

Sleep Terrors Disturbing Me And My Relatives 
I am 29 years old man and this problem is since 3 years, I had fallen into depression when I was 18 years and was treated by a good doctor,however I had …

I Remember Waking Up From Sleep Terrors Every Night 
Every morning when I wake up I can recall waking up frequently throughout the night. Sometimes I will fully wake up and be up for an extended amount of …

Medical discharge from the Navy due to Night Terrors 
I have had night terrors since I can remember. I'm 22 now and have injured myself on several occasions. I have broken my foot before and even had my …

Night Terrors For 44 Years - Screaming, Injuring Myself, and Sleepwalking 
I'm at the point of despair as you can imagine. I'm over it.

Screaming All Night! Scared Or Angry? 
My whole family is telling me I screamed last night, but I don't remember a thing. I remember waking up feeling weird, like I wasn't rested, but don't …

Recurring Sleep Terrors 
Hello. Two nights in succession this week I have sat bolt upright in the middle of the night screaming. They seen to be blood curdling screams; really …

My 8 Yr Old Son Has Approx Two Night Terror Episodes A Month  
My 8 yr old son has approx two night terror episodes a month. He wakes, runs around, wide eyed and terrified. Heart rate and breathing rapid. After 5 …

Sleep Terrors In My 5 Year Old Child 
Events are rare - once every 3 to 4 months sometimes occur few weeks of one another, then not a gain for months. Notice it happens when she has a cold …

Relating To Someone Who Experiences Sleep Terrors Every Night 
It seems that the people that do these studies in fact do not suffer from these episodes...if they did they would understand just how truly terrifying …

Sleep Terrors 4 Times In One Night 
My boyfriend and I have been together for about 1 year now. I've been having trouble sleeping due to the fact I wake up from hearing him scream and scared …

My Baby Is Having Sleep Terrors... 
My son, who is 1 yr. old now, has had sleep terrors since his 3rd month. At first it occurred only once a month, now it is more frequent, twice a month. …

My Son Has Sleep Terrors Every Couple Days 
My son is 6 years old. About 4 weeks ago he started doing weird things in his sleep. The first night he got out of bed, went to his bathroom and was trying …

Sleep Terrors: 14 And Still Going On...  
I had sleep terrors quite frequently when I was a kid but I have them less often now, so what is the chance they will go away into adult hood? And also …

Click here to write your own.

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