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Section 1
Characteristics & Symptoms of Nightmare

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Incidence, Characteristics & Symptoms of Night Terrors
New Content Added: To update the content we have added Sleep Disorders information found at the end of the Table of Contents.

In this section, we will discuss type ‘A’ night terrors. We’ll be examining incidence of type ‘A’ night terrors, characteristics of type ‘A’ night terrors, and symptoms of night terrors. As you listen to this track, you might consider how the information might be applied to one of your own clients.

Type ‘A’ Night Terrors - 3 Considerations

#1 - Incidence of Type ‘A’ Night Terrors
First, let’s discuss incidence of type ‘A’ night terrors. Type ‘A’ night terrors occur typically in children, but may persist into adolescence. According to Dr. Joyce Kales about three percent of children experience type ‘A’ night terrors 36 percent of type ‘A’ night terrors in children persist into adolescence. Dr. Kales states, "Night terrors typically begin in childhood or early adolescence and are usually ‘outgrown’ by the end of adolescence." 

However, these statistics can be misleading.  As you know, these numbers only reflect reported cases. It has been theorized that night terrors in general are an under reported, closet condition. The parents of children who suffer night terrors are often quite upset by the child’s apparent distress, but may simply view the occurrence of night terrors as ‘just a bad dream.’  Such was the case with Nadine, age 7.

Nadine’s mother, Beth, stated in one of our sessions, "Nadine first started having these really bad dreams when she was about two. I’d wake up in the middle of the night and hear her screaming and struggling. At first I thought Nadine was just having one or two bad dreams each month because I only heard her screaming every once in a while. I didn’t realize that she had night terrors almost every time she went to bed! She never told me about them." Think of your Nadine. Does he or she avoid talking about night terrors with her friends or family? 

#2 - Characteristics of Type ‘A’ Night Terrors
Next, let’s discuss some of the characteristics of type ‘A’ night terrors. As you are aware, no one is absolutely certain what causes type ‘A’ night terrors, but, as you know, type ‘A’ night terrors are not a result of child abuse or extreme trauma.Conversely, research indicates that overreactions by a child’s undeveloped emotional system may be misinterpreting rather mundane environmental stresses.

Clearly, this research is supported by the fact that an unexplained resolution occurs when the child reaches an age of more advanced cerebral comprehension with correspondingly elevated association skills. This results in over 60 percent of type ‘A’ night terror sufferers ‘growing out of it.’  Are you treating a child like Nadine or an adolescent with type ‘A’ night terrors? On the next track, we will discuss some treatment strategies that Nadine’s parents implemented to speed the natural process of Nadine ‘growing out’ of her night terrors.

#3 - Symptoms of Night Terrors
In addition to incidence of type ‘A’ night terrors and characteristics of type ‘A’ night terrors, our third topic for discussion is symptoms of night terrors. These signs and symptoms relate to both type ‘A’ and type ‘B’ night terrors, which we will discuss on track 3. Common symptoms of night terrors are waking with a scream followed by moaning or gasping, rapid heartbeat, profuse sweating, rapid breathing, and increased blood pressure. 

Another common somatic response is activation of the fight or flight response which, as you know, can result in heightened abilities for fleeing and defending. Signs of night terrors may include violent body movements, such as thrashing, open eyes, unresponsiveness or violent or aggressive response to efforts to comfort, and poor recall. As you are already aware, night terrors can occur during episodes of sleepwalking. The signs and symptoms of night terrors generally last between 5 and 20 minutes. 

In this section, we discussed type ‘A’ night terrors. Our discussion included an examination of incidence of type ‘A’ night terrors, characteristics of type ‘A’ night terrors, and symptoms of night terrors.

In the next section, we will discuss ways of treating type ‘A’ nigshst terrors. I have found that for parents with children or adolescents suffering from type ‘A’ night terrors, three effective cognitive intervention treatments are behavior documentation, assisted recall, and associative connections. 

Peer-Reviewed Journal Article References:
Godin, I., Montplaisir, J., & Nielsen, T. (2015). Dreaming and nightmares in REM sleep behavior disorder. Dreaming, 25(4), 257–273. 
Kelly, W. E., & Mathe, J. R. (2019). A brief self-report measure for frequent distressing nightmares: The Nightmare Experience Scale (NExS). Dreaming, 29(2), 180–195.
Mathes, J., Weiger, N., Gieselmann, A., & Pietrowsky, R. (2019). The threat simulation in nightmares—Frequency and characteristics of dream threats in frequent nightmare dreamers. Dreaming, 29(4), 310–322.

What are three signs of night terrors? To select and enter your answer go to Test.

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