Jessica is 6 years old. Her parents recently saw her pediatrician because they were concerned about the sleeping difficulties Jessica has been having
Often she would scream out loud in her sleep. Her parents would rush to her room and find her sitting upright in bed, panting heavily in a state of panic. Jessica would not respond to her parent's words of consolation, and the next morning she would have no memory of the incident at all. Her parents were worried about the anxiety their daughter was experiencing and asked the pediatrician what they could do about her nightmares. The pediatrician explained Jessica was likely suffering from sleep terrors and carefully described what that meant.
What are the similarities and differences between nightmares and sleep terrors?
What are the characteristics of motor, sensory, and autonomic function during REM sleep? What is thought to be the importance of this stage of sleep?
Jessica's pediatrician said that the careful management of sleep hygiene may help to decrease the incidence of her sleep terrors. What is included in an overview of the general features that demonstrate good sleep hygiene?
Both nightmares and sleep terrors cause frightening experiences and hyperarousal for the individual experiencing them. Nightmares occur during REM sleep and usually awaken the sleeper. The nightmare is remembered by the individual and often makes the return to sleep difficult as a result. Sleep terror, in contrast, occur during stage 3 and stage 4 sleeps. The individual is hyperaroused and appears awake, but is unresponsive to external stimuli. Unlike the experience of a nightmare, sleep terrors are not remembered, and the return to sleep happens quickly after the event.
During REM sleep, motor output is inhibited so that voluntary movements are lost accompanied by a decrease in muscle tone. Sensory input from the external environment is also inhibited, but internal sensory awareness (particularly auditory and visual senses) is heightened. The autonomic nervous system causes fluctuations in blood pressure, heart rate, and respirations during REM sleep.
The function of REM is thought to involve the vivid dreaming that takes place during this stage. Central nervous system reprogramming is thought to occur during this stage, and previous experiences are processed in preparation for new ones to come. Learning experiences and memories are also processed and organized during this stage.
Good sleep hygiene involves creating an environment that ensures the best sleep possible. It involves practices such as going to bed at a regular time and sleeping long enough to feel refreshed. Appropriate sleep hygiene emphasizes the restriction of caffeinated products before sleeping and the elimination of distractions from the bedroom. Finally, good sleep hygiene addresses the external bedroom environment; the best sleep is achieved in a room that is dark, quiet, and at a comfortable temperature.
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