Strategies for handling night terrors
I had night terrors for about two years, and they were one of the most distressing things I've had to deal with, aside from the traumatic event that caused them. Living with complex PTSD has made my relationship with sleep deeply complicated, turning bedtime into a source of dread rather than relief. I would wake up from a nightmare in an absolute panic without the ability to come down. It would take a really long time for me to get back to sleep due to the fear of going right back into the nightmare. At other times I am so tired that I will wake up and fall back asleep and re-enter the nightmare. The night terrors were quite frequent and would leave me dysregulated for most of my day. I would feel the lingering sensation of panic of the night before coupled with the exhaustion of not having a good night's rest.
There are various strategies we can use to help cope with and reduce the impact of night terrors. I wanted to share with you a few things that have helped me deal with nightmares. I'll be going over some things you can try now and other strategies that you should do under the care of a licensed professional.
Managing stress before sleep and once woken up from a nightmare is something that I find to be crucial. I noticed a higher likelihood of experiencing a night terror if I go to sleep feeling anxious. I found that having a calming pre-bedtime routine did ameliorate my sleep. Reducing anxiety after waking up from a nightmare has also been important for me not to re-enter into the nightmare. Another thing that reduces the likelihood of me re-entering a nightmare is to make sure that I fully wake up from it. I've found that if I don't fully wake up from my nightmare and manage my stress I will fall into a cycle of waking up in a panic and falling asleep again which would recur all night. This led to really poor sleep quality.
Part of managing the distress of a night terror is creating a sense of safety. Creating a sense of safety can be done in multiple ways, what's worked for me has been grounding techniques like deep breathing and self-talk. Deep breathing exercise has been effective for me since it would lower my anxiety by activating my parasympathetic nervous system which does things like slowing down your heart rate for example. I would simultaneously use deep breathing with self talk to ease my mind. When it comes to self talk I would simply remind myself that I am safe and that it's just a dream. I would also remind myself that what I was feeling was temporary and would pass, while also practicing self-compassion for both my past experiences and the distress I was currently facing.
The nightmare protocol which is often referred to as Imagery Rehearsal Therapy has been a game changer for me. This protocol involves rewriting nightmares to create a less distressing or more positive version of the dream. This is followed by rehearsing the modified dream scenario during the day and before bedtime. Studies have demonstrated that IRT reduces the frequency and intensity of nightmares and improves sleep quality.The way I rewrote my recurring nightmare was by creating a different ending . I would go over my nightmare during the day multiple times with the new ending being me asking someone in my dream for help. After rehearsing this new ending to my dream my nightmare changed. I was surprised by the fact that when I would have this recurring nightmare I started to ask for help within my dream which would end the nightmare. After some time, I stopped having this nightmare altogether or experienced it very rarely, and there was a significant reduction in the feelings of distress I would feel afterward. I would exercise this technique with caution. Going over your nightmare without having coping skills that can ease the stress of rehearsal could possibly be re-traumatizing as well as result in emotional distress. Adequate support is essential to the implementation of this protocol. I would consult a licensed professional to see whether this is an appropriate strategy for you.
Medication has also helped me with dealing with my night terrors. The medication I took for years was called prazosin. Prazosin works by reducing the effects of norepinephrine, a neurotransmitter involved in the body's stress response. This mechanism is thought to decrease hyperarousal and the intrusive symptoms of PTSD, such as nightmares and distressed awakenings. While prazosin is effective for some individuals, its benefits are not universal, and more research is needed to determine who may benefit most.
Night terrors can be incredibly distressing, but with the right strategies and support, it’s possible to find relief. Whether through grounding techniques, therapy, or medication, there are ways to regain control and improve your sleep. Remember, you’re not alone in this, and healing is possible.
