Do Night Terrors Increase in Pregnancy?

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Parasomnia is a benign sounding medical term for some strange and frightening sleep disorders. These include night terrors, sleep paralysis, and the ominous sounding exploding head syndrome. According to the American Academy of Sleep Medicine, there are 11 types of parasomnias. There are some links between parasomnias and pregnancy you should know about.

What are the parasomnias?

Parasomnias are unusual and unwanted movements, behaviors, emotions, perceptions, or dreams that occur during sleep, falling asleep, or waking up. These are the 11 types:

  • Sleep or night terrors cause you to wake up with intense fear. You may wake up thrashing, screaming, or kicking, with your heart pounding. You may have no memory of a dream that caused your fear.
  • Sleep paralysis causes you to have a period of being unable to move while waking up or falling asleep. Although this is frightening, it passes quickly.
  • Nightmare disorder is frequent nightmares disturbing enough to cause a fear of falling asleep or going back to sleep.
  • Confusional arousal causes strange or confused behavior just after waking up. You do not know what you are doing.
  • Sleep walking can include walking around inside or even outside your house. There is a danger of falling.
  • Sleep eating disorder causes binge eating while you are only half awake. You may not have any memory of eating.
  • REM sleep behavior disorder is a dangerous parasomnia that causes you to act out your dreams. You may injure a sleep partner by kicking or punching.
  • Bedwetting is a common sleep disorder in children but may also occur in adults.
  • Sleep hallucinations are dreams that are so real you can hear, touch, taste, or smell the dream experience.
  • Sleep talking is one of the most common and harmless parasomnia. Talking in your sleep does not bother you, but it may bother your sleep partner. Some people also groan in their sleep.
  • Last but not least, is the exploding head syndrome. The good news is your head does not actually explode, but you may hear a loud imagined noise like an explosion, gun shot, clanging, or crashing just before falling asleep or waking from sleep.

Are parasomnias more common in pregnancy?

Sleep disturbance is more common during pregnancy. In fact, 97 percent of pregnant women report sleep disturbance in the third trimester. These disturbances may be triggered by pregnancy hormones that change sleep cycles. You may become a lighter sleeper with more frequent periods of waking up and going back to sleep. This may cause you to have more frequent dreams and to remember your dreams more vividly. [2,3]

Many pregnant women report increased nightmares, vivid nightmares, and dreams that cause anxiety. There is no evidence that pregnancy causes parasomnia. In fact, in one study of 325 women with a diagnosed parasomnia, most women reported that their symptoms decreased during pregnancy. Vivid dreams and nightmares may be a sign that you are anxious about your pregnancy.

What if you have a parasomnia before pregnancy?

Although pregnancy probably will not make a parasomnia worse, it could be dangerous for your pregnancy if you have a sleep disorder like sleepwalking, confusional arousal, or REM sleep behavior disorder that could cause an injury. You might gain too much weight or eat something toxic if you have binge eating during sleep.

Another danger could be your treatment medication. One common medication used to treat parasomnias is a benzodiazepine. Brand names include Klonopin and Ativan. Benzodiazepines are not considered safe during pregnancy. Use in early pregnancy has been linked to miscarriage (loss of pregnancy from spontaneous abortion).

If you are on a benzodiazepine, you should come off before you try to get pregnant. This is the best choice, because it is safer to taper the dose of these drugs over time than to stop abruptly. Let your doctor know if you become pregnant on a benzodiazepine.

What can you do about parasomnias or disturbing dreams during pregnancy?

The first thing to do is talk to your doctor or pregnancy care provider about any sleep disturbance. Some sleep disorders like sleep apnea and restless leg syndrome are more common during pregnancy and may trigger a parasomnia.

If a sleep disorder is causing anxiety or preventing you from getting enough sleep, your health care provider may send you to see a sleep medicine specialist. There are also some simple things you can try on your own:

  • Tell your pregnancy care provider if you are struggling with any fears or anxiety about your pregnancy.
  • If you have a parasomnia that may cause you to leave your bed at night, add locks or alarms to doors and windows, sleep on the ground floor, and remove any clutter from your floor to prevent falls.
  • Keep a good sleep schedule. Try to go to sleep and wake up at about the same time every day.
  • Practice good sleep hygiene, which includes keeping your bedroom dark, quiet, and comfortable.
  • Avoid disturbing or exciting activities or media before bed. Leave the last hour before sleep for some relaxation.
  • Avoid drinking fluids in the hours before bed. This may cut down on waking to go to the bathroom.
Christopher Iliades
Dr. Chris Iliades is a medical doctor with 20 years of experience in clinical medicine and clinical research. Chris has been a full time medical writer and journalist since 2004. His byline appears in over 1,000 articles online including EverydayHealth, The Clinical Advisor, and Healthgrades. He has also written for print media including Cruising World Magazine, MD News, and The Johns Hopkins Children's Center Magazine. Chris lives with his wife and close to his three children and four grandchildren in the Boston area.

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