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My husband always gets night terrors and hits me. What do I do?

The question: My spouse has night terrors. He frequently yells out in the night, often profanities, and thrashes around wildly. What could be causing this?

The answer: Night terrors – also known as sleep terrors – are intense nightmares that can occur recurrently. Up to 6 per cent of children will experience night terrors, which they usually outgrow by adolescence. Night terrors are significantly less common among adults, with less than 1 per cent of adults experiencing them.

Night terrors are a parasomnia disorder and have a number of features that distinguish them from bad dreams or nightmares (which most people experience, particularly during stressful life periods). They typically occur within the first two to three hours of sleep, during stage 3 or 4 (non-rapid eye movement, or NREM) sleep, whereas dreams or nightmares occur during the rapid-eye movement (REM) stage of sleep.

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As with your husband, most people with night terrors will demonstrate elaborate motor activity: They'll thrash around, sometimes hitting or attacking who they are sleeping with, either during the night terror or immediately upon awakening. They will also demonstrate symptoms of high physiological arousal, such as an increased heart rate, rapid breathing or sweating. Sleepwalking may occur. Upon waking, they will experience intense fear and may be inconsolable, then often demonstrate partial or full amnesia about the incident.

Recurrent night terrors can have a significant impact on a person's quality of life, contribute to ongoing sleep deprivation, and even pose a risk to their partner when they sleep in the same bed at night.

First, it's important to obtain a correct diagnosis of your husband's condition. Speak to your family doctor about getting a full physical done, and ask for a referral to a sleep clinic. A sleep study, or polysomnography, involves overnight monitoring of an individual's sleep patterns, including brain activity, eye and muscular movements and heart-rate patterns. An appropriate diagnosis is vital to fully ascertain what treatment would be helpful for him. He must be able to rule out other health conditions that may be causing the night terrors, such as a low blood-sugar level or epilepsy.

From a behavioural and psychological perspective, night terrors can be the result of an underlying condition, such as post-traumatic stress disorder or another anxiety disorder. Effective treatment of any emotional difficulties can lead to significant improvements in your husband's sleep problems.

Good sleep hygiene is also key. Try these tips:

  • Establish a consistent wake-up time and aim to get seven to eight hours of sleep a night.
  • Reduce, and ideally eliminate, any non-prescription drug or alcohol consumption.
  • Stop caffeine intake by early afternoon.
  • Create a relaxing sleep routine. Try having a warm glass of milk or drawing a bath. The idea is to reduce activities that are associated with the state of being “alert” right before bed, such as watching TV or working on a laptop.
  • Ensure that the bedroom is a calming environment. Try out more comfortable bedding and pillows, or put up blinds or shades that block out light.

Dr. Joti Samra, R.Psych., is a clinical psychologist and organizational & media consultant. She is the host of OWN: Oprah Winfrey Network's Million Dollar Neighbourhood and is the psychological consultant to CITY-TV's The Bachelor Canada. Her website is and she can be followed @drjotisamra .

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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