An evolutionary perspective on night terrors.

Sean D Boyden,Philip T Starks,Martha Pott

doi:10.1093/emph/eoy010

Abstract

Night terrors, also known as sleep terrors, are an early childhood parasomnia characterized by screams or cries, behavioral manifestations of extreme fear, difficulty waking and inconsolability upon awakening. The mechanism causing night terrors is unknown, and a consistently successful treatment has yet to be documented. Here, we argue that cultural practices have moved us away from an ultimate solution: cosleeping. Cosleeping is the norm for closely related primates and for humans in non-Western cultures. In recent years, however, cosleeping has been discouraged by the Western medical community. From an evolutionary perspective, cosleeping provides health and safety benefits for developing children. We discuss night terrors, and immediate and long-term health features, with respect to cosleeping, room-sharing and solitary sleeping. We suggest that cosleeping with children (≥1-year-old) may prevent night terrors and that, under certain circumstances, cosleeping with infants (≤11-months-old) is preferable to room-sharing, and both are preferable to solitary sleeping.

Highlights

Night terrors are an early childhood parasomnia associated with disturbance from non-REM, slowwave sleep [1]
According to the American Academy of Sleep Medicine’s (AASM) International Classification of Sleep Disorders, night terrors are defined as ‘a cry or piercing scream, accompanied by autonomic nervous system and behavioral manifestations of intense fear. . . . Sometimes there is prolonged inconsolability associated with a [night] terror’ [2]
Research has yielded discrepant results regarding the likelihood of experiencing night terrors with measurements ranging from 1.7% to almost 56% of individuals and ages ranging from 18 months to adolescence [4,5,6]. (Night terrors occur in adults, but rarely so.) Prevalence has most frequently been assessed in school-age children, research has demonstrated that night terrors are most common in children between 1 and 5 years ß The Author(s) 2018

Summary

INTRODUCTION

Night terrors are an early childhood parasomnia associated with disturbance from non-REM, slowwave sleep [1]. By the summer of 2014, PTS’ 3-year-old child had been experiencing four to seven night terrors weekly for several months Finding this behavior disturbing, PTS standardized the child’s schedule, modified his diet, and monitored for suitability the images and stories to which he was exposed. When schoolaged children have any memory of a night terror they typically report indistinct recollections of threats (such as monsters, spiders, snakes, etc.) or fear of ‘something’ that ‘is after me’ or ‘that is going to get me’ [21] Other benefits, such as shared body heat and greater physiological regulation (e.g. of the heartbeat) have been demonstrated in infants (see Table 1 [11, 22,23,24,25,26,27]). Night terrors may be an extreme response to the evolutionary-environmental mismatch that has resulted from changes in human sleeping behavior from cosleeping to sleeping separately

ATTACHMENT THEORY

Unexpected infant death risk "

Comfort with sexuality in adulthood

Alternative hypotheses

Findings

CONCLUSION