Screaming

What makes people scream at night? Screaming out of a nightmare is not uncommon for most people. However, screaming can also be a sign of a  sleep disorder or anxiety. Night terror and REM Behavioral Disorder (RBD) are examples.

Treatment depends on identifying the disorder. It may require an evaluation by a sleep medicine specialist or psychiatrist. Here are case scenarios

Jack: is a 3 year old boy who screams at night from his sleep. His parents rush to his room only to find him sitting in bed, eyes open appearing in some anguished state. When his parents try to console him, he doesn’t respond to them but looks like he is in a different world. At times, he may walk around the house screaming, looking frightened. The whole ordeal may last 15 minutes; he goes back to sleep on his own. He has no recollection of this event. What Jack has is known as Night Terror. It occurs in children. They typically grow out of it. It may occur in adults, but rarely.

Mr Smith: is a 65 year gentlemen who sleep talks and at times screams. His wife wakes up frightened. Sometime, he kicks his arms and legs up in the air and appears to be acting out a dream. When his wife wakes him up, he recollects a bad dream; typically he is chasing someone who was attacking his wife. Mr Smith has REM Behavioral Disorder (RBD). It is more common in elderly men. When suspected, requires an evaluation by a sleep medicine specialist. In some case, it is associated with Parkinson’s disease or dementia. RBD is treated with medications.

Rick: is 25 year former marine who served in Iraq during the war. He wakes up in the middle of the night about twice a week panicking because he was dreaming about an actual battle scene. He replays that story in his dream. Rick is suffering from Post Traumatic Stress Disorder (PTSD). It is managed with cognitive-behavioral therapy (counseling) and medication.

Rebecca: is a 30 year old young teacher who wakes up about twice a month from sleep with a sensation of rapid heart rate, short of breath, sweating and very anxious. It lasts 15 minutes and then she calms down a while later.  She suffers from daytime generalized anxiety disorder and panic attacks. Rebecca suffers from Nocturnal Panic Attacks (NPA). It can mimic a heart attack or other serious condition, so make sure to discuss it with your doctor. NPA can be treated with cognitive-behavioral therapy (counseling) and medication.

Tips

  • If you were told by a bed partner that you scream and kick or you are troubled by disturbing and frequent nightmares, it is a good idea to talk to a doctor to seek medical attention. A sleep medicine specialist can sort out the cause and treat you or your child accordingly.