Menopause doesn’t directly cause night terrors, though sleep issues and insomnia are common during this transition. Night terror triggers vary but may include stress, medication, and more.
People of all ages may have night terrors, especially during stressful or challenging times.
Night terrors may sometimes begin in adulthood, including during menopause, but this isn’t common. The stress around this natural transition may be triggering them.
Partners and other household members, if any, may notice most of the symptoms of night terrors. The person experiencing the night terror typically remains asleep for the entire episode.
During a night terror episode, you may:
- appear to be experiencing extreme terror
- scream or shout
- violently or unruly flail your arms, kick your legs, or move about
- sit upright in bed
- open your eyes wide, even though you’re asleep
- have dilated pupils
- sweat profusely and look flushed
- have a racing pulse or breathe or pant heavily
- sleepwalk
- be hard to awaken or be soothed by others
You may be unusually tired the next day or wake up with unexplained injuries or feelings of intense confusion.
Night terrors can be short or last as long as 20 minutes. After the episode, you may enter REM sleep without remembering the event.
Night terrors vs. nightmares
Night terrors aren’t the same as nightmares.
| Night terrors | Nightmares |
|---|---|
| affect mostly adults | affect children and adults |
| usually don’t wake you up, and you won’t remember them | may cause you to wake suddenly and you may remember fragments of them |
| a form of parasomnia, which involves undesirable physical or verbal behaviors during sleep that aren’t under the sleeper’s voluntary control | aren’t a type of sleep disorder |
| occur during deep sleep, also known as slow-wave sleep, or during the transitional period from non-REM to REM sleep (happen earlier in the night) | occur during rapid eye movement (REM) sleep, a period of time when your brain is very active (happen later in the night) |
Menopause and perimenopause don’t directly trigger night terrors. Common triggers in adults may include:
- stress
- alcohol
- caffeine
Certain medications may also trigger parasomnia in some people. These may include:
- beta-blockers
- statins
- nicotine replacement therapy drugs
- selective serotonin reuptake inhibitors (SSRIs)
Health and mental health conditions may make adults more likely to have night terrors, possibly including:
Fluctuating hormones, including estrogen, may be at the root of your sleep issues during menopause.
Your levels of estrogen drop for several years after your last menstrual period. Once estrogen has stabilized, your sleep problems may improve.
Melatonin is another hormone that may affect sleep quality.
It supports regulation of the sleep-wake cycle, also known as your circadian rhythm. This cycle helps your body know when to go to sleep and when to wake up.
Melatonin levels gradually decrease as menopause approaches and with age. This may also contribute to menopause-related sleep disturbances.
If you experience frequent night terrors, talk with your doctor. This is especially important if night terrors expose you to danger or affect your ability to stay awake during the day.
Your doctor will physically examine you and look for signs of sleep disorders such as sleep apnea. They’ll talk with you about your symptoms and ask about your family history of parasomnia.
If you have a consistent sleep partner or other household members, your doctor may ask them what they’ve observed.
Your doctor may recommend a sleep study, or polysomnography. During this overnight test, sensors on your body will record your:
- brain wave activity
- blood oxygen level
- respiration
- heart rate
- leg movements
- eye movements
Treatments for night terrors vary and may be based on the underlying causes of your condition.
Since night terrors can lead to insomnia, creating a healthy sleep routine and incorporating good sleep hygiene tips may be beneficial.
This may include:
- limiting alcohol and caffeine consumption, especially in the evening
- waking up and going to bed at the same time every day (including weekends)
- avoiding large meals and spicy foods before bedtime
- exercising regularly
- putting your phone and other devices away at least 30 minutes before bed
Anticipatory awakening therapy may also be an option. This involves being woken up around 15 minutes before a night terror episode typically occurs.
You then keep yourself awake for several minutes before falling back asleep. You can have someone else wake you up or set an alarm.
Mental health conditions and sleep disorders may be addressed with therapies such as:
Working with a mental health professional may help you learn to manage stress and reduce night terrors.
Partners and other household members should take precautions to keep you safe from harm during an episode. This includes eliminating your access to:
- stairs
- outside of your home
- vehicles
If you wake up in places you know you didn’t fall asleep, you might also try motion-sensor cameras. You can then bring this footage to a health professional to help with their diagnosis.
Meditating, reading a book, or doing other relaxing activities, such as taking a warm bath, before bed may help.
Avoid engaging with stress triggers before bed, such as going through work emails and other stress-inducing behaviors.
Menopause isn’t a direct cause of night terrors, but it’s associated with several sleep concerns, including sleep apnea, night sweats, and insomnia.
Factors that increase your risk of night terrors include stress, alcohol, and certain medications. Speaking with your doctor or a mental health professional may help improve your sleep quality.
You might also try incorporating good sleep hygiene and establishing a sleep routine, among other lifestyle changes, to help improve your sleep during menopause.