Dear Dream Doctor,

I am 35, mother of four (ages 11, 10, 8, 3), a devout Catholic, college-educated, Anglo, married 13 years to an attorney who is doing well financially in his private practice. I have stayed at home to raise my family and have stayed active with volunteering and with writing for a few newspapers. I am happy these days, but nearly every night for months, I have nightmares. (I have experienced insomnia for years).

In my nightmares, for example, there is blood all over me or my child, or somebody’s dead, or there are slimy bugs covering me, or there are tarantulas in my bed, or evil spirits around me. When I open my eyes, I am still in a dreaming state for several seconds and “see” what I am dreaming, until I turn on the light. I also scream or gasp audibly—which alarms my family.

Though I am hallucinating things, I am conscious enough to know they are not actually there—even when I “see” them. I have thought about asking my doctor for a sleep aid (a small dose of Elavil for night time only which I used years ago) but wondered if I should consult a sleep disorder physician. Thanks!

—Deanna, Age 35, Married, USA

Hi Deanna -

Judging by your description, you appear to be experiencing what are known as night terrors—rather than nightmares. The difference is that night terrors occur during the transition from deep sleep (delta) to light sleep, usually within 1-3 hours of dozing off. Nightmares, on the other hand, occur during REM, and can come at any time during the night. As a rule, night terrors are not associated with any type of psychological disturbance, but they are associated (mildly) with anxiety. Did anything occur in the last few months (at the time the arousals began) that has caused you increased stress?

The reason the images persist after you awaken is because part of your brain—as is the case with night terrors—remains partly asleep. Night terrors are a subset of a broader group of sleep disorders known as confusional arousals. Mild confusional arousals, most common in children, are sitting up in bed during the night, sleep talking, and sleep walking. If an arousal is agitated, then the arousal is called a night terror. (The panic is caused by the disorientation which the half awake half asleep state causes.) As a rule, children’s confusional arousals—including night terrors and sleep walking—are not recalled the following day, because, in actuality, the child never was fully awake. Because you awaken gradually from your arousal, you are able to recall your event.

Confusional arousals in adults are less common than in children, but still occur with a great deal of frequency throughout the population. It is a mystery why people who experience confusional arousals from sleep often dream of spiders, insects, and other “disgusting” creatures—but the general feeling we experience in these states is one of vulnerability—again, most likely due to the confusion which being half awake, and half asleep, causes.

Before you pursue a path of seeking medication to help your arousals, I suggest you try a simpler approach, alluded to by your report. It is consistently reported among sufferers of night terrors that leaving a light on in the room while sleeping eliminates the confusional arousals—and the hallucinations. The reason why is because the light will allow you—in those half-asleep, half-awake states—to quickly orient yourself to your bedroom and surroundings. This orientation will prevent the confusion and ensuing sense of vulnerability. Most people report it is very effective. Try a soft light (a night light), so that it doesn’t disturb your husband. If you do give it a try, I hope you will please write back and let us know how it works. Many people with the same problem will be curious to hear your experience.

Dear Dream Doctor,

Thanks for your analysis. It is a relief that the hallucinations do not mean that I’m crazy. Actually, because we have a three-year old who wanders into our bed at night, we have several soft glow nightlights throughout the room. It is through this illumination that I am able to “see” the spiders (or whatever) yet I know they’re not really there and I prove it by turning on the big light.

Though the night terrors have increased in frequency for the past several months, they started four years ago, when a 36-year old friend died in her sleep of “nothing” (results of autopsy). A few months prior to her death, I had premonitions of someone in that family dying (though I did not know it would be her) which increased the stress that horrible event caused. Within a year of my friend’s death, several more stressful events occurred. (For instance, six weeks after our fourth child was born, my husband said he wanted a divorce because he had become involved with a young law student at his office. We made it through that difficult time and he stayed.)

I know how much I have been through and I sometimes think my brain or parts of its structure has suffered chemical damage from the stress hormones to which it has been exposed. I just wish I could make the night terrors stop...Thanks again.

Hi Deanna—