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Cited by 9Infant Health and DevelopmentSleep and related disordersSleep and Wakefulness Research

An evolutionary perspective on night terrors

Open access
Boyden, Sean D, Pott, Martha, Starks, Philip T·2018·Evolution, Medicine, and Public Health
DOI 10.1093/emph/eoy010PMC PMC5941156
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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.

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Crossref · 10.1093/emph/eoy010

Cites

51 of 51 references verified0 citation errors · 0 not checkable

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  • Attempts to interrupt a sleep terror episode can lead to a paradoxical increase in aggression.

    “Attempts to interrupt a sleep terror episode should be avoided as such intervention may confuse and frighten the child even more and can lead to paradoxical increase in aggression [33, 61, 76].”

    From Sleep Terrors: An Updated Review (2020) · cites this paper as [76]

    The Introduction recommends letting a night terror proceed uninterrupted because the child is unlikely to respond to attempts to wake them and may be inconsolable afterward. It does not say that interruption can cause a paradoxical increase in aggression. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Attempts to interrupt a sleep terror episode may confuse and frighten the child even more.

    “Attempts to interrupt a sleep terror episode should be avoided as such intervention may confuse and frighten the child even more and can lead to paradoxical increase in aggression [33, 61, 76].”

    From Sleep Terrors: An Updated Review (2020) · cites this paper as [76]

    The Introduction (page unavailable) recommends letting a child's night terror proceed uninterrupted, noting that the child is unlikely to respond to waking attempts and is often inconsolable upon awakening. It does not say that interruption may make the child more confused or frightened. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Anticipatory awakening, performed approximately half an hour before the child is most likely to experience a sleep terror episode, is often effective for the treatment of frequently occurring sleep terrors.

    “Anticipatory awakening, performed approximately half an hour before the child is most likely to experience a sleep terror episode, is often effective for the treatment of frequently occurring sleep terrors [9, 22, 42, 57, 65, 76].”

    From Sleep Terrors: An Updated Review (2020) · cites this paper as [76]

    The Introduction (page unavailable) says scheduled awakenings have been used to treat night terrors. It does not specify awakening half an hour before an expected episode or say the approach is often effective; it reports that scheduled awakenings had little impact in one child's case. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • In the majority of cases, no medical intervention other than reassurance and parental education is required for sleep terrors.

    “Otherwise, no medical intervention is required [76].”

    From Sleep Terrors: An Updated Review (2020) · cites this paper as [76]

  • Melatonin has been found to be useful for the treatment of sleep terrors.

    “Melatonin (N-acetyl-5-methoxytryptamine) has also been found to be useful [17, 76, 80-82].”

    From Sleep Terrors: An Updated Review (2020) · cites this paper as [76]

    The Introduction says some medications have been effective in case studies, but does not identify melatonin as one of them. The cited treatment in the References is ramelteon, not melatonin; a search for melatonin found no passage addressing its use for sleep terrors. The paper’s statement that no effective remedy has been established does not, by itself, show that melatonin is ineffective. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

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Cites

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Research works printed but not linked: 2

  1. [38]Heron P. Nonreactive co-sleeping and child behavior: getting a good night’s sleep all night every night, Masters’ Thesis Bristol, UK: University of Bristol 1994.
  2. [41]Mosenkis J. The effects of childhood coslceping on later life development, Masters’ Thesis. Chicago, IL: University of Chicago 1998.

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Authors
Boyden, S. D., Pott, M., & Starks, P. T.
Affiliations
Tufts University (US)
Corresponding author
Starks, Philip T
ORCID
Starks, Philip T
Venue
Evolution, Medicine, and Public Health
Publisher
Oxford University Press (OUP)
Published
2018-01-01
Volume
2018
Issue
1
Pages
100-105
ISSN
2050-6201 (ISSN-L)
DOI
10.1093/emph/eoy010
PMC
PMC5941156
OpenAlex
W2801518328
Cited by
9
References
51
Citations by year
2025: 1 · 2022: 4 · 2021: 2 · 2020: 1 · 2019: 1
FWCI
1.98
Type
journal article
Language
en
Open access
Licence
Locations
  • Evolution Medicine and Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › Pharmacy › Infant Health and Development
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
Keywords
night terrors, sleep terrors, parasomnias, co-sleeping, evolutionary medicine, room sharing, infant sleep, children's sleep, cultural practices

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