Someone sits bolt upright in bed, screaming, eyes open, and cannot be comforted. Or walks downstairs fast asleep and tries to leave the house. Or wakes again and again from the same terrifying dream.
These are parasomnias: unwanted events that happen during sleep. They are common in children and not rare in adults, and they can be alarming for everyone in the house.
The main types
Sleepwalking. Getting up and moving about while still asleep, with a blank expression and no memory afterwards.
Sleep terrors (night terrors). A sudden scream and apparent terror, with a racing heart and sweating. The person is not really awake, cannot be consoled, and remembers little or nothing.
Both of these happen in deep sleep, usually in the first third of the night. They are partial awakenings: part of the brain wakes while the rest stays asleep.
Nightmares. Frightening dreams that wake you fully, with clear memory of the dream. These happen in REM sleep, more often towards morning.
The difference matters, because the treatments differ.
What the research shows
A five-year study. Sleep specialists at the Mayo Clinic gave 36 patients, aged 6 to 71, one or two sessions of hypnotherapy for parasomnias such as sleepwalking and sleep terrors, and followed them by questionnaire.
- At one month, 45 per cent were free of symptoms or much improved.
- At eighteen months, 42 per cent.
- At five years, 41 per cent.
The authors concluded that one or two sessions of hypnotherapy might be an efficient first-line treatment for certain parasomnias.
There was no control group, and some parasomnias improve with time anyway. But a benefit holding steady over five years after one or two sessions is notable, particularly as the alternatives are limited.
Children’s sleep. In a review of 84 children and teenagers treated with hypnosis for insomnia at an American clinic, 90 per cent of those who had taken more than half an hour to fall asleep reported that it took less time afterwards. Of those who woke in the night more than once a week, 52 per cent reported that the awakenings stopped and a further 38 per cent that they improved. This too was an uncontrolled review of case notes.
Why hypnosis might help
- Lower arousal at bedtime. Stress and overtiredness trigger deep-sleep parasomnias.
- Suggestions for calm, continuous sleep.
- A cue to wake fully or settle back. For sleepwalkers, a suggestion that feet touching the floor is a signal to wake.
- For nightmares: rehearsing a changed ending.
- Less fear of going to bed.
Nightmares: rewrite the script
The best-tested treatment for recurrent nightmares is imagery rehearsal therapy, and it combines well with self-hypnosis.
- Write the nightmare down.
- Change it in any way you like: the ending, a detail, the whole plot. It does not have to be realistic.
- Rehearse the new version in your imagination for ten to twenty minutes a day, while relaxed.
- Do not rehearse the original.
Over a few weeks, many people find the nightmare becomes less frequent or changes.
Nightmares after trauma should be treated as part of trauma care.
A bedtime routine
- Keep a regular bedtime and get enough sleep. Sleep loss is a major trigger.
- Wind down for half an hour without screens.
- In bed, breathe slowly and relax your body from head to toe.
- Imagine a peaceful place.
- Suggest: “I sleep deeply and calmly through the night, safe in my bed, and wake refreshed.”
- Sleepwalkers can add: “If my feet touch the floor, I wake up.”
- Let yourself drift off.
Safety first for sleepwalkers
- Lock doors and windows; keep keys out of easy reach.
- Use a stair gate if needed.
- Clear the floor of things to trip on.
- Avoid bunk beds and sleeping near balconies.
- Do not shake a sleepwalker awake. Guide them gently back to bed.
- Avoid alcohol, which makes episodes more likely.
For parents
Sleep terrors look dreadful and are harmless to the child, who will not remember. Do not try to wake them. Stay close, keep them safe, and wait. Most children grow out of both sleepwalking and sleep terrors.
If episodes happen at a predictable time, gently rousing the child fifteen to thirty minutes beforehand for a few weeks can break the pattern.
See a doctor
- Episodes that are frequent, violent or cause injury
- Onset in adulthood
- Acting out dreams, with shouting, punching or kicking, especially in an older adult. This can be a different disorder that needs assessment.
- Loud snoring, gasping, or daytime sleepiness, which suggest sleep apnoea
- Any possibility of seizures
- New episodes after starting a medication
A sleep clinic can sort out which kind of problem it is.
The bottom line
For sleepwalking and sleep terrors, one or two sessions of hypnosis helped around four in ten people in a five-year study. For nightmares, rewriting and rehearsing the dream is the proven method. Start with regular sleep and a safe bedroom.
Next in the series: Hypnosis for Pregnancy Sickness
This article is for general information and is not medical advice.