An assessment of risk factors is necessary as part of the determination of treatment. If the sleep terrors are thought to be an adverse drug effect, discontinuation of the triggering medication is advised. When an antihistamine is considered as the triggering medication, an evaluation of the cause of rhinitis would be beneficial. Many patients misuse allergy medications, and a physician-directed approach may help determine whether it is possible to identify and avoid the allergy-inducing substance. If avoidance is not feasible, the physician can recommend another treatment for the allergic symptoms that does not precipitate sleep terrors.
Some patients who have persistent sleep terrors despite conservative measures may benefit from counseling and talk therapy. Medication is sometimes prescribed for patients with persistent symptoms. The medications used for sleep terrors include benzodiazepines and selective serotonin reuptake inhibitor (SSRI) antidepressants, such as paroxetine.
The prognosis of sleep terrors is generally favorable. Children may outgrow the episodes. Additionally, children often experience improvement with management of underlying risk factors, such as sleep deprivation or anxiety.
Adults also have a good prognosis but are more likely to require medical intervention. When a medication causes sleep terrors, stopping the medication generally leads to a resolution of symptoms.
However, adults may be more disturbed by the events than children are and could become concerned about a possible underlying psychological or psychiatric disorder. Adults may also be concerned about the effects of their parasomnia on others. Reassurance about the prognosis and about the lack of a strong link to underlying psychological or psychiatric causes can be beneficial for adult patients who are concerned about the implications of their sleep terrors, and this may also help to prevent exacerbation of the symptoms.
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