Night Terrors
Case Study, Sleep Disorder Nov 16, 2023

Subject: John D., 39 years old


John D. is a 39-year-old project manager in the field of national security. He has lived with his wife, Emily, for seven years. Their life, on the surface, appeared stable and fulfilling. Yet beneath the normalcy, John struggled with a haunting phenomenon. This invaded his nights and left him and his wife bewildered and sleep-deprived.

Presenting Issue:

John had been experiencing severe night terrors since the aftermath of the 9/11 terror attacks. A day that not only shook the world but left an indelible mark on John’s psyche. Working in a field directly related to national security, the constant exposure to terrorism-related information took a toll on his mental well-being.


John’s night terrors began, manifesting as heightened anxiety and occasional nightmares in the months following the 9/11 attacks. However, as the years passed, the intensity escalated. It transformed into full-fledged night terrors. Night terrors were marked by intense fear, vivid imagery, and frantic movements.


Night Terrors: John would awaken from sleep, drenched in sweat, with a look of sheer terror. Rapid breathing palpitations accompanied these episodes. And an inability to communicate or recall the content of the nightmares.

Sleepwalking. John’s tendency to sleepwalk during these night terror episodes was a concerning development. Emily reported finding him in various parts of their home and sometimes engaging in innocuous activities. Other times, it is more hazardous, such as attempting to open windows.

Emotional Distress. Outside of the nocturnal episodes, John exhibited signs of emotional distress during waking hours. He displayed heightened irritability, difficulty concentrating, and an overall sense of unease.

Contributing Factors:

Occupational Stress. John’s occupation in the national security field exposed him to constant information about terrorism, threats, and security concerns. The cumulative effect of this exposure contributed to his heightened anxiety and distress.

Post-Traumatic Stress: The 9/11 attacks acted as a catalyst for John’s night terrors. It served as a traumatic event that lingered in his subconscious and manifested during sleep.

Irregular Sleep Patterns. The stress and anxiety associated with his work are coupled with irregular sleep patterns due to demanding hours and further disrupt John’s sleep architecture, making him more susceptible to night terrors.

Fear of the Unknown: The nature of John’s work amplified his fear of the unknown. It created a constant hypervigilance that infiltrated his subconscious mind, even during sleep.

Treatment Approach:

John’s case necessitated a comprehensive and multidisciplinary approach to address both the psychological and behavioral aspects of his condition:

  1. Cognitive-behavioral therapy (CBT).

    CBT was employed to help John identify and challenge negative thought patterns associated with his work-related stress and the traumatic memories of 9/11. This included desensitization techniques to reduce the emotional charge related to those memories.


  2. Sleep Hygiene Education:

    John received guidance on establishing a consistent sleep routine. It created a sleep-conducive environment and minimized factors that could disrupt his sleep.


  3. Medication Management:

    In consultation with a psychiatrist, John was prescribed medication to reduce anxiety and promote more restful sleep. with careful consideration given to potential side effects and interactions.


  4. Trauma-Informed Counseling:

    A specialized form of counseling focused on trauma was integrated into John’s treatment plan. To address the lingering effects of the 9/11 attacks on his mental health.


  5. Sleep Study:

    A comprehensive sleep study was conducted to check John’s sleep patterns. Further, to identify any potential sleep disorders and tailor interventions.


Over several months, John showed significant improvement. The frequency and intensity of his night terrors decreased. And the occurrences of sleepwalking diminished. Combining therapeutic interventions, improved sleep hygiene, and medication management was crucial in restoring a sense of normalcy to John’s life.

However, ongoing therapy and support were deemed essential. to help him navigate the ongoing challenges associated with his occupation and the potential triggers that might resurface. The case of John D. underscores the intricate interplay between life experiences, occupation-related stress, and the manifestation of sleep disorders, emphasizing the importance of a holistic and individualized approach to treatment.

"Night terrors: where the shadows whisper louder than dreams."
About author

Karuna Kaul is psycho socio clinical psychologist, who works with all age group people. Her profession motivates her to serve people who are facing behavioral issues. She has over 8 years of experience and has successfully established credibility in the areas of counselling and wellness. Assessment and behavioral analysis and training and coaching. She has been an active advocate of mental health awareness. And all her endeavors in the field are primarily focused on educating more and more people about Mental Health concerns and promoting Holistic Wellbeing. She has done master in clinical psychology PG Diploma in counselling and guidance and certified in drug addiction counselling Also she has done neuro medicine psychology from London University, Kent College of United Kingdom. With an experience of six years, she had worked with various organization which provides mental health services.