rors usually begin during the first third of the major sleep episode and last 1–10 minutes,
but they may last considerably longer, partic ularly in children. The episodes are accom-
panied by impressive autonomic arousal and behavioral manifestations of intense fear.
During an episode, the individual is difficult to  awaken or comfort. If the individual awak-
ens after the sleep terror, little or none of th e dream, or only fragmentary, single images,
are recalled. During a typical episode of sleep terrors, the individual abruptly sits up in
bed screaming or crying, with a frightened ex pression and autonomic signs of intense anx-
iety (e.g., tachycardia,  rapid breathing, sweating, dilati on of the pupils). The individual
may be inconsolable and is usually unresponsive to the efforts of others to awaken or com-
fort him or her. Slee p terrors are also called “night terrors” or “pavor nocturnus.”
Associated Features Supporting Diagnosis
Sleepwalking episodes can include a wide va riety of behaviors. Episodes may begin with
confusion: the individual may simply sit up in  bed, look about, or pick at the blanket or
sheet. This behavior then becomes progress ively complex. The in dividual may actually
leave the bed and walk into closets, out of th e room, and even out of buildings. Individuals
may use the bathroom, eat, talk, or engage in  more complex behaviors. Running and fran-
tic attempts to escape some apparent threat can also occur. Most behaviors during sleep-
walking episodes are routine and of low complexity. However, cases of unlocking doors
and even operating machinery (driving an au tomobile) have been reported. Sleepwalking
can also include inappropriate behavior (e.g.,  commonly, urinating in a closet or waste-