Nightmares & Night Terrors
How can I help my child with their nightmares or night terrors?
Nightmares and night terrors are very different experiences.
This article explains how to tell them apart, what causes them, and how you can respond calmly and effectively. Most children outgrow both with time.
Both nightmares and night terrors are very common in young children. Many people think a night terror is a very bad nightmare, but nightmares and night terrors are different.
Nightmares are associated with light [REM] sleep and night terrors happen during deep [Non REM] sleep.
Here’s how to recognise the difference and help your child with nighttime disturbances.
Nightmares
Nightmares or scary dreams are very common indeed in young children. Almost all of two to five year olds will have the odd one. About a quarter of children in this age group will have recurrent or chronic nightmares. Because nightmares are far more common in children than they are in adults, they can be seen as a normal part of child development.
More about nightmares
Nightmares usually happen later on in the night. This is when children experience more light or rapid eye movement sleep [REM sleep.] REM sleep is often called “dream sleep,” in fact. During a nightmare, a child is very unlikely to move, talk or cry out.
They will often wake and cry afterwards. Sometimes they can remember what the scary dream was about and later in the day, they will still be troubled by it. It’s not uncommon for children to be so upset by a nightmare that they are afraid to go to bed at night.
As with bed time fears, a child’s nightmares reflect where they at in terms of their development. A child of two is more likely to dream about scary monsters, whereas a child of five is more likely to dream about something upsetting that they’ve seen in the day – either a real life event or a film or video.
What triggers nightmares?
Having the odd nightmare is just a normal aspect of sleep and childhood. The main factors which are known to make the nightmares worse or more frequent are:
- Not getting enough sleep. When children are over tired, they are more likely to have nightmares.
- Stress or trauma. Nightmares which follow an upsetting or traumatic incident in your child’s life, will usually start about three months after the event.
- Being unwell or having a high temperature.
- Family tendency for nightmares. If you or your partner had or have nightmares, there is more potential for your child to have them too.
- Anxiety. If your child is generally anxious and/or has separation anxiety, they may have more of tendency to have nightmares.
How you can help your child with their nightmares
Young children don’t find it easy to tell the difference between dreaming and reality. So it is really helpful to tell them that their bad dream was not a real thing that happened.
During the day, explain that bad dreams are normal, not real life and they do not come true.
When you’re in the moment
• If they wake from a nightmare and they are upset, reassure them and explain that it was just a dream.
• Encourage them to them to repeat a simple mantra e.g. “Its gone now – silly dream!”
• If your child is old enough, teach them how to change the ending of a bad dream into a funny or safe one, e.g. the giant that was chasing them turns into a little mouse and runs away!
• Try always to act in a way that is calm and reassuring. If they are feeling frightened and out of control, they need to know that you are strong, and they are safe.
• After you have given them some reassurance, it’s better that they go back to sleep in their own bed rather than getting in with you. Firstly, coming into your bed may become a habit and secondly, it may give validation to the dream and their fears that actually they are not safe on their own.
• For the same reasons, it is best that you don’t sleep on their bedroom floor or in their bed with them.
Other ways to help your child with nightmares are:
- Make sure that they have early nights and are well rested.
- Keep their temperature down if they have a fever.
- Follow a reassuringly repetitive bedtime routine, to help them feel safe.
- End the day on a calm and happy note.
- Avoid having them watch scary films.
- Be careful about books with scary content if you know that they are sensitive or anxious.
- If they need a nightlight, have one with a red glow. This is less likely to interfere with their sleep hormone production.
When to seek help
If your child is having nightmares very often, it’s a good idea to speak to their doctor. The same applies if the dreams are always about the same thing, or if they seem to be making your child anxious or fearful during the day.
Night Terrors [Sleep Terrors]
Because these episodes can also happen during naps, health professionals usually refer to night terrors as sleep terrors.
Unlike nightmares — which occur during lighter sleep — sleep terrors happen during deep (or slow wave) sleep. They’re part of a group of sleep disturbances known as disorders of arousal or parasomnias, which also include sleepwalking and sleep talking.
Sleep terrors occur when there’s a brief, partial awakening during deep non-REM sleep. They typically happen in the first part of the night — usually between one to three hours after your child has fallen asleep.
What a night terror looks like
During a night terror, a child will usually thrash around and often cry and call out. They can look terrified [hence the name] and they may also be sweating and have a racing pulse. Although they look like they are awake, they are not, and they will not respond to you trying to comfort and reassure them.
The whole event can last for anything between a few minutes to over an hour. Although they are very dramatic and distressing for parents to see, the child doesn’t wake up and usually can’t remember anything about it in the morning. It is often said that the night terror is worse for the parents than for the child.
More about night/sleep terrors
It’s very important to understand that sleep terrors are connected with brain development and are not usually caused by emotional or psychological issues. Neither does the experience of having a sleep terror cause any emotional or psychological damage to a child. However, if your child has a tendency towards having them, they can be worse at stressful times.
Traditionally it has been thought that night terrors start at around the age of four, but a recent study found that they can start from about eighteen months old. The same study also found that just over half of all children will experience at least one night terror at some point before the age of thirteen. Often with a younger child, a confusional arousal [see below] can be mistaken for a night terror, as they occur at the same time of night and have similar features.
A family thing!
Night terrors affect between one percent and six percent of children and so they are not that common. Whilst they can continue throughout childhood, they are usually worse and more frequent when they first start happening.
Then they gradually improve and are outgrown by adolescence. However children who have experienced night terrors when they are small, will often continue with or go on to become sleep walkers or sleep talkers!
Night terrors, sleep walking and sleep talking often run in families. If you or your partner had or have any of these, there is an increased chance that your child will too.
Things that can make night terrors worse or more frequent
• Over tiredness [sleep deprivation]
• A high temperature during illness
• Separation or general anxiety
• Inconsistent sleep routines
• Sudden loud noise when your child is in deep sleep
And in addition, some longer term physical conditions:
• Obstructive sleep apnoea
• Night time asthma
• Restless leg syndrome
• Gastro intestinal reflux
How you can help your child with their night/sleep terrors
♥ Avoid your child becoming sleep deprived and keep a very regular sleep/wake schedule.
♥ Make sure that any medical conditions, especially those that affect their breathing are being treated and controlled.
♥ If they are poorly, keep their temperature down with paracetamol, a cool room and clothing, and plenty of fluids
♥ Have a consistent bed time routine and do the best that you can to create a calm atmosphere in your home, especially before bed time.
♥ Keep your child’s sleep space safe and remove any pieces of furniture that they could fall over or hurt themselves on.
♥ Have a dim, red night light on, so that you can see them and keep them safe if they experience a night terror.
When you're in the moment
• During an episode do not try to wake your child. It will not help and it could cause them to feel distressed if they wake up and don’t recognise you at first.
• Stay calm, stay quiet, stay with them and keep them safe.
• Be patient, don’t panic – just wait for the episode to pass.
• When it is over, guide them back to bed if they’ve got out and let them continue to sleep.
• If your child’s night terror happens at the same time either every night or on the nights where they have one, you can try something called “scheduled awakening.” [See below.]
Talking to your child
Because your child has no recollection of the night terror, there is no benefit in discussing the episode with them afterwards. However, if you’re moving things in their bedroom so they don’t hurt themselves, it is right to explain why. Use simple and harmless terms. Try something along the lines of, “Sometimes when you are deeply asleep, you stomp, shout and move about!……and you don’t even wake up!”
Reassure them that lots of children do the same thing, and that they will grow out of it. Tell them [if it’s true] that you or your partner used to do the same when you were children.
You should also explain their night terrors to them if you are talking to their siblings about them, or are preparing them to go for a sleep over with family or friends.
Scheduled awakening
Scheduled awakening is a technique that can be used to treat night terrors and sleep walking. Fifteen to thirty minutes before you predict that your child is going to experience an episode, you go them and semi wake them up. The best way to do this is by repositioning them, tucking them in, telling them that you love them etc. This disrupts their sleep cycle and causes them to enter a new one, often “bypassing” the night terror. Don’t wake them up fully as this may upset and confuse them. Equally, don’t be too tentative as you may not rouse them enough, and the technique won’t work. They need to come into lighter sleep but still have their eyes closed.
Note: Scheduled awakening can also be used to try and extend the night of a child who wakes up too early in the morning.
Other sleep disturbances
Confusional arousals
These are very common in toddlers and young children, and they can easily be mistaken for night terrors. In fact in very young children, confusional arousals are far more common than night terrors!
About seventeen percent of young children will experience confusional arousals. Like night terrors, they mainly happen early in the night if a child stirs or is awoken during non REM sleep [deep/slow wave] sleep. Sometimes these episodes can happen when they are waking up first thing in the morning as well.
What a confusional arousal looks like
Typically, a child will be sitting up in their cot or bed, with their eyes open and crying things like “No! No! No!” Sometimes they will be just moaning or whimpering. They are still asleep and so they will seem disorientated and in another world. They will be difficult to rouse, and this is one of the ways that helps you to distinguish a a confusional arousal from a nightmare. Often they will seem angry and will fight you off if you try to comfort them. Confusional arousals usually last for about five to fifteen minutes. As with night terrors, children don’t tend to remember the event, and it is not a sign of emotional or psychological difficulties. It is a developmental stage that lots of children go through and eventually grow out of.
Preventing Confusional Arousals
As with night terrors, to prevent these confusional arousals from happening, avoid letting your child become over tired. When they are unwell, keep their temperature down. If the arousals are happening most nights and at the same time, you can try the scheduled awakening technique, mentioned earlier. When your child is experiencing an episode, it is best to sit quietly beside them and let it run its course rather than trying to wake them up.
Another really helpful thing that you can do to help is to make sure that when your child goes to sleep, they are in the same conditions as they will find themselves in when they naturally wake in their sleep later on. If they fall asleep with the light on/you sitting next to them/music playing etc. and then they wake later and the light is off/you’re gone/the music has stopped, they will understandably feel strange and upset.
Take home
The difference between nightmares and night terrors.
Nightmares are frightening dreams which happen during REM sleep [usually in the last third of the night.] A child wakes up and remembers.
Night Terrors [and Confusional Arousals] happen during NREM sleep – usually in the first part of the night. They can be very dramatic and distressing to witness but the child doesn’t wake up and doesn’t remember.
Further help
If you’re struggling with your child’s sleep either now or in the future, I am here to help you.
My books
My bestselling books give you the tools to help your baby and yourself get a good night’s sleep. They are full of expert, practical advice and case studies. Each book teaches you to create your baby or child’s personal sleep plan and is written in a clear and accessible style.
They are available in all formats from Amazon and other booksellers.
My self guided sleep plans
My sleep plans are a mix of video, graphics and easy-to-read text. They are a great way to access my expert help – from your phone, tablet or laptop. They have no expiry date and are updated frequently. The Settled sleep plan is very comprehensive, easy to dip in and out of and is very empowering.
The Settled Mornings sleep plan is concise and accessible – it takes around an hour to complete and it may be the best hour you’ve ever spent!
Both of the plans contain helpful schedules for day and night time sleep.
Private Consultations
If you choose to book a one-to-one consultation with me, you will receive my expert, individual advice.
You will be in very safe, experienced hands and I treat every parent and child with kindness. As a qualified health professional, I can help if your baby or you have medical needs. I have helped over 15,000 families from all over the world to get a good night’s sleep.
See my reviews on Trustpilot