Nightmares vs. Night terrors: How to know the difference

nightmaresNo one likes nightmares.  Even as an adult, nightmares are scary and can leave me awake for extended periods in the middle of the night while I try to remind my brain that it is safe to go back to sleep.  In children, it is no different only they don’t have the ability to understand that the vivid images they just experienced were not real.  Sometimes, however, children experience what looks like a nightmare but it is, in fact, a night terror.  It is important to understand the difference, to know how to spot a night terror, and how to handle each of these circumstances.


Nightmares occur during REM sleep, typically during the end of our sleep period.  When your child has a nightmare, she will seek comfort from you and may not want you to leave for a bit until she has recovered.  She may be able to describe the dream in detail both at when she wakes and hours later the next day.  It may take a while to go back to sleep.  Nightmares can begin as early as age 2 when your child’s imagination starts to develop.  They are very common after difficult events or when your child is reliving a trauma.

When your child wakes from a nightmare, it is important to go to her, offer comfort, help her understand that it was just a dream and she is safe.  Use creative visualization to help her come up with happy thoughts to put into her head to replace the scary thoughts that remain after a bad dream.  Avoid television shows or movies, even ones that, as adults, we think of as fairly benign and not scary at all.  It is particularly important to screen the media your child is being exposed to, especially if your child is sensitive to these things and often gets “the scaries.”  Even television or radio news can spark a bad dream.

Night terrors

Night terrors are very different from nightmares.  Night terrors usually occur within the first two hours of the onset of sleep, during nonREM sleep.  Your child is not actually awake even though his eyes may be open.  He may be screaming, sweating, his heart is racing, and he is inconsolable.  Typically, they last between 5-15 minutes unless you interfere with it and try to wake him.  Night terrors are more common in boys and can start as early as 15 months old.  They are often caused by sleep deprivation or sleep disturbances resulting from illness, travel, stress or sleep apnea.  Your child will not remember the incident in the morning.

When your child has a night terror, less is more, when it comes to what to do.  Make sure he is safe and can’t hurt himself but other then that, do as little as possible.  Doing too much to interfere can prolong the episode.  Research has recently come out that shows a link between screen time and night terrors.  Limiting screen time sometimes altogether or at least in the later half of the day can reduce the incidences of night terrors.  Also, helping your child get more sleep by moving bedtime earlier (even briefly) and regulating his sleep schedule so he is going to bed at the same time and waking at the same time is important.  If your child is frequently experiencing night terrors, start keeping a detailed log for 7-10 nights.  If they are always occurring at the same time each night, you can wake him briefly 15 minutes prior to the terror.  Wait until he mumbles, moves, and rolls over before letting him go back to sleep.  Do this for 7-10 days to 2 weeks to interrupt the sleep cycle.


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