Nightmares vs. Sleep Terrors: Understanding the Differences and How to Help Your Child

Nightmares and sleep terrors are both common childhood sleep disturbances, but they are very different experiences. As a parent, it can be distressing to see your child wake up frightened or upset, and knowing how to respond can make a big difference.

What Are Nightmares?

Nightmares are vivid, frightening dreams that typically occur during REM (rapid eye movement) sleep, the stage of sleep associated with dreaming. They usually happen in the second half of the night when REM sleep is more frequent. When a child has a nightmare, they may wake up scared and often remember the details of the bad dream.

Nightmares are common in children, especially between the ages of 3 and 6, as their imaginations develop. They may be triggered by something as simple as a scary story, a TV show, or anxiety over a real-life event. Children may wake up from a nightmare and seek comfort from a parent, making them more alert and able to recall the dream.

Signs of Nightmares:

• The child wakes up scared and may cry or call for a parent.
• They remember the details of the bad dream.
• The child may be hesitant to go back to sleep and ask for comfort.
• Nightmares typically happen during the later part of the night.

What Are Sleep Terrors (Night Terrors)?

Sleep terrors, on the other hand, are much more intense episodes of fear that occur during non-REM (NREM) sleep, usually in the first half of the night during deep sleep (stage N3). Unlike nightmares, a child experiencing a sleep terror is unlikely to fully wake up, even though they look and behave like they are awake, or unlikely to remember the event in the morning. Sleep terrors are part of a group of sleep disorders known as parasomnias, which also include sleepwalking.

During a sleep terror, the child may scream, thrash around, sweat, and appear terrified or like having a tantrum. However, they are usually still asleep and unaware of their surroundings. Sleep terrors are much more unsettling to witness than nightmares, but the child usually has no memory of the event the next day.

Signs of Sleep Terrors:

• The child appears distressed and may scream, thrash, or sweat, but is not fully awake.
• They do not respond to comforting and may seem confused or disoriented, in fact they may push you away.
• The episode typically lasts from a few minutes to 45 minutes, and the child often falls back to sleep afterward.
• Sleep terrors happen in the earlier part of the night.

Possible causes:

• Over-tiredness or insufficient sleep
• Bedtime is too late
• Stress or major changes in routine
• Fever or illness
• Sleep disruptions (such as a noisy environment)
• A family history of parasomnias, including sleep terrors or sleepwalking

How to Prevent Nightmares and Sleep Terrors

Preventing Nightmares:

• Create a calming bedtime routine: Read soothing stories, avoid scary media before bed, and ensure the child feels safe and secure.
• Address fears: Talk to your child about their fears during the day and offer reassurance.
• Establish a consistent sleep schedule: Regular bedtimes and wake times can help improve overall sleep quality and reduce nightmares.
• Limit stimulating activities before bed: Avoid TV, screens, and intense playtime an hour before bedtime to help your child wind down.

Preventing Sleep Terrors:

• Ensure adequate sleep: Overtiredness can trigger sleep terrors, so make sure your child is getting enough sleep for their age.
• Create a consistent bedtime routine: A calming, predictable bedtime routine can help reduce the occurrence of sleep terrors.
• Limit stress: Try to identify any sources of stress or anxiety in your child’s life, such as a new routine or big changes at home.
• Adjust the bedtime: If you child has been going to bed after 8 PM, moving the bedtime earlier can help prevent sleep terrors by ensuring the child is not overtired and getting enough deep sleep.

What to Do (and Not to Do) When Your Child Experiences Nightmares or Sleep Terrors

During a Nightmare:

• Offer comfort: Reassure your child that they are safe and that it was just a dream. You can stay with them until they feel calm enough to fall back asleep.
• Avoid discussing the dream in detail: Help them shift focus by offering comfort rather than going over the details of the nightmare, which might cause them to relive it.

During a Sleep Terror:

• Stay calm: As terrifying as it might look, your child is not fully awake and won’t remember the episode. Stay close to ensure their safety.
• Do not wake the child: Trying to wake a child during a sleep terror can be difficult and may make the episode last longer.
• Keep your child safe: If they are thrashing or moving around, gently guide them back to bed to prevent injury.

What Not to Do:

• Don’t panic: Sleep terrors can be alarming, but they are not harmful, and your child won’t remember them.
• Don’t discuss the sleep terror: Since the child won’t remember the episode, there’s no need to bring it up the next day unless it’s happening frequently, in which case it might help to discuss with a pediatrician.
• Avoid reinforcing fears: After a nightmare, avoid making the child feel their fear is something to worry about. Instead, calmly reassure them that everything is fine.

When to Seek Help

If your child experiences frequent nightmares or sleep terrors that are affecting their sleep quality or causing distress, it may be worth talking to a pediatrician or sleep specialist. Frequent sleep terrors can sometimes be a sign of an underlying sleep disorder, especially if they persist as your child grows older.

While both nightmares and sleep terrors are common in young children, understanding the differences can help you respond in a way that supports your child and helps them feel safe and secure. With consistent bedtime routines and good sleep habits, you can reduce the likelihood of these sleep disturbances and help your child enjoy a more peaceful night’s sleep.