Waking up to the sound of your child crying out for you and in distress is hard for any parent to hear, especially when you aren’t sure how to help calm them down. Many parents assume that when their child wakes up hysterical, they must be having a nightmare, or worse, a night terror. This isn’t always the case.
While most children will experience nightmares at some point, there are many other reasons children wake up upset in the middle of the night. It could be something as simple as discomfort or being startled in the middle of a sleep cycle. It can be difficult for parents to determine the difference between nightmares and night terrors. Many of the behaviors and symptoms are very similar, and both are referred to as parasomnias (disruptive sleep-related disorders). So what is the primary difference? How can you determine whether or not your child is experiencing a nightmare or night terror?
Children often start to experience nightmares around the age of two. They generally occur during REM sleep, which is a lighter and more active stage of sleep. Concerned parents frequently ask me about their infants having nightmares, but this is not the case. Before age two, children are not at a stage developmentally where they experience nightmares or night terrors.
According to the National Sleep Foundation, about 10-50% of children ages 2-5 experience disturbing nightmares. The cause of nightmares isn’t entirely known. But many things likely trigger them, such as exposure to frightening media, witnessing or experiencing traumatic events, stress, and anxiety.
Nightmares can be alarming and unpleasant, causing your child to get very upset and emotional. Often they will cry or scream while seeking comfort from a caregiver/parent. When your child is having a nightmare, it might cause them to become very upset, but typically it will not invoke violent behaviors such as thrashing around. Most children (and adults) will wake up in distress when having a nightmare. But most will quickly realize that what they were experiencing was a dream and will calm down shortly after.
When your child is experiencing a nightmare, it is important to help them feel safe and secure by comforting them. One way to do this is by repeating over and over, “I’m here, and you are safe.” Or “You had a bad dream, but it isn’t real.” Don’t ask them what they dreamed about because it will only have them continue to think of their nightmare.
If your child is having a hard time calming down, it may be necessary for you to stay in their room until they fall asleep. Or you may allow your child to sleep in your room for the rest of the night, as long as this doesn’t become a habit. Your child may also find comfort in a security item such as a stuffed animal, a photo, or a very dim night light, which is okay to use in these situations if it helps your child.
Night terrors are less common. These affect closer to 1-6% of children ages 2-5. Night terrors typically occur during non-REM sleep and can cause children to experience behaviors such as thrashing around, screaming, kicking, or even sleepwalking. A significant difference between nightmares and night terrors is that children often do not wake up from a night terror. They may not even remember the episode the next day.
Similar to nightmares, the cause of night terrors isn’t entirely known. But some studies have shown that genetics may play a role and other sleep disorders, anxiety, trauma, stress, and certain medications. If your child is experiencing frequent night terrors, classified as two or more per week, it is recommended that you speak with your pediatrician for evaluation. Most of the time, children will grow out of these episodes. However, that is not always the case. So raising the concern with your doctor is always a good idea.
If your child is experiencing a night terror, it is essential, first and foremost, to make sure they are safe, especially if they are flailing around or sleepwalking. You want to remove anything around them that could be hazardous. You may need to gently walk them back to their bed without waking them up. During a night terror, you must remain calm and don’t startle your child awake. This could cause them to become more fearful and potentially violent.
It can be very concerning and stressful for parents to witness their child having a night terror. But it will usually pass relatively quickly. The best thing to do is to stay calm and in control.
With both nightmares and night terrors, limiting screen time and exposure to media that might be scary for your child are generally recommended. Also, try to be aware of your child’s stress and anxiety levels throughout the day and close to bedtime. Speaking to your child about their fears during the day and identifying some potential triggers is also helpful. I also recommend keeping a diary to try and identify any correlation with foods, medication, events, etc., and the timing of nightmares or night terrors.
Parents should find comfort in knowing that both disorders are relatively common and typically nothing to worry about. But your child’s pediatrician will be able to provide further recommendations and insights based on your child’s complete medical history.