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Nightmare or Night Terror? How to Help Your Child

If you’re a parent, you’ve most likely been awoken from a dead sleep to the sound of your little one crying out from their bedroom. Nothing can make you feel less helpless then seeing your little one wide-eyed, crying in their bed.

“Nightmares and night terrors are common for preschool-aged children, especially as their awareness of the world grows,” said Walter Castro, MD, a pediatric pulmonologist and sleep medicine specialist at Banner Health in Arizona. “Many parents can confuse the two because they sound alike, but the two sleep conditions are quite different.”

If you believe your child is experiencing nightmares or night terrors, here’s how to differentiate between the two and how to help solve them.

What are nightmares?

Nightmares are scary dreams that can wake children up and make them afraid to go back to sleep. Your child may wake up feeling scared or upset, but they’ll respond to comfort and reassurance. They can usually remember bits and pieces of their nightmare the next morning.

What are night terrors?

Night terrors are disruptions from sleep with behaviors such as screaming, kicking, mumbling or sitting up in bed. During this event, your child can’t be awakened or comforted easily. They may even have their eyes open but won’t make eye contact with you. Often, they won’t remember what happened in the morning.

How are nightmares different from night terrors?

Nightmares and night terrors are both parasomnias, or disruptive sleep disorders, that can occur during REM-sleep (dreaming sleep) or non-REM (NREM) sleep, respectively. Other parasomnias include sleep talking and sleep walking.

“The main distinguishable difference is that night terrors usually happen during the first part of the night, typically in the first four to five hours of sleep—depending on your child’s age,” Dr. Castro said. “Whereas, nightmares usually happen more on the second-half of the night where they have more REM-sleep as sleep architecture varies throughout the night.”

What causes nightmares and night terrors?

The most common causes for nightmares and night terrors are due to insufficient sleep and sleep disruptions, such as snoring, loud breathing during sleep, restlessness, nocturnal cough, seizures and sleep apnea.

How can I help my child?

If your child is experiencing nightmares or night terrors, Dr. Castro offers the following ways you can help.

For Nightmares
  • When you enter their room, offer comfort, reassurance and snuggles.
  • Give them a security blanket, toy or “lovie” if it normally provides them comfort.
  • Let your child go back to sleep in their own bed; don’t make a habit of them sleeping in your bed.
  • If they’re comfortable, talk about their nightmare the next day to help them process.

“Typically, after a nightmare, it’ll take your child a little bit to fall back asleep,” Dr. Castro said. “This is due to the intense sympathetic output of their central nervous system from the unpleasant dream. Bad dreams can create a fight-or-flight response that will take time to calm.”

For Night Terrors
  • When you enter their room, don’t try to wake them.
  • Don’t interact with them as this can make the event worse and more prolonged.
  • Protect your child against injury. If they start walking, gently direct them back to their room and bed. Make sure all clothes and toys are picked up off the floor, so they don’t fall.
  • Be patient, your child should eventually relax and sleep quietly again.
  • Prepare any babysitters or caretakers of what to do if it happens while you are away.

“The best thing you can do is to remain calm,” Dr. Castro said. “It can be very scary, especially for new parents, if you come in to see your child seemingly awake but unresponsive. Just sit in the room and wait it out.”

Additional ways you can help prevent nightmares and night terrors

When should I talk to the doctor?

“Parents can do certain things at home to make nightmares or night terrors better, but I encourage parents to always speak to their child’s doctor,” Dr. Castro said. “It’s the physician’s duty to find the root of the problem.”

Before the doctor’s appointment, it also doesn’t hurt to keep a sleep log and bring that with you to the appointment, so you and the doctor can dig into the potential causes. In certain cases, your child’s doctor may recommend your child see a pediatric sleep medicine specialist for further evaluation. To find a pediatric sleep specialist near you, visit bannerhealth.com.

Additional Help:

Children's Health Parenting

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