Helping Your Kids With Nightmares

Is it a nightmare or sleep terror? Get advice for helping kids with nightmares sleep peacefully.

Whether it’s a piercing scream coming from your child’s bedroom or finding your son or daughter at your bedside in tears, there are few everyday occurrences more distressing for parents and upsetting for kids than a nightmare. Nightmares may be a normal part of growing up, but when they happen, they can be disruptive, especially if they happen regularly.

There’s some dispute about when children start having actual nightmares as opposed to night or sleep terrors — short-lived events that can unsettle parents more than kids.

According to the National Sleep Foundation, nightmares are common during the preschool years as children begin to understand there are things in life that can hurt them.

Kyle P. Johnson, MD, director of the Oregon Health & Science University Child & Adolescent Psychiatry Clinic in Portland, agreed, explaining that children develop vivid imaginations by age 3 and are more able to express their experiences.

“There is a sudden awakening from sleep and a scary story in their head,” Dr. Johnson said. Because very young children have trouble separating dreams from reality, they may wake up with intense feelings of fear, anxiety, sadness, or disgust. “They want to share it to be reassured,” he said.

Jess Shatkin, MD, MPH, an associate professor of child and adolescent psychiatry at the New York University Child Study Center, said that though preschool-aged children probably dream, most are too young to put stories together, and that when kids in this age group wake up terrified in the middle of the night, they’re probably experiencing a sleep terror. During a sleep terror, a scary image has them sitting bolt upright and screaming, or even talking for 30 seconds or so, and waking up their parents before going back to sleep. In the morning, they won’t remember a thing.

The experience can be so intense that parents may worry their children are having a seizure, Dr. Shatkin said. As far as anyone knows, there are no long-term health effects.

Sleep terrors usually happen in the earlier part of the night, while children are in a deep sleep. By age 6, Shatkin said, most children have the mental ability to put a story together and remember a nightmare, which is more likely during the early morning hours when there’s less deep sleep and more rapid-eye movement, or REM, sleep.

Nightmares: What’s Behind Them

Though children can have nightmares at any time, certain triggers can make a child more prone to nightmares, Shatkin said.

Exposure to media — movies, billboards, video games, news shows — is one of the top causes for nightmares, he said. Bullying, divorce, and a move to a new neighborhood also can cause the type of anxiety in a child that will spawn nightmares.

Johnson added that routine sleep deprivation can also lead to nightmares, and that children who naturally are anxious are more prone to nightmares as well.

Sleep and Nightmares: It’s Just Your Imagination!

He estimated that about half of the children who have nightmares need their parents’ help and that about 25 percent have recurring nightmares that leave them fearful of going to sleep.

Johnson advised parents to avoid a long discussion about the nightmare in the middle of the night. Rather, the goal should be to help children calm down and breathe easier and to reassure them they’re safe so they can get back to sleep. “Concentrate on their basic needs,” he said.

The next day, talk to your child about the nightmare and help the child understand that it’s his or her imagination and not reality. If the nightmare turns up again and again, it may be helpful for the child to draw pictures about the dream and change the ending. “Maybe a superhero comes and saves them,” Johnson said. “Or if it’s a scary monster, the child could draw a picture of the monster and then tear it up.”

Reassuring Rituals for Helping Kids With Nightmares

A night light, stuffed animals or other security objects, or learning to roll over when bad thoughts creep in can all be helpful, Johnson said. He also recommended Native American dream catchers, which are hoops with a net or webbing that lets in the good dreams but traps the bad ones. They’re decorative, come in a variety of sizes, and can be hung in the child’s bedroom.

Routines can be helpful, too, such as using the same special flashlight to look under the bed or in the closet for monsters. “Just having that ritual can be reassuring,” he added.

If all else fails, he said, it may be time to visit the child’s pediatrician.

By Jennifer Anderson