What’s Behind Your Child’s Nightmares and Sleep Terrors?

Is your child having a nightmare or a night terror? Learn the difference between the two sleep disruptions and what to do — and not do — to help your child.

Most children will experience a nightmare from time to time — a scary dream that causes them to wake up in the middle of the night. But if you hear a bloodcurdling scream and find your child in a state of panic with a glazed look in their eyes, it may be a night terror, not a nightmare.

Night or sleep terrors affect as many as 6.5 percent of all children and are considered normal up until about age 6. “Don’t be concerned about [night terrors], unless they cause significant distress and dysfunction during the day,” says William C. Kohler, MD, medical director of the Florida Sleep Institute in Spring Hill and director of pediatric sleep services at University Community Hospital in Tampa.

This may be easier said than done, however. Listening to your child scream wildly can unnerve even the most patient parent, especially when there is nothing you can do to comfort them.

Nightmares and Sleep Terrors: Understanding the Difference

How do you know if your child is having a nightmare or a night terror — and what should you do about it? Nightmares typically occur late in the night or early morning during rapid eye movement (REM) sleep, or dream sleep. Children having a nightmare will easily awaken, remember their dream, and respond to your comfort. The best thing you can do for your child during a nightmare is to console them, says Kohler.

Night terrors, on the other hand, typically occur earlier in the night during non-REM sleep, about two hours after a child goes to sleep. During a night terror, which can last from 10 to 30 minutes or longer, your child is only partially awake, although he may appear fully awake.

A child having a night terror will be very difficult to rouse and will not respond to being consoled. In fact, waking up a child during a night terror can make him even more agitated. Some children who have night terrors also sleepwalk. In the morning, your child will have no memory of the incident.

“Sleep terrors are actually more frightening for the parents than the patient,” says Rachel Salas, MD, assistant professor of neurology and pulmonary and critical care medicine at the Johns Hopkins Hospital in Baltimore, Md.

Lacie Thorson, mom of Nathan, 7, and Connor, 2, agrees. Nathan has had night terrors since he was about 2 1/2. “It is really scary to see your child scream for help and know that there is nothing you can do,” she says. Nathan never remembers the night terror in the morning, Thorson confirms.

Of the medical advice not to wake a child having a night terror, Thorson says, “We learned this the hard way.” Waking Nathan up during his night terrors caused them to escalate. The best thing you can do is to make sure your child is safe, not restricted by bedding or in a dangerous situation, says Kohler. If your child has gotten out of bed, gently direct him back to it. Also, if your child sleepwalks, take steps to protect him by putting a gate at the top of the stairs.

By Hedy Marks, MPH – Medically reviewed by Pat F. Bass III, MD, MPH