Understanding the Difference Between Nightmares and Night Terrors

Have you ever been deep in your slumber only to awaken to your child screaming and crying out? Maybe they run into your room crying telling you they are scared. It can be hard seeing that level of fear in our child’s eyes. You wonder if this is a nightmare or a night terror. Thankfully, both are common childhood sleep problems that are not worrisome unless they consistently interrupt sleep or lead to self-harm. Although they sound very similar, they are distinctly different so let’s compare the two below.

Nightmares typically occur during REM sleep which is the final stage of the sleep cycle. REM sleep occurs more often in the middle of the night and early morning, so children commonly wake up complaining of nightmares at those times. Nightmares typically contain scary elements like ghosts, monsters, or aggressive animals. During a nightmare the child is mostly non-responsive and does not typically yell out, thrash about, or have autonomic symptoms (rapid breathing, sweating, & dilated pupils). Upon waking from a nightmare your child will typically seek comfort and recognize you. They will be able to recall the nightmare, but it may take some time to put the scary thoughts out of mind and fall back asleep. Research shows that nightmares peak between the ages of 3-6 years old and 5-9 years old and tend to affect both sexes equally. You can cut down on nightmares by avoiding scary videos, books, and games prior to bed. If your child is having a nightmare, make sure to respond quickly and reassure them that they are safe.

Night terrors differ from nightmares in that they typically occur during non-REM sleep and during the first part of the night. They are defined as episodes of terror and panic that occur during sleep. During a night terror your child may call out, thrash about, or have autonomic symptoms (rapid breathing, sweating, & dilated pupils) as if they are acting out against the dream. Your child will likely not recognize you when you approach, and they are often inconsolable. Night terrors typically last 10-15 minutes but can be as long as 90 minutes. These episodes tend to be more upsetting for the parent than they are for the child, as children do not typically remember them. Night terrors are most common in children between the ages of 3-7 years old but can occur up until the age of 10. Approximately 30% of children will experience night terrors and family history (i.e., night terrors or sleepwalking as a child) increases that risk. If your child experiences a night terror, monitor them closely to ensure physical safety but avoid interfering as this may worsen the episode.

Both nightmares and night terrors occur more often if your child is sleep deprived, so maintaining a regular sleep schedule to ensure adequate rest is key. You can also discuss triggers for fear and anger during the day in a relaxed setting, and discuss strategies (deep breathing, muscle relaxation, etc.) that they can use to regulate those emotions. Assigning a sleep partner in the from of a stuffed animal or blanket may also be useful in providing comfort to your child. If you find that your child is having nightmares or night terrors frequently, it is best to start a sleep log. Keep close track of how often these sleep disturbances occur and if they are happening 2-3x/week consistently for several months, reach out to your pediatrician for evaluation. If you want guidance on how to ensure adequate rest for your child, please reach out for a free 15-minute discovery call. I’d be happy to help you and your family get the rest you need!