Parents often ask how to tell the difference between a nightmare and a night terror. Both are more prevalent during childhood. Both can be frightening and cause sleep disturbances.
There are key differences between the two. Nightmares are much more common than night terrors. Knowing this and other distinctions can help parents know what to do when their child has trouble sleeping.
Nightmares are normal for both children and adults. Frequent nightmares are more common in young children.
Nightmares in children are most prevalent between the ages of 3 and 6. These are the years when children start developing normal fears, are afraid of the dark and have an active imagination.
According to the American Academy of Sleep Medicine, up to 50 percent of young children have nightmares that cause them to wake up their parents.
“Experiencing nighttime fears is a normal developmental stage that starts around age 2,” says Matilda Remba, MD, a pediatrician at Scripps Clinic in Mission Valley. “Preschoolers have a vivid imagination and are also beginning to understand that there are things out there in the world that can hurt them.”
Most nightmares occur during the second half of the night, when dreaming is most intense. This is also known as the rapid eye movement REM phase of the sleep cycle. Your child may wake up crying or feeling afraid and may have trouble falling back asleep.
If this is happening with your child, the American Academy of Pediatrics (AAP) recommends parents do the following:
- Getting to your child as quickly as possible
- Assuring them you are there and will protect them
- Encouraging your child to tell you about the dream
- Keeping on a dim light if that helps
- Encouraging your child to go back to sleep as soon as they are ready
- Checking if there is something specific that is scaring your child, such as dark shadows, and removing it
Dr. Remba suggests letting your child sleep with a special blanket or stuffed animal for security, or creating a special kit to keep near your child’s bed and include such items as a flashlight and a favorite book. “Listen to your child’s fears and take them seriously,” she says.
Most night terrors, also called sleep terrors, occur during deep sleep or early in the night and are partial arousals from sleep. They occur most often in toddlers and preschoolers and can last up to 45 minutes though most are much shorter.
Indications that your child is experiencing a night terror, and not a nightmare, include:
- Uncontrollable crying
- Sweating, shaking or fast breathing
- Terrified, confused or glassy-eyed look
- Screaming, kicking or thrashing
- Not recognizing that you are there
- Trying to push you away, especially if you're trying to hold them
“Night terrors can be very upsetting for parents, but they are usually not a reason for concern. Your child will fall asleep as soon as the episode is over,” says Dr. Remba. “The fright of a night terror will probably persist more for parents who have watched their child experience it than your child, who will not remember it in the morning.”
Parents can help their child during a night terror episode by doing the following:
- Staying calm
- Not waking up the child
- Making sure he or she cannot hurt themselves, gently restraining them if they try to get out of bed
- Keeping the child’s room safe by picking up toys on the floor before they fall asleep
“The best thing parents can do during a night terror is to wait it out,” says Dr. Remba.
In addition, parents can help prevent them by:
- Reducing your child’s stress
- Establishing and maintaining a relaxing bedtime routine
- Making sure your child is not overtired
If you are concerned about your child’s nightmares or night terrors, talk with your pediatrician. Keep a sleep diary to help track your child’s sleep problems for one to two weeks and bring it to your appointment. Include the following information:
- Where your child sleeps
- How much sleep he or she normally gets at night
- What they need to fall asleep
- How often they wake up during the night
- What you do to comfort and console them
- Time and length of naps
- Any changes or stresses at home
Keep in mind sleep problems are very common among young children and can be overcome with time and help from your child’s pediatrician.