Nightmares vs. Night Terrors: What’s the Difference?

| Pediatrics

What you can do to help solve your child’s sleep problems

A mother comforts her child after he woke up from a possible nightmare or night terror.

What you can do to help solve your child’s sleep problems

Parents often ask how to tell the difference between a nightmare and a night terror. While both can be disturbing for parents, there are differences between the two, including what you can do to help solve your child’s sleep problems.


Nightmares may be very common for preschoolers, but for parents they can seem anything but routine. Children ages 3 to 6 are particularly prone to nightmares because this is the age when they 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.” 

How parents can help

Nightmares often occur during the second half of the night, when dreaming is most intense. Your child may wake up crying or feeling afraid and may have trouble falling back asleep.


If this is a common scenario in your home, try these recommendations from, the American Academy of Pediatrics (AAP): 


  • Go to your child as quickly as possible
  • Assure them that you are there and will protect them
  • Encourage your child to tell you about the dream 
  • Keep on a dim light if that helps
  • Once your child is ready, encourage him or her to go back to sleep
  • See if there is something specific that is scaring your child, such as dark shadows, and make sure they are gone  


Dr. Remba also 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.

Night terrors vs. nightmares

Nightmares should not be mistaken for night terrors, which occur during the deepest stages of sleep, 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.”


To help your child during an episode:


  • Stay calm
  • Don’t try to wake your child
  • Make sure child cannot hurt himself, gently restrain if he tries to get out of bed
  • Keep 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 to 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.