Nightmares or Night Terrors – Toddlers’ Sleep May Need Monitoring

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  • August 06, 2009

night terrorsNightmares and night terrors are confusing in both cause and treatment. Knowing the difference between the two is the key to determine the best way to handle each episode. Nightmares occur during REM sleep, which happens near the end of our sleep period. When children have a nightmare, they will seek comfort from their disturbing dream and recognize you upon seeing you. They are able to recall the nightmare, but it may take awhile to fall back asleep and get the scary thoughts out of their minds. Nightmares are very common and are part of normal development. Their occurrence often peaks at two and three years of age when children have rich imaginations and have some trouble distinguishing between reality and fantasy. Nightmares are, of course, common after difficult events or when children are re-living a trauma.

What to do

  • Avoid scary videos, books, etc. prior to bed
  • Don’t play scary games
  • Respond quickly and assure them of their safety
  • Help your child get enough sleep – sleep deprivation can increase nightmares
  • Avoid high-dose vitamins at bedtime
  • Check with your pediatrician to make sure your child is not on any medications that might be interfering with his night sleep

Night terrors are different from nightmares in both the symptoms and the experience. When a child is experiencing a night terror she may scream and appear anxious. There may also be sweating and/or a racing heart beat. The child is often inconsolable. The terror usually lasts between five and fifteen minutes and then subsides. These incidents are often more upsetting for the parent than they are for the child, as children do not usually remember them. Night terrors occur during NON-REM sleep (the period of coming out of deep sleep), and usually within two hours of going to sleep. Night terrors are not bad dreams. They do NOT occur during dream sleep. They are not a sign of a psychological problem. Night terrors can also occur during a developmental milestone.

Night terrors seem to be more common in boys, and occur in 5% of all children. Your child is more likely to have night terrors if either parent had them as a child, or if either parent had a partial arousal sleep disorder such as sleepwalking. There are other causes for night terrors. The most common cause is sleep deprivation or a disturbance in a child’s sleep patterns. Stress that causes big changes in their sleep schedule (like traveling to a different time zone, sleep apnea, or fever) can also be contributing factors.

What you can do

  • If your child is having a night terror, monitor the child but avoid interfering, as this can worsen the episode
  • Make sure your child is physically safe during the night terror
  • Put your child to bed earlier – even if by only 30 minutes
  • Keep a regular sleep schedule for him
  • Don’t talk about the terror with your child in the morning

If your child is having night terrors two to three times a week at set times during the night (i.e. 2 hours after going to sleep) do the following

  • Keep a sleep log
  • Plan on the episodes taking at least 7-10 days to diminish
  • Wake your child 15 minutes prior to the time he usually has an episode to the point where he mumbles, moves, or rolls over
  • Do this every night for 7-10 nights in a row

As these two phenomenons differ so greatly in treatment, it is important to clearly understand the difference between nightmares and night terrors. Keeping a calm presence of mind and using a reassuring voice can make a huge difference in these middle-of- the-night episodes for both you and your child. Remember to reassure your child as needed, showing love and respect for these normal experiences. I wish you and your family many sweet dreams!

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photo credit: hlkljgk via photopin cc

Kim West
Kim is a Licensed Clinical Social Worker who has been a practicing child and family therapist for more than 24 years, and the creator of the original gentle, proven method to get a good night’s sleep for you and your child. She is the author of The Sleep Lady's Good Night Sleep Tight, its companion Workbook and 52 Sleep Secrets for Babies. Click here to read more about her.

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5 Comments

  • Sara H says:

    Our Son is almost 20 months now and we think he may have had a night terror or two. My husband had them as a child, so we were aware that it could be a possibility. This article is really helpful in clarifying the difference between nightmares and night terrors. I have two questions though – first, you said that children with night terrors might need monitoring, but I’m not clear why. Is it just because they are thrashing about and could hurt themselves? Second, we think my Son may have had a night terror during a nap at daycare. It took place about 2 hours into the nap and he woke up screaming and kicking and wouldn’t let the day care provider touch him or console him in any way. I was wondering if it’s possible for night terrors to happen at nap time. Thanks!

    • Breanna Gunn says:

      Hi, Sara! What you’re describing certainly sounds like it could be a night terror, which occur in non-REM sleep-usually about 2 hours after falling asleep. The fact that he wouldn’t be comforted and was very disoriented also hints that the daycare experience may have been a true night terror. Sleep is sleep. The monitoring comes more from knowing what’s going on, making sure that there’s nothing he can pull into bed or onto himself, as well as trying to have a stable, and possibly earlier bedtime.

    • breefawn says:

      Sara HHi, Sara! What you’re describing certainly sounds like it could be a night terror, which occur in non-REM sleep-usually about 2 hours after falling asleep. The fact that he wouldn’t be comforted and was very disoriented also hints that the daycare experience may have been a true night terror. Sleep is sleep. The monitoring comes more from knowing what’s going on, making sure that there’s nothing he can pull into bed or onto himself, as well as trying to have a stable, and possibly earlier bedtime.

  • Cati Ellen says:

    As a mom with two children who suffered from TERRIBLE nightmares AND
    night terrors, I can tell you that NOTHING worked to calm them down and I
    dreaded the 11:00 hour, when they both seemed to wake like clockwork. 
    After lots and lots of research, I rather accidentally stumbled upon an
    article online that suggested that children with nightmares, and
    especially night terrors are sometimes triggered by the sensation of a
    full bladder.  If you have a child who is in the middle of a fit,
    though, they might insist that they absolutely do NOT have to use the
    bathroom.  But when my husband and I carried our children to the
    bathroom (fighting us all the way) and put them on the toilet (eyes
    still closed), they went pee anyway.  Within THIRTY SECONDS, sometimes
    less, they were either calm or back to sleep.  We had to hold my younger
    child while she was on the potty, because we knew that as soon as she
    went potty, she would quickly be asleep again as if nothing had
    happened.  We were there to catch her if she dozed off the toilet. 
    Haha.
    I suggest this method, because like I said, NOTHING else
    worked for us.  It was the only “unconventional” method I had stumbled
    upon while trying to solve our nightly nightmare.  My hope is that for
    some other desperate parents out there, it works for you, too!
    Now if I could only get my 16 month old to sleep….. Ha.

  • […] Is it a nightmare or night terror? […]