Night Terrors & Nightmares in Children: Causes, Symptoms, and How to Help

Night terrors and nightmares in children can be distressing for both the child and parents. Learn the causes, symptoms, and expert-backed strategies to help your child sleep peacefully.

Sleep disturbances like nightmares and night terrors are common in children. While they may seem similar, they are distinct conditions that require different approaches.

Nightmares occur during REM sleep (the dreaming phase) and often cause the child to wake up feeling scared and distressed. The child can usually recall the nightmare and may feel hesitant to go back to sleep. They may seek comfort from a parent and might need reassurance before they can rest again.

Night terrors, on the other hand, happen during deep non-REM sleep, typically within the first few hours of falling asleep. Unlike nightmares, night terrors do not wake the child fully. Instead, the child may sit up in bed, scream, sweat, or appear confused and panicked. Even though their eyes may be open, they are not fully awake and will not respond to comfort. Most children do not remember night terrors the next day.

The severity of these sleep disturbances varies. In mild cases, nightmares may occur occasionally and do not significantly impact the child’s well-being. Similarly, night terrors that happen infrequently may not require intervention.

In moderate cases, nightmares can become more frequent, leading to bedtime resistance and increased anxiety about sleeping alone. Night terrors occurring weekly may disturb both the child’s and the family’s sleep patterns.

In severe cases, nightmares can be so intense that the child becomes afraid of sleeping, leading to sleep deprivation and daytime anxiety. If night terrors happen multiple times a week, they can cause exhaustion, affect daily activities, and may require medical attention.

Several factors contribute to sleep disturbances in children:

1. Stress and Anxiety: Emotional distress, such as school-related stress or changes in the family environment, can lead to nightmares and night terrors.

2. Sleep Deprivation: Irregular sleep schedules or insufficient sleep can increase the likelihood of night terrors.

3. Overstimulation Before Bedtime: Watching scary movies, playing intense video games, or hearing frightening stories can cause nightmares.

4. Fever or Illness: High fevers can trigger vivid dreams and night terrors.

5. Genetics: A family history of sleep disorders may make a child more prone to night terrors.

6. Medications: Certain drugs, including antihistamines and antidepressants, can affect sleep patterns.

Symptoms of Nightmares:

• Waking up suddenly, crying, or appearing frightened.

• Clearly remembering the frightening dream.

• Feeling anxious about going back to sleep.

• Resisting bedtime due to fear of recurring nightmares.

Symptoms of Night Terrors:

• Sitting up in bed suddenly with a look of terror.

• Screaming, sweating, and appearing confused.

• Breathing rapidly with an increased heart rate.

• Unresponsive to comfort or attempts to wake them.

• Having no memory of the episode the next morning.

1. Establish a Relaxing Bedtime Routine

A predictable bedtime routine can create a sense of security. Encourage calming activities such as reading a soothing bedtime story, taking a warm bath, or listening to soft music. Avoid electronic screens at least an hour before bed, as blue light can interfere with sleep.

2. Provide Comfort After Nightmares

If your child wakes up from a nightmare, offer reassurance and comfort. Let them know they are safe and encourage them to talk about the dream if they want to. Comfort items like a favorite stuffed animal or nightlight can help reduce bedtime anxiety.

3. Do Not Wake a Child During a Night Terror

During a night terror, it is best not to forcefully wake the child, as this can lead to increased confusion and agitation. Instead, ensure they are safe by gently guiding them back to bed if they move around. Speak in a soft, calming voice and wait for the episode to pass naturally.

4. Reduce Stress and Anxiety

Encourage open conversations about fears or worries before bedtime. Teaching relaxation techniques such as deep breathing or visualization can help children feel more secure. Avoid discussing stressful topics before sleep.

5. Ensure a Comfortable Sleep Environment

Make the bedroom a relaxing space by keeping it cool, dark, and quiet. A nightlight can help if the child fears the dark, and a white noise machine can create a soothing atmosphere.

6. Encourage a Healthy Sleep Schedule

Make sure your child gets enough sleep based on their age. Set consistent sleep and wake times, even on weekends. Limit late naps, as they can interfere with nighttime sleep.

7. Address Possible Triggers

If your child experiences frequent nightmares, identify possible triggers. If a certain story, movie, or event seems to be causing distress, avoid exposing them to similar content. If fever-related, ensure they stay hydrated and comfortable.

8. Try Scheduled Awakenings for Night Terrors

If night terrors occur at the same time every night, gently waking your child 15-30 minutes before the usual episode can help reset their sleep cycle and prevent the terror from occurring.

9. Seek Professional Help if Needed

If sleep disturbances significantly impact your child’s daily life, consult a pediatrician or sleep specialist. Therapy can be helpful, especially if nightmares are linked to trauma or anxiety.

If Your Child Has a Nightmare:

1. Calmly reassure them that they are safe.

2. Offer comfort by staying with them until they feel secure.

3. Encourage them to talk about the dream if they want to.

4. Help them relax with deep breaths or soft music.

5. Guide them back to sleep gently.

If Your Child Has a Night Terror:

1. Do not try to wake them forcefully.

2. Ensure their surroundings are safe.

3. Speak in a soothing voice and wait for the episode to pass.

4. If they move around, gently guide them back to bed.

5. Monitor frequency and seek medical help if necessary.

While night terrors and nightmares can be distressing, they are usually not signs of serious health problems. Children often outgrow these sleep disturbances with time. Panicking or reacting with fear can make bedtime more stressful for both the child and parents. Instead, focus on maintaining a calm and patient approach.

By creating a secure sleep environment, reducing stress, and using gradual interventions, parents can help their child overcome nighttime fears and develop healthier sleep patterns.

Nightmares and night terrors are common in childhood but can often be managed with a consistent bedtime routine, stress reduction, and reassurance. If these sleep disturbances persist or severely impact a child’s well-being, seeking professional guidance can be beneficial.

With patience, understanding, and the right strategies, children can overcome nighttime fears and enjoy restful, peaceful sleep.

1. American Academy of Sleep Medicine. (2022). Childhood Night Terrors and Nightmares: Symptoms and Management.

2. National Sleep Foundation. (2023). Understanding Sleep Disorders in Children.

3. Mayo Clinic. (2023). Night Terrors: Causes and Treatment Options.

4. American Academy of Pediatrics. (2022). Helping Children Cope with Nighttime Anxiety and Sleep Disturbances.