When it comes to parenting, there are few things as terrifying and heartbreaking as witnessing your child wake up screaming in fear in the middle of the night. What often makes things worse is that many parents are unsure of how they can help coax their child during this time. This uncertainty stems from being unaware of the difference between nightmares and night terrors as the two types of abrupt awakenings should be managed differently.
Here we hope to help dispel the confusion between the differences of night terrors vs nightmares and what you can do for your child in either event.
What are Nightmares?
Nightmares are experienced when children (and occasionally adults) awaken from vivid dreams with intense feelings of fear or dread. Most of the time the child can recall the content of the dreams with a fair degree of detail.
Nightmares can often be attributed to a child seeing or hearing something frightening or that causes them anxiety. They can be caused by both things that have really happened or things that are make believe.
Nightmares are very common in children ages 3-6 with approximately 30-90% experiencing occasional nightmares and often in 5-30% of children in this age group.
What are Night Terrors?
Night terrors are partial arousals from sleep in which a child may shout, thrash about, kick, or scream as if in an intense panic.
During a night terror the child may be sitting bolt-upright in bed with eyes wide open, but will not likely notice the presence of their parents. Children experiencing night terrors cannot be comforted or woken and often will have no memory of the events later. Occasionally children will be able to recall vague information about the event such as feelings of an indistinct threat that they had to defend themselves from.
Night terror episodes often last between 10-30 minutes. After a night terror episode the child often lays back down and falls to sleep without needing to be consoled.
Night terrors affect approximately 3% of children ages 4-12 with peak prevalence between the ages of 5-7 (source). Night terrors are more common among children who have family members that have had the disorder.
What Are the Differences Between Nightmares and Night Terrors?
One of the biggest differences between nightmares and night terrors is the awareness on the part of the child. With nightmares, children can often recall the experience in vivid detail. With night terrors, they usually have no recollection of the event at all the next morning.
Night terrors can cause confusion and the child is most likely unaware of the presence of a parent in the room. With nightmares there is little to no confusion, and the child often seeks out a parent to help assuage their fears.
Night terrors occur during non-rapid eye movement sleep, during the short wave period of sleep. They often occur in the first few hours of sleep before REM sleep occurs
Nightmares most often later at night during REM sleep where dreaming is most prevalent.
What to do with Nightmares
With nightmares it is a good idea to console and soothe your child to help calm them. Assure them that there is nothing to be frightened of. Once they've calmed down, help them return to sleep.
Find out if what may be worrying your child or what they may have witnessed that may have caused the nightmare.
Keep your child from viewing age inappropriate frightening movies, television shows, or pictures.
Develope a relaxing bedtime routine for your child to help them rest easier.
Give your child a "security" blanket, stuffed animal, or allow them to sleep with a nightlight.
See their pediatrician or a sleep specialist if the nightmares are occurring often and if they have a recurring theme.
If your child's nightmares are occurring because of a traumatic past event, counseling may be recommended.
Dr. Angie Randazzo, clinical psychologist and behavioral sleep medicine specialist, discusses cognitive behavioral therapy for children suffering from nightmares is a technique called dream rehearsal. She says:
"Therapeutic intervention for nightmares is dream rehearsal. In the daytime, the patient would review any typical dream and develop an alternative ending. This might be changing the content to something silly instead of scary, or having the patient be incontrol in the dream somehow. This requires review of the dream's content with the therapist to decide what kind of alternative outcome would be best for the patient. With rehearsal every day for several weeks, the patient's dream content tends to change to what they have been rehearsing instead of being scary."
What to do with Night Terrors
During a night terror event the best thing you can do is patiently wait it out.
Make sure the child's environment is safe and that they can't hurt themselves if they're moving or thrashing about during an episode.
Put yourself between your child and anything potentially harmful.
Keep the child's room safe and secure by picking things up before they go to sleep and making sure doors and windows in the house are locked. If there are stairs in the home, keep a gate left up at the top of the stairs.
After the episode has passed it's safe to wake the child. Try and keep your child awake for a bit to make sure they don't fall back asleep too quickly. If they go immediately back to sleep there is a higher likelihood of having a second episode in the same night.
Establishing a regular, relaxing bedtime routine can help prevent night terrors.
If the night terrors are frequent and occuring at the same time every night, try waking your child a few minutes before the episode usually occurs to break the cycle of events. Doing this for a week may break disrupt the pattern without causing them a great loss of quality sleep.
Both nightmares and night terrors rarely have long lasting psychological effects on children.
If your child's nightmares or night terrors are occuring frequent enough to be a cause for concern, it may be time to speak with your child's pediatrician or even a sleep specialist for diagnosis.
For more information on children's sleep health, check out some of these articles:
- How to Tell if Your Child's Snoring is Normal or a Sleep Disorder