Nightmares and Night Terrors

Overview

What are nightmares?

Nightmares are scary dreams. Most children have them from time to time. Most nightmares happen very late in the sleep period (usually between 4 a.m. and 6 a.m.). Your child may wake up and come to you for comfort. Usually, he or she will be able to tell you what happened in the dream and why it was scary. Your child may have trouble going back to sleep. Your child might have the same dream again on other nights.

What are night terrors?

Some children have a different kind of scary dream called a "night terror." Night terrors happen during deep sleep (usually between 1 a.m. and 3 a.m.). A child having a night terror will often wake up screaming. He or she may be sweating and breathing fast. Your child’s pupils (the black center of the eye) may look larger than normal. At this point, your child may still be asleep, with open eyes. He or she will be confused and might not answer when you ask what’s wrong. Your child may be difficult to wake. When your child wakes, he or she usually won’t remember what happened. Children who have night terrors may also sleepwalk.

Will my child keep having nightmares or night terrors?

Nightmares and night terrors don’t happen as much as children get older. Often, nightmares and night terrors stop completely when your child is a teenager. However, some people, especially people who have active imaginations and are creative, may keep having nightmares and night terrors when they are adults.

Causes & Risk Factors

When should I worry about nightmares or night terrors?

Nightmares and night terrors in children are usually not caused by mental or physical illness. Often nightmares happen after a stressful physical or emotional event. In the first 6 months after the event, a child might have nightmares while he or she gets used to what happened in the event. If nightmares or night terrors keep happening and disturb your child’s sleep, they can affect your child’s ability to function during the day. Talk with your doctor about whether treatment will help your child.

Treatment

What should I do?

If your child has night terrors, speak to him or her calmly and gently and try to get your child back to bed. Do not shout or shake your child. Night terrors and sleepwalking require that you protect your child during sleep. Be sure your home is safe (use toddler gates on staircases and don’t use bunk beds for children who have nightmares or night terrors often). Talk with your doctor if your child ever gets hurt while sleeping. Your doctor may want to study your child during sleep.

Tips to Help Your Child Sleep Better

  • Follow a regular routine before bedtime. Pleasant activities, such as reading, may help your child relax.

  • Fatigue may contribute to night terrors. Make sure your child gets enough sleep every night.

  • If your child is stressed or anxious, talk to your child about what is stressing him or her. Together, try to come up with a plan to handle the stress.

Questions to Ask Your Doctor

  • Why is my child having nightmares and night terrors?

  • Is there anything I can do to help my child?

  • Should I talk with my child about his/her nightmares or night terrors?

  • Should I lock my child’s door at night for protection?

  • Would it help if I slept in my child’s room?

  • Are there any treatments we could try?

Citations

  • Nightmares and Disorders of Dreaming by JF Pagel, MD( 04/01/00, http://www.aafp.org/afp/20000401/2037.html)