Nightmares & Night Terrors: How to Tell the Difference

Nightmares 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 them. Nightmares
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 or three years of age when children have rich imaginations and trouble distinguishing between reality and fantasy. Nightmares are, of course, common after difficult events or when children are re-living a trauma. Here's how to cut down on nightmares:

  • Avoid scary videos, books, etc. prior to bed.

  • Don't play scary games.

  • Respond quickly when your kid has a nightmare and assure him that he's safe.

  • 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
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 and may not recognize you when you approach her. There may also be sweating and/or a racing heartbeat. 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 and usually occur 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 seem to be more common in boys, and occur in 5% of all children. Sometimes they occur when your kid is working on a developmental milestone. 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. The most common cause of night terrors is sleep deprivation or a disturbance in a child's sleep patterns—like traveling to different time zones, a new home or a later bedtime. Other reasons for night terrors can include sleep apnea and fevers.

Here are some tips on how to handle night terrors:

  • 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.

  • 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) try the following:

  • Keep a sleep log to chart your kid's sleep patterns.

  • Wake your child 15 minutes prior to the time he usually has an episode.

  • Do this every night for 7-10 nights in a row and you will most likely see the episodes start to diminish.

As these two phenomena differ so greatly in treatment, it's important to clearly understand the difference between nightmares and night terrors. Once you know what you're dealing with, you'll be able to help your kid deal!

Credit: Lisa Ponton