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Nightmares and night terrorsDisclaimer: This fact sheet is for educational use only. Please consult your doctor or other health professional to make sure this information is right for your child. Key points to remember
 Back to TopWhat is a nightmare?Nightmares occur when your child is woken while having a bad dream. It is sometimes not easy to comfort your child because they might recall the content of the nightmare and be afraid to go back to sleep. Give your child a reassuring hug and then they will usually settle back to sleep quickly.
Nightmares can occur in children of any age and are most likely to happen during the later part of the sleep such as in the early morning. This is when REM (rapid eye movement) or dream sleep usually occurs. Nightmares can reflect worries that your child might be having during the day and it might be useful to talk about this with them. Back to TopWhat's the difference between nightmares and night terrors?Night terrors occur when children are partially aroused from deep (stage 4) sleep. They are not quite awake yet not completely asleep. Throughout the night terror, your child’s “mind” remains asleep, whereas the “body” looks somehow awake and facial expressions are very emotional. Your child may scream and appear very frightened, usually not recognising the parents or carers. It will be difficult to reassure your child and they may try to run away or push away those trying to console.
Night terrors do not arise from REM (rapid eye movement) sleep and are therefore under the group of non-REM sleep disorders. Usually your child does not remember having the night terror the next morning.
Night terrors tend to occur in younger children and are usually outgrown by the end of primary school age. They are also different to nightmares because they usually take place in the early part of the night, usually one or two hours after the child falls asleep.
Like nightmares, there are usually no long-term psychological effects. Back to TopWhat to do?Nightmares
With nightmares, it is usually enough to reassure your child and stay with them until they are comfortably off to sleep again. The next day, it usually helps to talk about the dream and ask about any worries or fears they may be experiencing.
Night terrors
With night terrors, your child will appear to be confused and not fully awake, so keeping them out of harm’s way is important. Make sure the home environment is safe as they may sometimes run around. Doors and windows should be locked and sleeping on the ground floor is encouraged.
During the episode, keep them away from danger by gently restraining them – your child will usually go straight to sleep after a few minutes. Parents / carers often report that the more they try to wake them the longer the episode lasts. Back to TopCan they be prevented?Nightmares
Before bedtime, try to spend time with your child and ensure activities have a calming effect; for example, try reading a book with them. Try to avoid your child watching exciting videos, inappropriate television or commencing vigorous activity prior to bed.
Night terrors
It is important to make sure your child has a very regular bedtime and consistent routine. This will help to ensure that they get enough sleep. Fevers also make night terrors worse so it is important to try and keep the fever down when your child is sick (see fever fact sheet). If the night terror happens at the same time every night, it sometimes helps to wake your child (for example by gently nudging their shoulder until they stir) 15 minutes before this time, letting them drift off to sleep again. This can be very effective – usually after four or five nights of this you can stop the partial waking and see if the night terrors have stopped. Back to TopWhat is the treatment?It would be wise to see the doctor if the nightmares or night terrors:
It is important to rule out an underlying medical disorder related to sleep such as sleep apnoea (snoring, stopping breathing and working hard to breathe), heartburn, epilepsy (very stereotyped features, most of the night, several times a night) and periodic limb movements (the child complains about pains in the limbs). These can cause a partial arousal, which may lead to a night terror.
Sleep disorders are very common in childhood and fortunately most of the time there are no underlying medical conditions. Your local doctor and paediatricians are very familiar with these problems and can offer help. Back to TopAcknowledgementsStarship Foundation and the Paediatric Society of New Zealand acknowledge the co-operation of The Children's Hospital at Westmead, Sydney Children's Hospital at Randwick, and Kaleidoscope - Hunter Children's Health Network in making this fact sheet available to patients and families.
Back to TopYour notesEndorsement
This fact sheet was endorsed by PSNZ - 10/02/2006
CopyrightFact sheets are subject to copyright. In the interests of information sharing they may be copied but acknowledgement must be given to PSNZ and Starship Foundation. © The Paediatric Society of New Zealand and Starship Foundation 2005 - 2012
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