Nightmare or Night Terror?
Most children make some sounds in their sleep from time to time. You may hear little whimpers or fussing as your little one gets comfortable in their bed or experiences dreams. But a sudden scream in the night may come from a nightmare or a night terror. If you concerned that your child’s night wakings and middle of the night crying could be caused by a nightmare or a night terror, read on for more about:
What is a nightmare?
Why do nightmares occur?
What is a night terror?
Why do night terrors occur?
How can I help my child if I suspect nightmares or night terrors?
What is a Nightmare?
A nightmare is a frightening dream that occurs during REM sleep (Rapid Eye Movement, AKA Dream Sleep). A child who has a nightmare may wake up very scared or frightened, but upon waking will be awake and aware of their surroundings and will remember their dream. Nightmares typically occur in the last half of the night, and most commonly in the early morning hours when sleep becomes more largely comprised of REM sleep stages. Nightmares have been thought to happen in babies as young as 6 months of age, but this is very rare. A child’s first nightmare is most commonly between the ages of 1.5-2 years old, with the peak in nightmares occurring between the ages of 3-6. Nightmares can remain common in children through the age of 12.
Why Do Nightmares Occur?
Nightmares are completely normal, and are a result of your child’s growing mind and imagination or learning to deal with the stresses of the day. The following may contribute to nightmares:
Stress/Anxiety. If your child feels anxious, fearful, or stressed about something, it may carry over into their dreams.
Fears. Some children may be fearful of the dark or a movie or TV show that they found scary (even if it wasn’t scary to us.)
Overtiredness. Lack of sleep and overtiredness may lead to stress.
What is a Night Terror?
A night terror may seem similar to a nightmare, but there are some important distinctions. While a nightmare is a dream that occurs during REM sleep, a night terror occurs during non-REM sleep, when a child is in a deep sleep. For this reason, a child rarely remembers having a night terror. Night terrors come with fearful screaming and flailing. When you go in to comfort your child during a night terror, they will not be responsive and will be basically inconsolable. Nothing you do seems to calm them down. This is because they are still actually asleep! Night terrors typically occur during the first half of the night and most commonly 3-4 hours after falling asleep. Night terrors rarely happen in children younger than age 3, and 3-8 years old is the normal age range for night terrors to occur.
Why Do Night Terrors Occur?
Night terrors are attributed to a general overstimulation of the central nervous system during deep sleep and have several potential causes:
Stress, anxiety, and fears.
Chronic overtiredness
Excessive sugar intake
Vitamin/Mineral deficiencies (most commonly iron, magnesium, or vitamin D)
Fever
Full bladder
How Can I Help my Child with Nightmares or Night Terrors?
Once you have determined whether nightmares or night terrors might be causing your child to have tearful and fearful wakeups at night, you will want a plan for responding to and preventing these episodes.
If your child experiences nightmares, you’ll want to respond immediately by going into their room and providing reassurance that they are safe and that the nightmare was just a dream and was not real. A hug or back rub and staying with your child until they are calm is a good idea so that they can calmly return to sleep.
If your child is suffering from a night terror, they will not actually be awake, though the may seem to be. They will not respond to your voice or attempts to calm, so it is best to just sit nearby to ensure safety until the night terror passes, which may be several minutes or more. You can gently try to help your child lay back down every couple of minutes. Do not try to wake a child who is experiencing a night terror. To prevent night terrors from occurring, ensure proper nutrition—limit daily sugar intake, provide a nutritious bedtime snack, and supplement with magnesium and/or vitamin D with a product and dosage appropriate for your child’s age. Consult with a physician if you are concerned about iron levels. If your child is ill and has a high body temperature, try to lower their fever before bedtime with over-the-counter fever-reducing medication. Reduce fluid intake in the hour or two before bedtime and have your child use the bathroom twice during the bedtime routine to ensure that their bladder will not be too full while sleeping.
Regardless of whether the issue is nightmares or night terrors, you will want to:
Ensure that your child has space during the day and during the bedtime routine to talk about and process their fears and anxieties. This is especially important if your child has recently experienced any big life events such as divorce/separation of parents, moving, death/loss of a loved one, starting school, etc.
Be aware of your child’s exposure to TV shows and movies that might be scary. They may find a character or scene in a children’s show to be frightening, even if it seems harmless to us. Be sure to reassure your child that things like monsters, ghosts, or that scary character in the movie are just pretend and are not real.
Consider providing a dim red or amber night light for sleep in your child’s room if it helps them feel safer and more comfortable. Red or amber light is less disruptive to circadian rhythm and okay to use all night in your child’s bedroom. Pay attention to how your child responds to a night light; some children do find any light in the bedroom at night to be too stimulating.
Make sure your child is getting enough sleep and is not overtired. Children need the following amounts of sleep in a 24 hour period:
Preschoolers, ages 3-5: 10-13 hours of sleep
School-age children, ages 6-12: 9-12 hours of sleep
If your child is not sleeping a sufficient amount, you’ll want to identify the cause and solution to help them get the sleep they need to be well rested. A certified sleep consultant like Summit Slumber Pediatric Sleep Consulting can be helpful in providing multiple solutions for improving sleep in toddlers and children.
