Nightmare and Night Terror: What’s the Difference?

It can be quite concerning when your child wakes in the middle of the night crying or scared. There are different reasons why your child may wake up. Here are some tips to how to recognize if your child has a nightmare or night terror and how to handle.

I have heard of nightmares and night terrors. Are they different?

Yes. Nightmares are actually common (even 50% of kids can have nightmares), especially in preschool children as they start to have great imaginations. Nightmares occur in the later part of the night after your child has been sleeping for a while and in the REM stage of sleep. They do remember these nightmares. Night terrors on the other hand are much less common, only a small percent of kids have, and occur early on in the night soon after your child goes to sleep. These occur in the non-REM deep stage of sleep and your child won’t remember having the night terror in the morning.

What do you do when your child wakes up?

It is so hard to see your child so scared! For nightmares, go to your child, hug and comfort her. Reassure her it is just a dream and let her know she and everyone at home are safe. Also remind her where she can find you if she needs so she is comfortable going back to sleep. Basically, do just as your mom instinct would do! In the morning, or the next day you can try to find out why if your child asks or if the dream is recurring.

Night terrors, as mentioned, are in the non-REM sleep cycle and kids don’t remember. When your child wakes with a night terror in this stage of sleep, you will not be able to console your child when you try. They seem like they are awake but they are not. Your child will sit up, cry very loudly or even scream and may even be sweating. Typically your child will go back to sleep much sooner than with a nightmare, less than 30 minutes to even within minutes, however they won’t remember waking up.

The hardest part with night terrors are that you as a parent really want to console them when they seem to be in such distress and you cannot since they are not truly awake. Some children may even try to push you away if you try to hold them. I know first hand how difficult it can be to see your child having a night terror! You so badly want them to hear you and comfort them. It is best not to wake your child however. Actually, it is difficult to wake them in this deep sleep stage and if they are awoken they are confused and may take longer for them to fall asleep.

Remember, you child won’t remember what happened and is typically asleep the whole time. As long as you are there to ensure they are safe and return to sleep when they settle down, you have done a great job.

What causes nightmares and night terrors and how can they be prevented?

Nightmares can be caused from any stress or change and are often about what is going on in the child’s life at that time. However, sometimes there really is no reason at all. For preventing nightmares, it is good to have a bedtime routine and make bedtime peaceful and calm. Read a book or listen to music. Avoid anything that may have triggered the nightmare in the past. Encourage good dreams. If the child is scared, reassure them that the nightmare isn’t real and they are safe.

Night terrors can be caused when a child is overtired, or has any stress or even an illness or is in a new environment. Reduce any stress as best as possible, keep a bedtime routine, ensure your child has enough rest and prevent your child from getting overtired (such as taking longer naps or have an earlier bedtime).

Any last pieces of advice you have on this topic?

It is helpful to be aware of nightmares and night terrors. Nightmares are very common and comforting your child with hugs, kisses and reassurance that it was a dream and not real does work. If your child is experiencing a night terror, know she will be OK, even though it can be upsetting to see. Understanding them and knowing what to expect, can help you stay calm when they occur and be rest assured your child will be fine. Most resolve and are not cause for concern. Also, if anyone other than yourself is caring for your child during nap time, it is important you let them know about the child’s night terrors so they are aware and educated how to handle them. If your child’s sleep issues persist or you have any concern, be sure to discuss with your pediatrician.

Image via Flickr User NNelumba

 

Alison Mitzner, M.D. is a board certified pediatrician. She received her medical degree from the State University of New York Health Science Center at Syracuse. After completing her pediatric residency at North Shore University Hospital in Manhasset NY, she practiced general pediatrics for five years in a private practice in Manhattan, NY. During her years practicing, she was also an attending pediatrician at multiple New York City teaching hospitals where she admitted and examined newborns and pediatric patients. Additionally she supervised and taught hospital residents and medical students in various aspects of clinical and academic medicine. Alison has since moved into the pharmaceutical industry. She has had experience in the industry with leading safety teams and physicians and currently mentors many physicians globally.
Alison enjoys sharing her knowledge and experiences as a pediatrician (and mom) with other moms and dads in addition to supporting moms-to-be. She has contributed to various online websites and blogs. She also has an interest for creating healthier lifestyles and safer environments for pregnant women and children. Her outside interests include working out, acting, piano, guitar, dance, and being a mom!

You can find Alison at www.alisonmitznermd.com and follow on Instagram @alisonmitznermd

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