Nightmares and Night Terrors: Causes, Signs and Solutions

Sleep is essential for our physical and mental well-being, but sleep for our children can sometimes be disrupted by parasmonias like nightmares and night terrors. Parasomnias are sleep disorders that are unwanted physical phenomena and they occur during sleep. They are disorders of arousal, partial arousal, and sleep-stage transition and can exhibit undesirable physical or verbal behaviours. Although these sleep disturbances are common in children, particularly through the early stages of childhood, they are not a biologically normal sleep presentation. 

Any sleep presentation that does not fall within the realm of normal should be explored and to navigate any resolution plan, you need to identify what the disturbance is so they can be address and managed appropriately. Though often confused, these two phenomena are distinct in their causes, manifestations, and impacts. Let's explore what nightmares and night terrors are, how they differ, and what steps can be taken to alleviate them.

What Are Nightmares?

Nightmares are frightening dreams that typically occur during the rapid eye movement (REM) stage of sleep and generally occur in the second half of the night in light sleep. They typically happen from 18 months of age but are particularly common from 2-4 years of age. 10-50% of children will experience nightmares between the ages of 3 and 6 years and it’s at this age that they can start to describe the frightening dreams. Occasional nightmares is a normal part of childhood but recurrent nightmares are not really within the realm of normal and are usually triggered from stress in a child’s life.

Signs of Nightmares

• Vivid and detailed dreams: The content of nightmares is usually vivid and disturbing.

• Emotional response: Intense emotions such as fear, sadness, or anxiety upon waking. 

• Recall: The child often remembers the details of the nightmare upon waking, or the following morning

• Sleep disruption: Nightmares can cause difficulty falling back asleep due to lingering fear or anxiety.

Causes of Nightmares

• Stress and anxiety: High levels of stress or anxiety can trigger nightmares.

• Trauma: Traumatic experiences can lead to recurrent nightmares.

• Sleep quality disruptions: Physiological, medical or nutritional disruptions leading to poor sleep quality can increase the likelihood of nightmares.

What Are Night Terrors?

Night terrors, also known as sleep terrors, are episodes of intense fear, screaming, and thrashing that occur during the non-REM (NREM) stages of sleep. They will typically present around 1-4 hours after first falling asleep, at the end of the first or second sleep cycle and the sleep terrors can last for 5-20 minutes. Sleep terrors can occur at any age, but are most prevalent in children between the ages of 4 and 12 years. 

Signs of Night Terrors

• Sudden arousal: The person may suddenly sit up, scream, or thrash around.

• Intense fear: There is a visible display of intense fear, such as sweating, rapid heartbeat, and heavy breathing.

• Confusion and disorientation: The person may appear confused and be difficult to comfort.

• No recall: Unlike nightmares, people typically do not remember night terrors.

• Sleepwalking: Night terrors can be associated with sleepwalking.

• Not awake: The child will not be truly awake, although they will appear awake, and have no idea of the occurrence, and return to sleep easily.

Causes of Night Terrors

• Sleep deprivation: Lack of sufficient sleep in quantity can trigger night terrors.

• Stress and anxiety: Emotional stress and anxiety can contribute to night terrors.

• Fever: In children, fevers can sometimes cause night terrors.

• Sleep quality issues: Underlying issues leading to poor sleep quality is the leading cause of night terrors

• Genetics: There may be a hereditary component, as night terrors often run in families but in these cases, this is usually related to a hereditary underlying issue.
  

Differences Between Nightmares and Night Terrors

• Stage of Sleep: Nightmares occur during REM sleep in the second half of the night, while night terrors occur during NREM sleep during the first half of the night.

• Awareness and Recall: Individuals typically remember nightmares but not night terrors.

• Behavioural Manifestations: Nightmares cause the sleeper to wake up and recall the dream, whereas night terrors involve physical manifestations like screaming and thrashing without full awakening.

• Presentation: During a nightmare, the child still presents as asleep, whilst during a night terror, the child looks awake but is not aware that you are there and will not respond accurately to you

• Settling back to sleep: After a nightmare, the child will need support and comfort from their caregiver whilst after a night terror, the child will just stop their outburst and return to sleep.

How to Stop Nightmares and Night Terrors

By now, you should have the tools to identify what your child’s disrupted night sleep is; night terrors or nightmares. The good news is, that in most cases, we can stop these parasomnias from occurring in the first place. But in the meantime, it can be useful to know some immediate strategies you can implement to ease the impact of these in the first instance. 

Strategies for Reducing Nightmares

1. Maintain a regular sleep schedule: Have a set wake time and bedtime for your child. Also, follow a set nap routine to balance the sleep/wake cycle and establish adequate sleep quantity - download your free copy of my Day Sleep Guide here

2. Create a calming bedtime routine: Engage in relaxing activities before bed, such as reading or recapping positives from the days events

3. Determine the underlying reason: stress, trauma, something they saw on TV etc

4. Communicate: If your child has the vocabulary, gently broach the topic to find out what they are scared of

5. Manage fear: After a nightmare, reassure your child that it is okay for them to feel scared, but they need to know that they are safe. Acknowledge then validate their feelings

6. Limit exposure to disturbing content: Avoid watching scary movies or reading frightening books before bedtime.

7. Seek professional help: If nightmares are frequent and severe, consider talking to a therapist or counsellor.
   

Strategies for Reducing Night Terrors

1. Ensure sufficient sleep: Make sure your child achieves enough restful sleep in the 24 hour period. Most importantly, they need optimal sleep quality; this is the leading cause of night terrors.  Find out more about sleep quality and sleep quantity in the blog: Quality vs Quantity.

2. Create a safe sleep environment: Remove any objects that could cause injury during a night terror episode.

3. Proximity: Don’t wake your child during a night terror however, stay with your child through a night terror to ensure they are safe, and do not harm themselves accidentally, and wait for it to pass

4. Avoid discussions about it: Try not to talk about it with their child the next day. They are not likely to remember, and talking about it when they can’t remember, can trigger some anxieties around going to sleep

5. Consult a care provider: If night terrors are frequent and disruptive, you can start by reviewing my Underlying Issues Affecting Children’s Sleep blog or book in for a Sleep Quality Assessment so I can determine the real cause of your child’s night terrors. 

Nightmares and night terrors can be distressing experiences for parents to observe, but understanding their differences, identifying the trigger of these parasomnias and managing them appropriately, we can reduce the frequency and intensity of these sleep disturbances, or even stopping them in most cases. If these issues persist, seeking professional guidance is crucial to ensure underlying causes are addressed and overall well-being is maintained. This is where I can help.

If you’d like to connect to learn more about how I can help you, book in for a free 15 minute discovery call.

Discovery Call

Book Now

Forever bringing sleep to families,

Shereen xx

I'm Shereen Nielsen, a certified Sleep Consultant specialising in infants and children from birth to 15 years old. With over seven years of experience, I've assisted over 4000 families in achieving better sleep. Additionally, I serve as a lecturer and mentor, guiding aspiring sleep consultants on their path to certification through my internationally recognised online Sleep Consultant Course.

Phone: +61419820474

Email: hello@shereennielsen.com 

Website: www.shereennielsen.com

Facebook: @shereennielsen.sleepconsultant 

Instagram: @shereennielsen_sleepconsultant