Nightmares and Night Terrors

Recently I have found myself losing sleep because parents are always asking me questions about their children having nightmares and night terrors.  Although many people think they are the same thing, they are not.  So this week, fear not as I tell you a bit about both of these sleep issues.

Nightmares are simply scary dreams, and 25% of children have them at least once a week.  They typically occur during the second half of the night when dreaming is more intense.  Night terrors are more rare, but are still seen in up to 3% of children, usually between the ages of 4 and 12. They tend to occur about an hour or two after bedtime, which is before your child enters the more intense dream phase of sleep.

A nightmare may result in a child waking up and seeking comfort from parents because they are scared or frightened about something they dreamt about.  A night terror results in a child sitting up in bed and often involves screaming, crying and repeatedly thrashing around. Some children even sleepwalk during a night terror, and although their eyes may be wide open, there will typically be no response to being consoled by a parent, and no recall of the event the following morning. 

Night terrors tend to run in families and occur more in children who are overtired, stressed or fatigued - although being overtired or stressed can result in more nightmares as well.

Although scary to watch, a night terror is dangerous only if your child gets out of bed and begins to sleepwalk, so please be sure that you have a gate across any nearby steps.  In some cases, you may need to hold your child so they do not get out of bed and hurt themselves.

In terms of prevention, my best advice is to make sure your child gets a good night’s sleep by having a regular bedtime and sleep routine. It’s also a good idea to avoid exposing them to scary movies or even scary stories before bed.  Figuring out if they may be overstressed and why that is occurring might also help reduce the frequency of these night events.

Hopefully, tips like these will result in pleasant dreams for you and your child now that you have a better understanding of your child’s nightmares and night terrors. 

Lewis First, M.D., is chief of Pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch "First with Kids" weekly on WOKO 98.9FM and on WCAX-TV Channel 3. Visit the First with Kids video archives at