Let’s first talk about the differences between nightmares and sleep terrors.

A nightmare is a bad dream that causes a child to wake up with feelings of fear. Nightmares are very common in young children. Most will seek out a parent after a nightmare and most will also recall them in the morning. Nightmares usually occur later in the night when there is more dream sleep.

A sleep terror seems similar to a nightmare, but a child will not have any memory of the sleep terror in the morning. Sleep terrors are also called night terrors, but the term sleep terrors is preferred because they can happen during daytime sleep (like a nap), too.

During a sleep terror, a child might have his or her eyes open, sit up in bed, leave the bed, scream or shout, or act frightened. A child will often seem confused, and he or she usually cannot be comforted by a parent. After a period of time (usually ten to thirty minutes), the child will calm down and go back to sleep. Sleep terrors usually occur during the first few hours of sleep.

Nightmares

If your child has nightmares or bad dreams occasionally, these are not cause for concern and are part of normal childhood development. If your child reports nightmares or bad dreams almost every night around bedtime, remember that nightmares usually occur during the second half of the night. This is important to remember because if your child is reporting these just after you leave or perhaps just an hour or so later, your child may be reporting them as an “admission ticket” to your bed.

Nightmares can happen more frequently for:

• sleep-deprived children
• children with inconsistent sleep schedules
• children who go to bed with a full stomach, so be sure dinner is eaten well before bedtime and that the bedtime snack is light.

You can teach your child some skills to deal with nightmares, too, by teaching your child to be “in charge of” his or her dreams. For example, you can help your child re-script the content of any bad dream that he or she has frequently. Your child can re-script the dream during the day and read this new version out loud one-half hour before bed. You can end the new script with a powerful statement like, “Even when monsters come after me in my dream, I have so many superpowers that I can always beat them!”

If you continue to be concerned about your child’s nightmares after your child is obtaining adequate sleep, please discuss this further with your child’s pediatrician.

Sleep Terrors

Remember, a sleep terror, unlike a nightmare, is something your child will not remember in the morning, so your main job is to keep your child safe during these events and not to wake him or her.

Sleep terrors can happen more frequently for:

• sleep-deprived children sleep
• children with inconsistent sleep schedules or a new daytime schedule
• children with undiagnosed or untreated sleep apnea
• children who are sick
• children with full bladders
• children who are sleeping in a new setting since sometimes noises or lights can trigger sleep terrors.

Most children outgrow sleep terrors by age four or so.

If your child has sleep terrors frequently (many nights a week), and if these occur around the same time each night, you might want to try scheduled awakenings. To try this technique, track the time that your child has a sleep terror for a couple of weeks and, if it does often occur at the same time, try going to your child about fifteen minutes prior to the usual episode. Gently awaken your child by speaking his or her name in a soft voice until your child flutters his or her eyelids or changes position, and then gently encourage him or her to drop right back off to sleep. Scheduled awakenings often result in a decrease in sleep terrors if used consistently for two to four weeks. If they do not, remember that your main job during a sleep terror is simply to keep your child safe.

To summarize, try to make sure that your child obtains plenty of sleep each night, sleeps in the same bed every night, and has a very consistent sleep schedule.