Is there a difference between night terrors and nightmares And what can you do about them?
It’s midnight, and you and your husband are sound asleep.
A blood-curdling scream jars you awake, and then the sound of footsteps, pounding down the hallway toward your bedroom. Heart pounding, your breath coming in gasps, you frantically reach for your bedside lamp and switch it on.
Your two older children run into the room and clamor onto your bed.
“Johnny’s having another nightmare! Do something momma!”
If you’re a parent, you’ve probably been here—startled from sleep, trying to get your bearings, wondering what to do.
Night terrors and nightmares are in the same family of “parasomnias”—disorders that intrude on normal sleep. But they manifest themselves in different ways and have different treatment techniques.
A “night terror” is an episode in which a child wakes suddenly from sleep and acts very upset. They might be sweating, trembling, breathing fast, or have a bounding heartbeat. It will usually last 10 to 20 minutes, and nothing you do is going to calm them down. A couple of precipitating factors can be having a fever and experiencing chronic sleep deficiency from a variety of reasons. A night terror usually occurs during the first few hours of sleep, in contrast to a “nightmare,” which happens during the second half of sleep.
A nightmare is a scary, frightening, or upsetting dream that wakes your child from sleep, just as it does with adults. We’re not sure why we experience nightmares, but once awakened from one, it will be difficult for your child to go back to sleep. And they will probably remember the dream in the morning. This is different from your child’s night terror, after which they will usually go back to sleep and won’t remember anything of the event in the morning.
They can be a little difficult at times to tell apart, but remember that night terrors usually occur in the first part of the night and your child, once the episode is over (don’t try to wake them up!), can be consoled and will go back to sleep. After a nightmare, your child is going to have trouble going back to sleep. There are a couple of things that might help calm him or her and get them to doze off again. Gently reassure them that what they just experienced was only a dream, and not real. Some experts suggest drawing a picture of the dream, or writing about it. That takes a little time, but it should make the dream less scary, maybe even funny. You can always help your child come up with an alternative ending for the dream—something happy and magical.
With night terrors, since these usually occur during the first part of the night, you might be able to identify a pattern and a time during which they are most common. Say, 11:30 to midnight. If that’s the case, you can try something called “scheduled awakening.” Wake them gently 15 to 20 minutes before the anticipated event, but only for a few minutes. Let them go back to sleep and see if it works.
From a medical standpoint, we would only worry about these if they become nightly occurrences, disrupting the entire household, or there are physical changes with your child that might be significant. These would include bedwetting (if they previously were staying dry at night), loud snoring or gasping during sleep (obstructive sleep apnea is possible, but unusual in children), and any seizure activity, or anything that looks like it might be a seizure. That would be something emergent.
As we’ve noted before, sufficient and good-quality sleep is important for all of us, especially our children. Make sure you know the recommended amount of sleep for your child, set a bedtime and abide by it, and develop a calming and quiet routine before sleep. Doing all of these things might not eliminate night terrors and nightmares, but it’s going to help.
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This is an excerpt from the new book I’m writing with pediatrician Dr. Robert Alexander. The book will address 100 questions from parents regarding their children’s health. Feel free to email us with questions: askthedox@yahoo.com
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