Helping children cope with night terrors and nightmares

Night terrors and nightmares are distressing for children – and also their parents, who never want to see their child so upset.

Here, learn from a CHOC expert about the difference between night terrors and nightmares, what to do when a child experiences them, and strategies to reduce their frequency.

What are night terrors?

A child experiencing a night terror is partially awake and showing other behaviors such as screaming, kicking, panic, sleepwalking, thrashing or mumbling, says Dr. Priya Mody, a pediatrician in the CHOC Primary Care Network. Though troubling for a parent to witness, night terrors are harmless and each episode will end in deep sleep.

These are common characteristics of a night terror:

• The child is frightened but can’t be awakened or comforted.
• The child’s eyes are wide open, but they don’t know the parent is there.
• The episode may last up to 45 minutes.
• The child often doesn’t remember the episode in the morning.

How can I help if my child is having a night terror?

Resist the urge to try to awaken the child. Instead, try to help them return to normal sleep with soothing comments and sounds. Try holding them, if that seems to make improvements. Shaking or shouting, even in a well-intentioned attempt to awaken them, may cause them to become more upset, Dr. Mody cautions.

Try to get them gently back to bed and protect the child from injury. During a night terror, a child can fall down a stairway, run into a wall, or break a window.

Prepare babysitters for these episodes. Explain to people who care for the child what a night terror is and what to do if one happens.

What causes night terrors?

A night terror can be triggered if a child becomes overtired.

How can I prevent night terrors?

Be sure children go to bed at a regular time, and early enough to give them enough sleep. Younger children experiencing night terrors may need to return to a daily nap.

When should I call the doctor about night terrors?

Night terrors are not harmful, but they can look like other conditions or cause injury. Dr. Mody recommends talking with a child’s healthcare provider if parents notice any of the following:

• The child has drooling, jerking or stiffening
• Terrors are interrupting sleep on a regular basis
• Terrors last longer than 30 minutes
• The child does something dangerous during an episode
• Other symptoms happen with the night terrors
• The child has daytime fears
• If family stress may be a factor

What are nightmares?

Nightmares are scary dreams that awaken children and make them afraid to go back to sleep.

Nightmares may happen for no known reason, but sometimes happen when the child has seen or heard things that upset them. These can be things that actually happened or are imaginary.

Nightmares often relate to the developmental stages of a child, Dr. Mody says. Toddlers may dream about separation from their parents. Preschoolers may dream about monsters or the dark. School-aged children may dream about death or real dangers.

How can I help my child with nightmares?

Here are things Dr. Mody suggests parents try to help a child experiencing a nightmare:

• Comfort, reassure and cuddle them.
• Help the child talk about the bad dreams during the day.
• Protect the child from seeing or hearing frightening movies and TV shows.
• Leave the bedroom door open. Never close the door on a fearful child.
• Provide a “security blanket” or toy for comfort.
• Let the child go back to sleep in their own bed.
• Don’t spend a lot of time searching for “the monster.”
• During the bedtime routine, before the child goes to sleep, talk about happy or fun things.
• Read some stories to the child about getting over nighttime fears.

When should I call the doctor about nightmares?

Dr. Mody suggests parents call the pediatrician about their child’s nightmares if they notice any of the following:

• The nightmares become worse or happen more often
• The fear interferes with daytime activities
• Parents have other concerns or questions about your child’s nightmares

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