What's the Difference Between Nightmares and Night Terrors in Toddlers, and How to Handle Them

fear Mar 16, 2022

One of the most common messages I get about toddler (and even baby sleep) is a parent concerned that their little one is experiencing nightmares or night terrors.

INTERESTING FACT: NIGHTMARES AND NIGHT TERRORS ARE ACTUALLY DIFFERENT!

It’s SO common to assume that when your baby or toddler randomly wakes up screaming or crying at nightime that it is a night terror…but this is actually a legit diagnosis and shouldn’t just be assumed immediately! This blog should help provide some basic information on nightmares and night terrors…and whether or not this is something you need to discuss with your child’s pediatrician.

WHAT ARE NIGHTMARES?

Simply put, nightmares are scary/bothersome dreams that make toddlers, children and even adults scared or anxious to go back to sleep. Nightmares can begin to occur between 2-6 years old

Nightmares typically occur in the last part of the night during Rapid Eye Movement (REM) sleep. This is the lightest stage of sleep where your baby is easily awakened.

As adults we assume nightmares are super scary monsters, ghosts and goblins or horror movie style, and this could be true if your child has been exposed to such media. However, for children, something scary can be something as simple as a bunny they saw in the garden that ran by them really fast, a loud noise that startled them, or something that surprised them when watching a children’s show on television. It also may be as simple as dreaming of being separated from their parents.

HOW TO PREVENT NIGHTMARES

Although the exact cause isn’t really known, nightmares are common in children who are overtired, under some kind of stress, have experienced significant trauma, or are on a specific medication that may cause nightmares (make sure to ask your child’s doctor if you are concerned about medications causing nightmares).

The number one thing you can do to help with nightmares is getting your toddler onto a consistent sleep schedule and routine. Routine is SO important for your child, and making sure they aren’t getting overtired with adequate naps and bedtimes is critical.

If your little one is already a fantastic sleeper - Try putting them to bed 10-20 minutes earlier each night to see if it helps with any night wakings or possible nightmares.

If your little one has always struggled with sleep and isn’t yet sleeping through the night - Then you’ll want to start with my FREE Toddler Bedtime Guide (ages 14 months +). Getting these basics down can make ALL the difference.

FREE TODDLER BEDTIME GUIDE

WHAT DOES A NIGHTMARE LOOK LIKE?

Your child will wake up scared and likely tell you something was scary to them! They may even explain what they saw in their dream that frightened them. This of course could include them crying, calling out for you, or screaming. Your child will likely remember and recall this nightmare to you the next day and potentially several days or weeks later.

HOW CAN I HELP THEM THROUGH A NIGHTMARE?

Nightmares can be scary and SO SAD to observe for parents. It hurts to watch our children scared or frightened.

Absolutely don’t be afraid to cuddle and comfort your little one.
Go in and reassure them that they are safe in their bed and that you are here for them and love them.
Validate their fears and do not downplay them or say “that’s not scary.” These nightmares/dreams can feel SO real and terrifying for your little one, and downplaying it will not help. Validate their feelings and provide empathy.
Consider introducing a lovey/comfort item. Learn more about how and WHEN to introduce a lovey here.
Consider introducing a nightlight if they are saying they’re afraid of the dark. I ALWAYS suggest a red night light, as blue light can stimulate their little brains and discourage sleep. Read more about when and how to introduce a night light, along with how to navigate fear of the dark here.
Talk about their fears during the day, and spend lots of time in their bedroom so they know it’s a safe, happy place!
Avoid talking about potential dangers, monsters, or looking for anything “bad” or “scary” under the bed, as this can just increase anxiety and fear. Focus on the fact that they are safe in their beds, and you and other caregivers are ALWAYS there for them no matter what.
In future, monitor television shows/books that may have anything “scary” and try to limit any screen time before bed by at least 1-2 hours. Make sure to have an engaging 1:1 bedtime routine before bed with lots of cuddles and reassurance.

WHAT ARE NIGHT TERRORS?

Night terrors are a common pediatric parasomnia (along with sleep walking/talking etc.) For children ages 2-12 years old, or maybe older. They can affect up to 40% of children, with this percentage usually (but not always) declining in adolescence. The peak age for night terrors is between ages 5-7 years of age. They can sometimes occur as young as 18 months, but this isn’t super common.

Night terrors are a partial waking from sleep and can be quite traumatic for a parent to see… but are actually harmless in terms of “fear.” Your child will not remember a night terror in the morning as they are totally asleep.

Night terrors most commonly happen at the beginning part of the night during non-REM (Rapid Eye Movement) sleep. Usually this is a couple of hours after bedtime, when parents are still awake. This is when they are emerging from the deepest kind of sleep (stage 3, or slow-wave). Sleep or night terrors rarely happen during naps.

Interestingly, night terrors are more common in females than males, and are more likely to occur if there is a family history of them.

What does a night terror look like?

As I said earlier, night terrors are often more traumatic for the parent than the child, as they will have no recollection of it come morning. A night terror commonly omits the following characteristics:

Kicking, screaming, yelling very suddenly.
Panicking
Sweating/heavy breathing
Thrashing and kicking
Pushing parent/caregiver away when trying to be consoled or comforted.
Sleep walking
Eyes wide open, but don’t seem to recognize your presence
Child cannot be comforted
Difficult to awaken, or confused/disoriented when woken up.
Sitting straight up in bed!
Can last from as little as 3 minutes to as much as 45 minutes.
Often no recollection of the event in the morning.

TIPS TO PREVENT NIGHT TERRORS

Like nightmares, night terrors are commonly caused by:

Over-tiredness/extreme fatigue
Stress/anxiety
Fever/sickness
Disruption of sleep routine when traveling/ life events.

Here are a few things you can do to prevent night terrors:

Reduce sugar intake, especially before bedtime.
Stick to your little one’s daily sleep schedule
Ensure earlier bedtimes as needed
If the nap has dropped, consider reintroducing a nap
Avoid “scary” television and books as a whole, and limit screen time 1-2 hours before bed.
Have a game plan on nights you know you’ll be out late or having ice cream dates, just in-case!

HOW CAN I HELP THEM THROUGH A NIGHT TERROR?

Although this feels instinctually wrong as a parent, it is best not to quickly interfere when your toddler or child is experiencing a night terror. The key is to STAY CALM yourself. Don’t panic and try to relax.

If it is only minor… watch the monitor to observe their safety and leave them be. I suggest you wait and observe for 3-5 minutes and use your parent gut!! Often night terrors last only a few minutes, and will go straight back to sleep.
If you are concerned, go and sit/stand next to them quietly but do not try to wake them up. This can actually make it worse.
Offer quiet and calm reassurance letting them know you are there for them.
If you feel like holding them will help, feel free to try this, but if it makes it worse or they push away, place them back into their crib or bed.
Again… do not try to shake your child awake or yell as it may make the situation worse.
You highest priority during a night terror is their safety. If they are in a crib this is helpful as they are confined to the crib. If they are in a bed, try to make sure their room is totally safe.

WHEN YOU SHOULD CALL YOUR CHILD’S DOCTOR…

Usually, night terrors aren’t anything to be hugely worried about, especially if you notice they only happen occasionally on days of over-tiredness, skipped naps, late nights, ice cream nights etc.

However, you’ll want to check in with your child’s doctor when:

Night terrors are occurring regularly.
Night terrors are lasting longer than 20-45 minutes
Your child does something dangerous during a night terror such as causing injury to someone else or themselves.
If your child is jerking, stiffening, or drooling.
If you are concerned for your child’s health and wellbeing.
You just want to learn a little more about night terrors.

IF YOU JUST FEEL LIKE YOU’RE CONSTANTLY STRUGGLING WITH YOUR CHILD’S SLEEP, I AM HERE TO HELP!

I work with families JUST LIKE YOU every single day. Families who are up every 2 hours, every 4 hours, replacing the pacifier, nursing, whatever it is, I can help you go from surviving to thriving! I can help you get your baby/toddler sleeping 11-13 hours straight (with age appropriate feedings).

If you’re ready to get started RIGHT NOW…….I offer self-led sleep guides that walk you through step-by-step on what to do at bedtime, how to handle every situation, and how to help your toddler sleep through the night!