Nightmares vs night terrors

By Dr Megan Yap - PaediatricianGeneral15 Jan 2017

G’day again parents and carers!

Today we are covering a topic requested by a bloggee – “Night Terrors”

This is a common question that comes up all the time at work, a topic that is frequently misunderstood, and a term that is frequently misused.  It is a topic close to my heart, because for some reason, I am a person that has suffered from NIGHTMARES all my life.  Whether it be because I am cursed with an overactive imagination, that I have an underlying anxious personality type or whatever, I have had them as long as I can remember.  They tend to be more frequent and of more distressing/violent content when I am stressed, overtired or badly upset about something.  They are awful.  My husband can attest to it, as he has had to wake me up more times that he probably cares to remember over the many years we have been together.

BUT, nightmares are different from night terrors.  Let me explain.

NIGHTMARE is a bad dream and these can occur at any age.  The child (or adult) can often recall all or part of the dream and find it difficult to go back to sleep.  They usually occur in the second half of the night (ie in the early morning) when a child has their dream sleep (ie REM or Rapid Eye Movement Sleep).  Most often, you can console and settle your child after a nightmare and they will remember it the next day.

NIGHT TERROR on the other hand generally tends to occur within the first 2-3 hours of falling asleep.  They often start with a cry or a scream and the child might look like they are panicking or distressed,  being sweaty and have fast breathing and a racing heart.  They may LOOK awake (ie with eyes open, crying, sitting up or running around) but they are not – the brain remains asleep, but the body appears awake.  Your child will not recognise anyone and will not be able to be consoled.  They usually settle down within about 5-15 minutes, and usually only occur once in the night (although can occur more).

It is really frightening and sometimes quite distressing to see your child have a night terror because you cannot comfort them – but almost universally, children don’t remember them in the morning.

Some interesting information about night terrors:

  1.  The typical age range for night terror is 18 months – 6 years (although the youngest child I have seen with them was 14 months old)
  2. Children grow out of them as their sleep patterns mature and change
  3. Almost 40% of kids between the ages of 2 years and 6 years have night terrors
  4. Night terrors and sleep walking (“somnambulance”) runs in families
  5. They occur as part of normal child development and cause no longstanding or serious emotional problems

Things that can worsen night terrors:

  1. Fever (ie temperature >38 degrees)
  2. Being overtired/sleep deprived
  3. Other sleeping problems eg snoring or obstructive sleep apnoea –> see your GP for a referral to an Ear, Nose and Throat Specialist if this is the case

Things that can worsen nightmares:

  1.  Vigorous physical activity before bed
  2. Exciting videos/movies/TV shows
  3. Exposure to inappropriate television programs or computer games
  4. Food or drinks within an hour of bedtime (for kids older than 1 year)


What to do with your child during a night terror:

  1.  Focus on keeping your child safe – they are not awake, seem confused and can sleepwalk; lock doors and windows
  2. Stay calm and do not try to wake your child – efforts to settle them can make the episode worse
  3. Try not to touch/restrain your child unless they are going to hurt themselves.
  4. Guide them back to bed

Treating night terrors

  • Make sure your child is getting enough sleep
  • Establish a regular bedtime routine with positive, calm and quiet activity before bed.
  • If your child is known to have night terrors and is unwell, treat fevers with medicines like paracetamol or ibuprofen


Know that it is a normal reaction for a parent to be worried about night terrors – they are hard and upsetting to watch.  But also realise that they aren’t harmful for the child, and they won’t even remember they had one when they get up in the morning.  They will grow out of them (thank goodness)!

I sincerely hope that your children don’t suffer from EITHER of these, but if they do… you now know what to do.

xxDr Megs

For more from Dr Megan Yap visit her blog – Kids Health Guru


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