Key points about nightmares and night terrors
- nightmares are bad dreams that often relate to your child's worries - talk to your child about their worries to help them go away
- night terrors usually happen a few hours after falling asleep and can be frightening for parents
- don't try to wake your child, but gently keep them out of harm's way until it passes - keep your home environment safe
- help your child get enough sleep with regular bedtimes and wake times
- make sure there is no underlying sleep disorder such as obstructive sleep apnoea or periodic limb movement disorder
- if episodes are severe or frequent, a health professional may need to check for an underlying condition
Find out about obstructive sleep apnoea on the page about snoring or noisy breathing.
Snoring Or Noisy Breathing In Children
What is a nightmare?
Nightmares happen when your child wakes from a bad dream. They may remember the 'scary dream' and feel afraid to go back to sleep. A reassuring hug will often help them settle back to sleep.
Tamariki can have nightmares at any age. Nightmares are more likely in the later part of the night or early morning, during rapid eye movement (REM) sleep.
Nightmares can be from worries that your child has. It is good to talk to your child about their worries. Tamariki can usually remember these nightmares the next day.
The difference between nightmares and night terrors
Night terrors happen when tamariki are only partly woken or when they wake from deep sleep. They are not fully awake, but they are not completely asleep either. Night terrors tend to start in the first 2 to 3 hours after sleep starts and may be at a predictable time each night.
During a night terror, the brain is asleep but the body looks awake. Your child may scream, look very frightened and not recognise people around them.
Do not try to wake your child, as this can make the episode last longer. They may try to run away or push people away.
Night terrors are a type of non-REM sleep arousal disorder (parasomnia).
Your child may remember feeling frightened but not what the dream was about. They usually do not remember the event the next morning.
Night terrors are more common in younger tamariki and most outgrow them by the end of primary school. Like nightmares, they do not usually cause long-term psychological effects.
Helping your child with nightmares or night terrors
Nightmares
With nightmares, it is usually enough to reassure your child and stay with them until they fall back to sleep. Talk about the dream the next day and ask about any worries or fears they may have.
A regular bedtime routine and quiet, screen-free time before bed can help.
Find out about managing nightmares.
Night terrors
During a night terror, your child may seem confused and not fully awake. Focus on keeping them safe, as they may move around.
Some tamariki may walk during a night terror. This can be called ‘confusional arousal’ or ‘sleep-walking’. These are types of partial waking from deep sleep.
Keep your home safe by locking doors and windows. It may be safer for your child to sleep on the ground floor.
During an episode, gently guide your child away from danger. They will usually settle back to sleep after a few minutes. Do not try to wake them, as this can make the episode last longer.
Find out about managing night terrors.
Preventing nightmares and night terrors
Nightmares
Before bedtime, spend time doing calm activities with your child, such as reading. Avoid exciting or unsuitable TV or videos before bed. For tamariki 12 months and older, avoid food and drinks in the hour before bedtime.
Night terrors
Things that can make night terrors worse include:
- tiredness
- not getting enough sleep
- fever
A regular bedtime and wake time (including weekends) can help your child get enough sleep.
If your child has a fever, try and keep it down, as fever can make night terrors worse.
If night terrors happen at the same time each night, you can try gently waking your child about 15 minutes before this time. Gently stir them, then let them go back to sleep.
If this helps, continue for 4 to 5 nights, then stop and see if the night terrors have settled. In some tamariki, waking them may trigger an earlier episode. If this happens, stop waking them and focus on keeping them safe during episodes.
Treatment for nightmares and night terrors
See a health professional if the nightmares or night terrors:
- are frequent, severe, disruptive or dangerous
- happen at an unusual age
- affect your child during the day, such as causing sleepiness
Your health professional may check for another sleep-related condition.
If there is an underlying cause, it may need treatment before the night terrors stop. Causes can include snoring, sleep apnoea or periodic limb movements. Treating these can greatly reduce night terrors.
If there is no underlying condition, your child may need extra support. This can include:
- hypnotherapy (which has been shown to be effective)
- medicine (for severe, frequent or distressing episodes, or if they affect daytime behaviour)
Sleep problems are common in childhood and usually do not have an underlying medical cause. Your health professional can help guide you.
Acknowledgements
Starship Foundation and the Paediatric Society of New Zealand acknowledge the cooperation of The Children's Hospital at Westmead, Sydney Children's Hospital at Randwick, and Hunter New England Kids Health in making this content available to patients and families. Adapted from The Sydney Children's Hospitals Network Nightmares and night terrors.
