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Nightmares and night terrors in kids: Do you know what to do?

Scenario 1:

You are snapped out of sleep by a teary little voice saying “Mummy, Mummy, I had a bad dream” over and over again. You look at the time — it’s 3am. And as you gather your trembling, sweaty child into your arms to comfort her yet again — for this is the fifth day in a row that this has happened — you wonder with anxiety in your mind, when this will end.

Scenario 2:

Your sleep is shattered by a blood-curdling scream from your little one. As you race to his room, you see him kicking, screaming and mumbling to himself. The sight is made even scarier because your child does not seem to know who you are, despite your desperate efforts to communication to him. After about 20 minutes of this behaviour, he falls back into a deep sleep like nothing happened. What’s going on? 

Do either or both of these scenarios seem familiar to you, mums and dads? The first one is typical of what happens when a child has a nightmare, and the second, when he has a night terror. 

Both nightmares and night terrors are common among young children, and while they may seem absolutely terrifying to you as a parent, they are actually much more common that you might imagine.

To bring you professional knowledge about these two experiences so that you know exactly what you are dealing with and what to do when they occur, we spoke to Dr Michael Lim, Consultant, Division of Paediatric Pulmonary and Sleep, National University Hospital. 

nightmares and night terrors in kids

A nightmare can be a terribly upsetting experience for a child, but usually, are nothing to be worried about from a developmental point of view.

Nightmares

What are they?

Nightmares are frightening dreams that usually awake a child or adolescent, leaving the child upset and in need of comfort, explains Dr Lim.

They happen during the REM (rapid eye movement) phase of sleep which is more predominant in the last third of the night, and the child tends to remember these dreams the next day.

These scary dreams tend to correspond to the developmental stages of a child, according to Stanford Children’s Health. So toddlers might dream about being separated from their parents; pre-schoolers about monsters or ghosts; and older kids about real dangers such as death or illness.

Nightmares can start as young as 2.5 years of age, says Dr Lim, but occur most commonly at 6-10 years of age, with 75% of children experiencing at least one nightmare in their lifetime.

nightmares and night terrors in kids

Nightmares may be triggered when your child reads scary stories or watching scary movies or TV programmes, especially before bed-time.

What triggers them?

The most common trigger of nightmares is stress or traumatic events. According to Dr Lim, nightmares usually occur within three months of the stressful or traumatic incident.

Other than this, anxiety (e.g. separation anxiety in younger children) can increase the frequency and severity of nightmares. Insufficient sleep can also result in intense and vivid dreams, reinforcing the need for children to get adequate sleep each night.

Read on the next page how to handle and prevent nightmares. We also discuss night terrors. 

How to handle nightmares

The following tips are from Dr Lim and also adapted from Stanford Children’s Health.

  • Reassure your child that it was only a dream.
  • Stay calm and matter-of-fact, striking a balance between reassuring the child and not providing excessive attention.
  • Do not talk about the nightmare at that moment. Instead, talk about the bad dreams the next day when you can also talk about coping strategies, as well as find out if anything is worrying your child and triggering the nightmares.
  • Encourage your child to go back to sleep in his own bed, but leave his bedroom door open (never close the door on a scared child).
nightmares and night terrors in kids

Allowing your child to sleep with a much-loved toy, or even having the family pet sleep in her room, may help her cope better with nightmares.

How to prevent or minimise the occurrence of nightmares

  • Do not allow your child to watch scary movies or TV shows, especially just before going to sleep.
  • During the bedtime routine, before your child goes to sleep, talk about happy or fun things. Prepare a ‘monster spray‘ if you feel your little one’s nightmares are triggered by the thought of monsters or ghosts.
  • Give your child a security blanket or other comforting object to take to bed. Even the presence of a family pet in the child’s room may be comforting and help your child get back to sleep faster.
  • Teach your child some simple relaxation strategies that he can use to calm himself down (e.g. slowly count to 10, take 10 deep breaths), or read children’s books which address ways to manage being scared at night.
  • Children of speaking age can be encouraged to use their imagination to alleviate nightmares (e.g. by imagining a positive ending to a frequently experienced nightmare).
nightmares and night terrors in kids

A night terror is usually significantly more dramatic than a nightmare and may involve shouting, screaming and thrashing around – all while your child is still asleep.

Night terrors

What are they?

Night terrors can be quite dramatic. During the experience of these, the child wakes with behaviour that manifests from intense fear, and can include extreme agitation, confusion, and screaming explains Dr Lim. A night terror can last from anywhere between 15 to 30 minutes.

Unlike nightmares, children are completely unaware of their behaviour and do not tend to remember these events; i.e. they are worse to watch than to experience.

These events happen during a different sleep phase from nightmares. Night terrors occur during slow-wave sleep (often described as deep sleep) and so tend to happen earlier in the night when this phase predominates, says Dr Lim.

Here are some common signs of a night terror:

  • Your child’s eyes are open but he doesn’t understand that you are there.
  • Your child is clearly scared but can’t be woken up or comforted.
  • Your child doesn’t remember the incident the next morning.

It’s important to keep in mind that night terrors do not signify psychological issues, says Dr Lim, and do not lead to psychological harm.

What causes a night terror? How should you handle one? And when should you see a doctor for nightmares and/ or night terrors? Find out on the next page. 

What triggers night terrors?

Dr Lim explains that night terrors in kids are more common if one or both parents also experienced them when they were children.

Other factors that may increase the likelihood of night terrors include not enough sleep and/or sleep disruptions; irregular sleep schedules; changes to regular sleep schedules (e.g. when stopping daytime naps); and sleeping in an unfamiliar environment (e.g. when travelling).

Night terrors may also be triggered by fever and illness, as well as stress and anxiety.

According to Dr Lim, night terrors occur in about 5% of children, usually during the preschool and primary school years. While the age of onset is usually between 4 and 12 years of age, most children will outgrow them by the time they reach puberty.

nightmares and night terrors in kids

Night terrors sometimes involve sleep walking or thrashing around the room, or in bed. As such, it’s important to ensure the safety of your child when one occurs.

How to handle night terrors

The following information is provided by Dr Lim and also adapted from Stanford Children’s Health:

  • Parents should not intervene or wake the child during an episode as this is likely to increase agitation and prolong the event. It is best to be around the child to ensure safety, but not to interact, says Dr Lim.
  • Unlike nightmares, parents should avoid next-day discussions about night terrors (unless your child brings it up) as this is likely to worry the child and may lead to bedtime resistance and insufficient sleep.
  • Do not shout at your child or try to shake him awake.
  • Remember to keep your child’s safety in mind during a night terror.
  • If your child is mobile while experiencing a night terror, be by his side until the terror subsides and he is back in deep sleep. If he is sleep walking, try to gently guide him back to bed.
  • Brief any other caregivers of your child (helpers, babysitters, relatives, friends) about these episodes and what to do when one happens.
nightmares and night terrors in kids

Try to ensure a consistent sleep-wake schedule for your little one to help minimise or even prevent night terrors.

How to prevent or minimise the occurrence of night terrors

  • Do not allow your little one to get over-tired especially before bed time.
  • Stick to early and regular bed times as much as possible. Have a consistent sleep-wake schedule for your child.
  • If you feel the night terrors are being triggered due to stopping his daytime nap, consider re-introducing it.
  • Ensure that your child’s bedroom is conducive for a good night’s sleep.
  • Be on the lookout for signs of other sleep problems that lead to poor quality of sleep (such as frequent waking and excessive snoring) as these sleep issues may need to be addressed to decrease night terrors.

Parents, you’ll be relieved to know that both nightmares and night terrors are not considered dangerous to a child’s development. In fact, nightmares are almost universal and part of normal development.

Night terrors too are not harmful to your child’s health as long as you make sure he or she cannot hurt himself while experiencing one (by following the simple tips described previously in the article).

Still, if you are worried about the frequency or severity with which your child is experiencing either nightmares and night terrors, and if you have tried all the prevention methods outlined in this article but find they are not working, it’s best to seek professional advice.

We hope you found this article useful and interesting. Has your child ever experienced nightmares or night terrors? How have you handled them? Do share your thoughts and experiences on this topic by leaving a comment below. 

Republished with permission from: theAsianParent Singapore