Nightmares vs. Night Terrors in Children: Causes, Differences & When to Worry

🩺 Written & Medically Reviewed by Dr. G
Board-Certified Pediatrician

Nightmares are frightening dreams. Children usually wake up, are aware of what happened, may remember the dream, and often seek comfort from a parent.

Night terrors are a type of partial arousal from deep sleep. A child may scream, sit up, look terrified, breathe rapidly, or even push a parent away—but they are usually not fully awake and often have little or no memory of the episode the next morning.

Nightmares typically occur later in the night, while night terrors more often occur during the first part of the night.

Most episodes do not require medical treatment. However, frequent events, injuries, daytime impairment, unusual movements, breathing problems, or episodes that do not fit the typical pattern should be discussed with your pediatrician.

• Nightmares and night terrors are not the same thing.
• Nightmares usually involve a child who is awake enough to remember the frightening dream.
• During a night terror, the child is often still partly asleep.
• Night terrors commonly occur in the first few hours after falling asleep.
• Nightmares are more common in the second half of the night.
• Parents should usually comfort a child after a nightmare.
• During a night terror, the priority is usually safety rather than trying to wake the child.
• Sleep deprivation, stress, illness, and disrupted sleep schedules can sometimes make nighttime events more likely.
• Frequent, severe, unusual, or dangerous episodes should be reviewed with the pediatrician.

You wake suddenly to the sound of your child screaming.

You rush into the bedroom.

Their eyes may be open. Their heart is racing. They may be sweating or breathing quickly.

You call their name.

But they don't seem to recognize you.

Then, several minutes later, they settle back to sleep.

In the morning, they remember nothing.

That can be a night terror.

Now consider a different situation.

Your child wakes crying and calls for you. They tell you that a monster was chasing them or that something terrible happened in their dream. They clearly recognize you, want comfort, and may be afraid to go back to sleep.

That is much more consistent with a nightmare.

Understanding the difference can help you know what to do—and prevent you from trying to “fix” something that may resolve on its own.

Nightmares and night terrors happen during different types of sleep

Sleep is not one continuous state.

Children move through different stages of sleep during the night.

Nightmares usually happen during REM sleep, the stage of sleep associated with vivid dreaming.

Night terrors usually occur during transitions out of deep non-REM sleep.

This explains why the child's behavior looks so different.

Nightmare vs. night terror

A child can look awake during a night terror

This is one of the most confusing parts for parents.

During a night terror, your child may:

• Sit upright
• Have open eyes
• Scream
• Sweat
• Breathe rapidly
• Have a racing heart
• Appear terrified
• Push you away
• Speak unclearly
• Move around

But despite looking awake, they may still be partly asleep.

That is why trying to reason with them often doesn't work.

Nightmares and night terrors do not always have an obvious cause.

Several factors may contribute.

Sleep deprivation

Not getting enough sleep can increase partial awakenings in some children and may make night terrors more likely.

Irregular sleep schedules

Late nights, missed naps, travel, or major changes in sleep timing can disrupt normal sleep patterns.

Illness or fever

Children may sleep more restlessly when they are sick.

Stress or emotional changes

Stress can contribute to nightmares.

Common triggers may include:

• Starting school
• Moving
• Family changes
• Conflict
• Frightening experiences
• Worry about school
• Exposure to upsetting media

Frightening content

Movies, videos, games, or stories that seem harmless to adults may feel much more intense to a child.

Even something watched earlier in the day may show up in dreams later.

Family tendency

Parasomnias such as night terrors and sleepwalking sometimes run in families.

Other sleep disruption

Anything that repeatedly disrupts deep sleep may increase partial arousals in some children.

This can include:

• Snoring
• Sleep apnea
• Restless sleep
• Certain medications
• Significant sleep deprivation

Signs of nightmares

A child having a nightmare may:

• Wake fully
• Cry
• Call for a parent
• Describe a frightening dream
• Be afraid to go back to sleep
• Seek comfort
• Remember the event the next morning

Nightmares may become more common as imagination develops.

Signs of night terrors

A child having a night terror may:

• Suddenly scream
• Sit up in bed
• Appear panicked
• Have open eyes
• Sweat
• Breathe quickly
• Have a rapid heartbeat
• Thrash or move around
• Push caregivers away
• Seem confused
• Be difficult to wake
• Return to sleep afterward
• Have little or no memory the next morning

During a nightmare

1. Go to your child

Your child is usually awake and frightened.

Offer reassurance.

2. Keep your response calm

Try:

“You had a scary dream. You're safe. I'm here.”

Avoid dismissing the fear.

To your child, the experience may have felt very real.

3. Keep the room calm

A dim light, brief hug, or checking the room may help.

Avoid turning the event into a long nighttime activity.

4. Help your child return to bed

Once they feel safe, encourage them to settle back to sleep.

During a night terror

1. Focus on safety

Move nearby objects that could cause injury.

If your child gets out of bed, gently guide them away from stairs or dangerous areas.

2. Avoid forcefully waking them

Trying to wake a child during a night terror can sometimes make the episode longer or more confusing.

You can stay nearby without trying to fully awaken them.

3. Keep your voice calm

Simple reassurance is enough.

You may say:

“You're safe. I'm right here.”

4. Let the episode pass

Most night terrors resolve on their own.

Improve overall sleep

Because sleep deprivation can contribute to nighttime events, make sure your child is getting enough sleep for their age.

A consistent bedtime can help.

Keep a sleep diary

If episodes are frequent, write down:

• Bedtime
• Time the event occurred
• Approximate duration
• What happened
• Whether the child remembered it
• Recent stress
• Illness
• Snoring
• Daytime symptoms

Patterns may become easier to recognize.

Consider scheduled awakenings for frequent predictable night terrors

If night terrors happen at almost the same time each night, your pediatrician may sometimes suggest a technique called scheduled awakening.

This involves briefly waking the child before the usual episode time for a period of days or weeks.

Do this only after discussing the pattern with your pediatrician.

Don't shake or forcefully wake a child during a night terror

Your child may become more agitated or confused.

Don't repeatedly question them during the event

A child experiencing a night terror may not be able to answer you normally.

Don't assume your child remembers the episode

Many children have no memory of a night terror.

Avoid describing the event dramatically the next morning if your child is unaware of it.

Don't shame or tease your child

Never make a child feel embarrassed about nightmares or night terrors.

These events are not intentional.

Don't expose your child to frightening content before bed

Be mindful of age-appropriate:

• Television
• Movies
• Social media
• Videos
• Games
• News
• Stories

Don't automatically use sleep medications

Nightmares and night terrors usually do not require medication.

Avoid over-the-counter sleep products or supplements unless your child's healthcare professional recommends them.

Talk with your pediatrician if:

• Episodes happen very frequently
• Night terrors are becoming more intense
• Your child is being injured
• Your child leaves the bedroom or house during episodes
• Events significantly disrupt family sleep
• Your child is unusually sleepy during the day
• School performance or behavior is changing
• Episodes begin suddenly and are very unusual
• Your child has repetitive unusual movements
• You are concerned the events could be seizures
• Your child snores loudly
• You notice pauses in breathing, gasping, or choking
• The episodes continue well beyond the age when you would expect them to improve
• Nightmares are associated with significant anxiety, trauma, or persistent emotional distress

Nightmares and typical night terrors are rarely emergencies.

Seek immediate medical care if your child has:

• Severe breathing difficulty
• Blue or gray lips or skin
• A prolonged seizure
• Loss of consciousness
• A serious injury during an episode
• Severe head trauma
• A suspected medication or toxic-substance ingestion
• An episode that does not resolve and your child is not responding normally afterward

If your child appears to be in immediate danger, seek emergency medical care.

• Your pediatrician will usually begin by asking you to describe exactly what happens.

  Helpful details include:

  • What time the episode occurs
  • How long after bedtime it starts
  • How long it lasts
  • Whether your child's eyes are open
  • Whether they recognize you
  • Whether they speak
  • Whether they remember the event
  • Whether there is snoring
  • Whether breathing appears abnormal
  • Whether there are repetitive movements
  • Whether your child is tired during the day
  • Whether episodes happen at the same time each night

• Your pediatrician may also review:

  • Sleep schedule
  • Sleep duration
  • Medications
  • Development
  • Emotional health
  • Family history of sleepwalking or night terrors
  • Possible sleep-disordered breathing

• Most children with typical nightmares or night terrors do not need extensive testing.

  If the events are unusual, frequent, dangerous, or suggest another sleep or neurological condition, your pediatrician may recommend additional evaluation or referral.

  A video recorded safely from a distance can sometimes help your pediatrician understand what is happening.

The most important thing to remember is this:

A frightened child who wakes from a nightmare usually needs comfort.

A child having a night terror usually needs safety and time.

Those are different situations.

During a nightmare, your child is awake enough to know they are frightened.

Be reassuring.

During a night terror, your child may look terrified but still be partly asleep.

You don't need to fight the episode.

Keep them safe and let it pass.

And if you're unsure which one you're seeing, pay attention to three things:

When during the night did it happen?

Did your child recognize you?

Did they remember it the next morning?

Those clues often tell us a great deal.

Most importantly, don't judge yourself based on a difficult night.

Sleep in childhood can be messy.

What matters is recognizing when something is normal, when it needs a little support, and when it's time to ask for help.

— Dr. G

• American Academy of Pediatrics / HealthyChildren.org
  Parent guidance on nightmares, night terrors, parasomnias, and healthy sleep habits.

  American Academy of Sleep Medicine
  Clinical information regarding parasomnias and childhood sleep disorders.

  National Heart, Lung, and Blood Institute
  Educational resources regarding normal sleep and sleep disorders.

  Nemours KidsHealth
  Parent education regarding nightmares and sleep terrors in children.

  
  

• Bedtime Problems in Children: Sleep Routines, Resistance & What Parents Can Do

  Snoring in Children: Causes, Sleep Apnea Signs & When to See a Pediatrician

  Sleep & Soothing

  Developmental Milestones

  
  

This article is intended for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Every child is different. Behavioral concerns should be considered in the context of your child's age, development, health, family circumstances, and individual needs.

If you have concerns about your child's behavior or development, contact your pediatrician or another qualified healthcare professional. If you believe your child is experiencing a medical emergency or is in immediate danger, seek emergency medical care.