Night Terrors vs Nightmares: What’s the Difference

It’s 9:30 pm and your child suddenly sat bolt upright in bed and starts screaming, thrashing and flailing around yelling “No, Stop It, Don’t, No, No, No, Don’t Hurt Me.” It’s frightening, confronting and worrying when you witness your child experience their first-night terror. It can be even more concerning and stressful if you see your child experiencing these night terrors repeatedly. 

Watching your child struggle, throw themselves around, scream, and appear unresponsive to you and your attempts to comfort them is confusing and upsetting. You can feel helpless and at a complete loss as to what to do. It can appear as if your child is genuinely terrified, upset, and distressed. They don’t seem to be able to see you, hear you or be helped or calmed down in any way.  

A night terror is very different from a nightmare.  When a nightmare occurs, your child will seek comfort and remember their bad dream.  Even if they present in the same way, they are very different. Neither is generally cause of concern although both are upsetting, especially for the parents.  

The Difference Between Night Terrors and Nightmares

The first and essential difference between Night Terrors and Nightmare is the stage of sleep they occur in. Nightmares occur in Stage 5 of Sleep REM (Rapid Eye Movement) sleep. REM sleep is a stage of sleep where we experience dreaming, sometimes intense and realistic imagery, and the brain is in an active state functioning as if the body were awake. 

However, during REM sleep, the body is practically paralyzed to protect you from acting out your dreams while you are asleep. Night Terrors, on the other hand, occur in stage 4 of sleep during the transition from Stage 4 (deep sleep) to Stage 5 REM sleep. During phase 4, when night terrors occur, brain function has slowed down, but the body can move around. 

Children and adults can often remember their dreams and the images they experienced during REM sleep when they wake up. When our children have woken up from Stage 4 non-REM sleep, they are in a deep sleep, hard to wake up and won’t remember anything from their sleep terror.  

Children will remember nightmares, or fragments of them, but will have no memory of a night terror even if they wake after the episode. 

When your child wakes from a nightmare, they might seek your comfort and assurance. They might want to talk about their scary dream and make sure the perceived threat is not real.  However, during a night terror, your child will appear unresponsive and uninterested in your calming and comforting efforts. They may look, act, and respond to you in a manner that is entirely foreign to your child’s normal behavior.  Once the night terror has finished, they will usually go back to sleep. 

Night terrors can last from 30 seconds and up to a very long 40 minutes. They generally last for 10 minutes. 

Night Terrors       

From Sleeping Talking to Nights Terrors

We all have partial awakenings during the night when we cycle from deep stages of sleep into a light stage. We might roll over, get into a more comfy position, and then head back into our sleep cycle. Sometimes babies and children need help getting back to sleep after these partial awakenings. Night terrors occur during the transition from stage 4 deep sleep to stage 5 REM sleep and can exhibit in several different ways.    

Richard Ferber lists a chart explaining the various stages of intensity that a night terror or Confusional Arousal can appear. 

• When Do They Usually Start?

Night terrors typically begin in children aged between 3 and 12 years.  However, they can occur earlier. Night terrors typically resolve themselves as your child matures.

• What Does a Night Terror look like?

The spectrum above is a good indication of the type and severity of the night terror your child is experiencing. Standard systems include: crying, shouting, yelling, screaming, increased heart rate, sweating, the difficulty is a rousing child, and they won’t remember the episode in the morning if they wake when they have calmed down. 

You child might sit up in bed suddenly, look confused, or start screaming and yelling. They may thrash around uncontrollably, looking disoriented, have a blank, confused look with glazed eyes and not appear to be themselves. It has also been described, and the child was looking as if they are possessed. 

Your kids will be unresponsive to your efforts to calm, comfort, and console them. They are also are not able to understand any boundaries or limit setting; they are not awake, so trying to reason, cajole, bribe, or reprimand won’t work. 

• What Causes Night Terrors?

Stress, sleep deprivation, overtiredness, being ill, and certain medications cause night terrors.  Experts believed children who present with night terrors have an over-arousal of the central nervous system. 

The Central Nervous System is comprised of the brain and spinal cord and is responsible for our thoughts, emotions, bodily movements, breathing, heart rate, body temperature, and more. An over-arousal of this system can be caused by your child body still maturing and growing.  It is why children often grow out night terrors. They are also thought to be hereditary with 80% of children who experience night terrors also had a family member who experienced them. 

• What Time of Night Do They Occur?

The time of night that the night terror occurs is a helpful way to indict that a night terror is actually what your child is experiencing. They generally occur 1 to 3 hours after your child has gone to bed.  It is because night terrors transpire during the transition from the deepest Stage 4 of sleep into REM sleep. It usually happens for the first time after the first sleep cycle, which is about 90 mins in length.  

As the night progresses, your child doesn’t reach the deepest stage of sleep, staying more in lighter stages of sleep and REM sleep (where nightmare occur) which is why night terrors usually present between 9 – 11 pm. 

Sleep Cycle Development

Overtired and Sleep Deprived

A fundamental cause of night terrors is overtiredness and sleep deprivation.  Maybe your family has had a few hectic weeks, a few missed naps and later bedtimes than usual.  Check out your child’s sleep needs first and see how much sleep they are getting. They might need to catch up on some sleep, to help stop the night terrors. 

The table below is an excellent guide. 

Along with overtiredness, chaotic, or messy sleep schedules can also cause night terrors. A chaotic sleep schedule where sleep is occurring at different times every day causes issues with the body’s internal biological clocks, rhythms, and circadian rhythms. It can disrupt your child’s natural drive to sleep and drive to wake. 

If these drives are confused and not working in harmony with each other, then night terrors can occur. They are spending some quiet times at home for a few weeks establishing a consistent routine meeting sleep needs with repeatable and consistent nap and bedtimes. It will help your child’s body natural rhythms work in sync with their environment. 

What can you do during the day?

• • Implement a consistent nap and bedtime routine
  • Try to identify and reduce any stresses that might be apparent in your child’s life
  • Have a regular and calming bedtime routine
  • Make sure your child is getting enough naps/ sleep during the day
  • Keep a sleep diary

Sleep and Mood Diary

If your child’s night terrors are consistent and prolonged, keeping a sleep diary will be a great way to see how much sleep your child is getting, and how much they need. It will be great information to take to your doctor if the night terrors continue for long periods. It’s a great idea to track your child’s mood as well and how they are generally feeling during the day. 

What Can You Do At Night?

When using your sleep diary, you notice that your child is pretty consistently experiencing their night terror around 9:30 pm, you can go to them 30 minutes before and slightly wake them.  This partial rousing from sleep can interrupt their sleep cycle, and might stop the night terror from happening. First, make sure that you meet your child’s sleep needs.

What Can You Do During The Night Terror? 

It’s a tough, tricky, and upsetting time for parents. As the child appears to be unresponsive and inconsolable, you can be at a loss as to what to do. During the episode there unfortunately not much that you can do. You will need to wait it out, make sure they don’t hurt themselves and that their environment is safe. 

Don’t try to wake them up, they will get even more disoriented and may have trouble getting back to sleep. If your child is sleepwalking or running around, try to guide them back to bed without waking them up gently.

When To See Your Doctor

Some form of night terror or confusional arousal is prevalent with up to 40% of children experiencing them.  Generally, they are in no way are harmful to your child, and most children grow out of them and have no memory of these nighttime episodes. However, if you are concerned, always go and see your doctor. 

In early childhood night, terrors are generally not contributed to emotional factors, but it could be a contributing factor with other children.  If the night terrors are prolonged and have been continuing for some time, or if they are causing excessive tiredness during the day or injuries go and see your doctor.      

Nightmares

‘Mommy, mommy, mommy help, I’m being chased by elephants!” Nightmares. Nightmares are prevalent in children with 80 to 90% of children experience nightmares in their life. They differ significantly from night terrors. 

Nightmares occur during Stage 5 REM sleep, and your child will most likely have a dream or fragments when they wake up. They will look for reassurance and consoling.  They generally start to occur between the ages of 3 to 6, and the lesson as children grow into adulthood. 

• What Causes Nightmares

Nightmares are prevalent and a very reasonable part of your child’s development. As their imagination develops, so does their ability to dream and have nightmares. Children of different ages seem to experience different nightmares based on fears in their stage of development.  Occasionally nightmares can be caused from outside stressors, such as family drama. It can also be as simple as watching a scary movie. 

• When Do They Occur?

Unlike night terrors which occur in the 1st half of the night, nightmares generally happen more frequently in the 2nd half of the night.  In the 2nd half of the night, we experience less deep sleep, and more REM sleep, which is where dreaming occurs. 

• What Do Nightmares Look Like?

Your child might be very visibly, upset, and crying from their dream. It can feel genuine to them, and they can have a lot of trouble going back to sleep. Recurring nightmares that children experience are mostly chasing, scary animals, monsters, ghosts, creepy toys, toys that are alive, bugs, snakes, spiders, bring left along, falling, and being bullied.

• What to Do?

As your child will remember fragments of their dream, they might have difficult heading back to sleep.  Provide them with lots of reassurance, cuddles, love, and the knowledge that you are there to keep them safe. Don’t dismiss their fears, anxieties, or worries; let them speak freely about their dream if they wish too. It’s also a great idea to discuss their vision or fears during the day.  

Teach them coping skills:

• Positive thinking
• Relaxation techniques
• Meditation and breathing exercises
• Imagining their favorite place

During the day, you might also want to move the room around to prevent any scary shadows falling, and the introduction of nightlight might help to alleviate fears when waking from a frightening dream. 

If your child is scared at bedtime to go to sleep, use the ‘Pop In Technique.’ It works by gradually leaving your child alone for longer and longer periods of time until they fall asleep. 

For example, you might say, “I’m just going to get a drink of water, and then I’ll be back to check on you.” Come back after a few minutes, make sure your child is ok and then say, “I’m just going to wash up the dishes by the sink, I’ll be back in a few minutes.”Keep finding excuses to leave the room with a job to do and allow the time before going back in to check to get longer and longer.

Night Terrors are scary for parents, and Nightmares are terrifying for children. Either of these episodes can cause upsets and worry during the night. You can be safe in the knowledge that both generally dissipate with maturing and growth. However, you should always see your doctor if you are concerned.