If your child has ever experienced a night terror, you might be asking what are the differences between night terrors and nightmares? These two occurrences look and feel very different. They tend to happen at different stages of sleep, and require a unique response from you.
It is important to note that whilst there are paediatric sleep disorders, night terrors and nightmares are extremely common and not usually a cause for concern.
Night terrors in children are episodes of intense fear, screaming, and physical agitation that occur during the deep, non-REM stage of sleep, typically in the first few hours after a child falls asleep. The child appears to be awake: their eyes may be open, they may be sitting up or even moving around, and they may be crying or screaming. But they are not conscious in any meaningful sense. They cannot see you, hear you, or be comforted by you.
This is what makes night terrors in children so alarming for parents. Your instinct is to hold and soothe your child, but your child is completely unreachable. Episodes typically last between five and fifteen minutes, after which the child simply returns to sleep. They often wake with no memory of the event that happened the night before.
Night terrors are most common in children between the ages of three and twelve, and they tend to run in families. Tiredness, illness, fever, stress, and disrupted sleep routines are common triggers.
Nightmares in children are very different. They occur during REM sleep, which happens in the later part of the night, and they are essentially vivid, frightening dreams. Unlike a night terror, a child waking from a nightmare is genuinely awake. They know where they are, they recognise you, and they can be comforted by your presence.
Children who have nightmares will often be able to describe what frightened them: monsters, scary situations, something that happened during the day. The distress is real and they will remember it in the morning.
Nightmares in children are extremely common and generally not a cause for concern. They tend to peak between the ages of three and six, when imagination is developing rapidly, and they typically reduce as children get older.
Understanding night terrors vs nightmares comes down to a few clear distinctions.
Night terrors happen in the first third of the night during deep sleep. The child cannot be woken or comforted, shows no recognition of their surroundings, and remembers nothing the next morning. Nightmares happen in the second half of the night during REM sleep. The child wakes fully, is aware of their surroundings, responds to comfort, and will often remember the dream.
The right response is also different. With a nightmare, go in, comfort your child, reassure them, and stay until they feel safe enough to sleep again. With a night terror, the best approach is to stay nearby to keep your child physically safe. Do not try to wake them. Do not restrain them, and do not speak loudly. The episode will pass on its own, and intervening often prolongs it.
What causes night terrors is not fully understood, but they are thought to result from the brain’s transition between sleep stages, a kind of partial arousal that gets stuck. They are significantly more common in children than adults because children spend more time in deep slow-wave sleep.
Known triggers include over tiredness, illness, fever, sleep schedule disruptions, stress or anxiety, sleeping in an unfamiliar environment, and occasionally certain medications. Addressing these triggers, particularly ensuring your child is getting enough sleep, is usually the most effective way to reduce the frequency of episodes.
To better support local families around Tugun, our Acute Paediatric Clinic is open every Monday. Dedicated to children who require prompt paediatric assessment for acute or urgent concerns, including persistent or recurrent fevers, unexplained weight loss or poor growth, ongoing abdominal pain or headaches.
If your child is experiencing any of the symptoms listed above, it could be a sign that something more serious is going on. To give priority to our youngest patients, infants under two years of age are given preference, as they present unique diagnostic challenges. Therefore, they are given priority access to our clinic wherever possible. Our committed team of paediatricians are here to help assess your child and recommend the appropriate care and treatment available. It should be noted that the purpose of our clinic is to strengthen the pathway between your GP and the Emergency Department, not to replace these essential services.
