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Night Terrors vs. Nightmares in Children: How to Tell Them Apart

Night terrors occur in deep sleep with no memory — the child cannot be consoled mid-episode. Nightmares happen in REM sleep and the child wakes, remembers, and can be comforted.

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Lena Park, PNP — Pediatric NP

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What a night terror looks like

A night terror typically happens in the first third of the night, during the deepest stage of non-REM sleep. The child may suddenly sit up, scream, thrash, or appear panicked, with eyes open and a frightened expression — but they are not actually awake. They may push away attempts at comfort and won't recognize or respond meaningfully to a parent's voice. Episodes usually last between 5 and 45 minutes and end with the child settling back into calm sleep on their own. In the morning, the child has no memory of the event 1.

Night terrors are classified as a disorder of arousal (a type of NREM parasomnia) and are most common between ages 3 and 8. The American Academy of Pediatrics notes they tend to run in families and affect an estimated 1 to 6 percent of children 1.

What a nightmare looks like

A nightmare happens during REM sleep, which predominates in the second half of the night. The child wakes up, is fully or nearly fully oriented, and can often describe a scary dream. They may want comfort, a hug, reassurance that the dream was not real, or a parent to stay nearby. They can be calmed by a caregiver's presence and voice. Nightmares are very common at all ages and tend to increase during stressful periods, after scary media exposure, or during times of developmental change 1.

How parents can respond to each

For night terrors: The most useful response is usually to stay calm and close, ensure the child is physically safe (cannot fall or hurt themselves), and resist the urge to try to wake them or restrain them — attempts to wake or hold often escalate the episode. Gently guide them away from danger if needed, speak quietly, and wait. The episode ends on its own. In the morning, there is no benefit to bringing it up, since the child has no memory of it and recounting it can create new anxiety 1.

For nightmares: Comfort and reassurance are exactly right. Going to the child, turning on a small light, listening to the dream if they want to talk, and sitting with them until they feel safe are all helpful. Simple rituals — checking under the bed together, a nightlight, a comfort object — can help some children feel more secure at bedtime.

What tends to trigger night terrors

Anything that deepens or disrupts the normal sleep cycle can increase the likelihood of a night terror in a susceptible child. Common triggers include sleep deprivation, illness with fever, a change in sleep schedule, stress, sleeping in an unfamiliar place, or a full bladder. The American Academy of Sleep Medicine notes that school-age children need 9 to 12 hours of sleep per night 2; many families notice that an earlier, consistent bedtime — reducing the child's overall sleep debt — actually decreases night terror frequency over time.

When to mention it to the pediatric provider

Occasional night terrors or nightmares are a normal part of childhood and do not require medical evaluation. It may be worth bringing up at a visit if: episodes occur multiple times per week; the child is significantly anxious during waking hours as a result; a school-age child seems very sleep-deprived; there is any concern about sleepwalking alongside the episodes; or night terrors begin suddenly in an older teenager without prior history — which can occasionally be associated with other sleep disorders. The AAP recommends consulting a pediatrician if night terrors keep happening and are disruptive to family sleep 1.

Common questions

Should I wake my child during a night terror?

Most pediatric sleep guidance suggests not trying to force the child awake — it usually makes the episode more prolonged and the child more distressed. Keeping them safe and waiting for the episode to end on its own is generally the recommended approach.

My child has night terrors several times a week. Is that a problem?

Very frequent episodes may be worth discussing with the child's pediatric provider. Addressing any sleep deprivation is often a helpful first step. In some cases of very frequent, predictable terrors, a provider may suggest a strategy called scheduled awakening — waking the child briefly about 15 to 30 minutes before the usual terror time to interrupt the sleep cycle.

Can night terrors be related to anxiety?

Stress and anxiety can increase the frequency of both nightmares and — in susceptible children — night terrors. If a child is notably anxious during the day and also has frequent sleep disturbances, discussing both with the pediatric provider can be worthwhile.

My 8-year-old just started having night terrors. Should I be more concerned because of their age?

Night terrors can begin at any age, though they are most common in young children. A new onset of episodes in a school-age or older child is worth mentioning at a pediatric visit, particularly if the child is also very tired during the day, is snoring, or if there are concerns about other sleep problems.

Talk to a clinician

Lena Park, PNP — Pediatric NP

kids & families. Gale can match you with a licensed clinician for a visit.

Find care →

When to get care right away

  • —A child is injured during a night terror episode due to falling or hitting something
  • —Sleepwalking alongside night terrors — especially if the child leaves the bedroom or goes near stairs
  • —A seizure: rhythmic jerking of limbs, stiffening, loss of bladder or bowel control during an episode
  • —Night terrors beginning in an older teenager without any prior history
  • —Child is excessively sleepy during the day despite adequate sleep time

Call 911 if a child has a seizure, is injured and bleeding seriously, or cannot be roused after an episode ends.

This article is general health information for parents and is not a diagnosis or medical advice for any individual child. A pediatric provider can evaluate concerns about a specific child's sleep.

References

  1. 1.American Academy of Pediatrics (HealthyChildren.org) (2023). Nightmares, Night Terrors & Sleepwalking in Children: How Parents Can Help. HealthyChildren.org. link ✓Clinical distinction between night terrors (NREM, no memory, 5–45 min) and nightmares (REM, child remembers); parental response guidance; when to consult a pediatrician
  2. 2.Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, et al. (2016). Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine. Journal of Clinical Sleep Medicine. doi:10.5664/jcsm.5866 ✓School-age children aged 6–12 need 9–12 hours of sleep per night; sleep deprivation is a key trigger for night terror episodes

2 sources, numbered by first appearance. General health information, not medical advice — synthetic demonstration content.