Nightmares vs Night Terrors in Toddlers: How to Help

It is scary to hear your child scream in the middle of the night. Was it a bad dream? Or something else? Nightmares and night terrors are common in young children, and most kids grow out of them. They are not the same thing, though, and each one needs a different response. Here is how to tell them apart and how to help your child sleep well again.

Healthy sleep for toddlers

Good sleep helps young children grow and learn. It also makes nightmares and night terrors less likely. The CDC says children need this much sleep every 24 hours, naps included:

• Toddlers 1 to 2 years: 11 to 14 hours
• Preschoolers 3 to 5 years: 10 to 13 hours

A regular bedtime and wake up time, every day of the week, helps a lot. The American Academy of Pediatrics (AAP) suggests a simple routine like "brush, book, bed." It also says to turn off all screens at least 1 hour before bedtime.

What is a nightmare?

KidsHealth says a nightmare is a scary or upsetting dream that usually wakes a person up. It is normal for kids to have nightmares sometimes, especially in the preschool years.

• Nightmares happen during REM sleep, the dream stage when the brain is very active.
• They tend to happen in the second half of the night.
• Your child wakes up, feels scared and wants you.
• Your child can often remember the dream.

No one knows exactly what causes nightmares. KidsHealth says dreams seem to be one way kids work through their feelings and worries. Nightmares may show up during stress or change, like moving, starting a new school, a new baby in the family or family tension. Scary books, movies or TV shows before bed can also lead to nightmares.

What is a night terror?

KidsHealth says a night terror is like a nightmare but much more dramatic. A child having a night terror wakes up screaming and can't be comforted. They don't seem to know you are there.

• Night terrors usually happen about 2 to 3 hours after a child falls asleep, during deep sleep (non REM sleep).
• Your child may sit up, scream, thrash around, sweat, breathe fast or even run from the bed.
• After a few minutes, or sometimes longer, your child calms down and goes back to sleep.
• Your child usually won't remember it the next day.

Night terrors look scary, but KidsHealth says they are not harmful and kids almost always grow out of them. They are most common in kids younger than 13, and they often run in families.

Things that can make night terrors more likely:

• Not getting enough sleep
• Being sick
• Some medicines
• Sleeping in a new place or away from home
• Stress or worry
• Too much caffeine
• Sleep problems like sleep apnea or reflux

Nightmare or night terror? How to tell

• When: Nightmares happen later in the night. Night terrors happen 2 to 3 hours after falling asleep.
• Awake or not: After a nightmare, your child is awake and wants comfort. During a night terror, your child is not fully awake and doesn't know you are there.
• Memory: Kids often remember a nightmare. They usually don't remember a night terror.

How to help after a nightmare

KidsHealth suggests:

• Be there. Your calm presence helps your child feel safe.
• Say what happened. Try "You had a bad dream, but now you're awake and everything is OK."
• Offer comfort. Let your child know it's OK to feel scared. Everyone has bad dreams sometimes.
• Use a little magic. With young kids, a spray of pretend "monster spray" or a check under the bed can help.
• Turn on a soft light. A nightlight or hall light can help your child feel safe.
• Help them go back to sleep. Offer a favorite stuffed animal or blanket, play soft music, or talk about happy dreams they would like to have.
• Talk in the morning. Keep it short at night. In the daytime, your child can tell you about the dream, draw it or make up a new happy ending.

How to help during a night terror

KidsHealth says the best way to handle a night terror is to:

• Sit quietly near your child.
• Make sure your child doesn't get hurt by thrashing or running around.
• Wait until your child goes back to sleep, usually within a few minutes.

Don't try to wake your child. It usually doesn't work, and kids who wake up are often confused and upset. They may take longer to fall back asleep. Don't shout or scold. Your child is not doing it on purpose.

Keep the bedroom safe too. Clear the floor of toys, and use gates on stairs if your child gets out of bed during night terrors. Our fall prevention post has more tips.

How to prevent them

• Keep a regular bedtime and wake up time.
• Use a calm bedtime routine, like a bath, a snuggle, a book or quiet talk about the good parts of the day.
• Make sure your child gets enough sleep.
• Avoid scary movies, shows and stories before bed.
• Avoid screens and caffeine at night. Caffeine is in chocolate, tea and soda too.
• Help your child with stress and big changes.
• If night terrors happen at about the same time every night, KidsHealth says you can try waking your child 15 to 30 minutes before that time.

For toddlers, a favorite stuffed animal or a nightlight can make bed feel cozy. For babies under 1, keep the crib empty. Read our why babies cry post for tips on calming little ones at night.

When to call the doctor

Most nightmares and night terrors are not a cause for worry. Talk to your child's doctor if:

• Nightmares happen more than once a week, often keep your child from getting enough sleep, or come with other emotional or behavior problems.
• Night terrors last longer than 30 minutes, happen more than once a week, or keep your child from getting enough sleep.
• Your child seems very sad, scared or stressed during the day.
• Your child drools, gets stiff or has jerking movements during a night terror.
• Your child snores, has heartburn or burps a lot.

For more warning signs, see our post on when to call a doctor.

Songs for bedtime fears

Songs can help your child feel safe at bedtime. In It's Just a Bad Dream, Bebo the Penguin wakes up scared after a dream about monsters. His mama and his teddy bear help him learn, "It's just a bad dream, they can not hurt you, it's just imagination." Afraid Of The Dark reminds kids, "It's ok to be afraid of the dark, just remember everything's the same as when there's light." In Monster Go Away, a little penguin is scared by a shadow on the wall and finds out the monster is friendly. And My Stuffie Lullaby shows Bebo snuggling his teddy bear as he falls asleep. You can find more songs for kids on our music page.

Questions Parents Ask About Nightmares and Night Terrors

What is the difference between a nightmare and a night terror?

A nightmare is a scary dream that wakes your child up, and your child wants comfort. During a night terror, your child screams or thrashes but is not fully awake and usually won't remember it.

Should I wake my child during a night terror?

No. KidsHealth says waking your child usually doesn't work and can make them confused and upset. Stay close and keep them safe until they fall back asleep.

At what age do nightmares start?

Nightmares are common in the preschool years. By about preschool age, kids begin to understand that a nightmare is only a dream.

Do kids grow out of night terrors?

Yes. KidsHealth says kids almost always grow out of them, and most stop before the teen years.

What time of night do night terrors happen?

Usually about 2 to 3 hours after your child falls asleep.

How much sleep does my toddler need?

The CDC says toddlers 1 to 2 years need 11 to 14 hours every 24 hours, and children 3 to 5 years need 10 to 13 hours, naps included.

When should I worry?

Call the doctor if nightmares or night terrors happen more than once a week, last longer than 30 minutes, keep your child from sleeping well, or come with drooling, stiffness or jerking.

This post is for general information only. It is not medical advice. If you have questions about your child's health, please talk to your child's doctor.