Nightmares or Night Terrors?

A child waking during the dark of night can cause much alarm for a sleeping parent. When these wakings are caused by parasomnias, the alarm for parents can be that much greater. Parasomnias are a category of sleep disorders including, but not limited to, Sleepwalking, Confusional Arousals, Nightmares, and Night Terrors. In this article I will discuss two parasomnias that are commonly confused–Nightmares and Night Terrors. Understanding the differences in these frightful awakenings is of great importance when determining the correct course of action. When addressing these parasomnias intentionally, we can reduce the likelihood of their occurrence.

Nightmares or Night Terrors?

Before you begin to address your child’s parasomnia, it is important to determine if they are a classified as Nightmares or Night Terrors.

NIGHTMARES

This parasomnia occurs during REM sleep, most often, later in the night or in the early morning hours. This parasomina abruptly awakens the child who can remember the terrible dream in vivid detail. Nightmares seem real to the child and should be addressed by the parent with direct comfort and support.

NIGHT TERRORS

This parasomnia occurs during non-REM sleep, most often, in the first few hours of the night. These parasomnias cause the sleeper to engage in frantic behavior–screaming, shouting and thrashing about. While the child may appear awake, he/she is actually still sleeping. Children are unaware of the occurrence of night terrors and have no recollection of the frightful event by morning. Night terrors should be addressed by the parent in an indirect fashion.

Understanding the Do’s and Don’ts of Frightful Awakenings

Now that you have determined if your child is experiencing Nightmares or Night Terrors, you will address these frightful parasomnias with the correct course of action. It is critical that we respond to our children in specific ways depending on the type of parasomnia they have developed.

Do’s and Don’ts

NIGHTMARES

• Do comfort your child and help reassure them all is well.

• Don’t have prolonged conversations regarding the nightmare that will exacerbate the thoughts in their mind.

• Do refrain from watching scary movies/shows in the evening hours.

• Do get your child back to sleep as quickly as possible to avoid further sleep loss.

• Don’t engage in extensive conversation the following day regarding the nightmare.

• Do talk to your child about calming techniques they can utilize when awaking from a nightmare to encourage and teach independence in self-soothing habits (i.e. holding tightly to their lovey and counting to ten).

NIGHT TERRORS

• Do explore the common trends occurring around the presence of night terrors to eliminate these triggers in the future (i.e. anticipation of kindergarten, excitement over upcoming holidays, family loss etc.).

• Do stay near the child to ensure their safety.

• Don’t touch your child as this may lengthen the duration of the night terror.

• Don’t engage with your child by talking to them as their night terror may intensify.

• Do allow the night terror to “ride out” as this is the healthiest way for the night terror to culminate.

• Do streamline your bedtime routine so your child gets to bed at an early hour to avoid the overtired state.

Night wakings are common for many children who struggle with sleep but the frightful nature of Nightmares or Night Terrors are in a class of their own. If you believe your child may be suffering from a parasomnia, be sure to observe the characteristics your child exhibits during these episode. Doing so will help to determine which parasomnia your child is experiencing. Then you can move forward with the correct course of action to help bring back your child’s restful night sleep.