How to tell the difference between a nightmare and a night terror

The first time it happened to Thea Laidman’s son, he was two and a half. The Burlington Ont. mom had put him to bed for the night, and two hours later, she heard loud screams coming from his bedroom. She found him sitting bolt upright and shaking. His eyes were wide open, but as Laidman and her husband tried to calm him, he just stared blankly.

“He was looking right past us with this weird glazed-over look,” Laidman recalls. She noticed he was warm, so she put cold compresses on his forehead and held him while he flailed his arms and screamed. About five minutes later, he went back to sleep, and in the morning, he had no memory of what happened.

Laidman learned that these episodes are known as night terrors (or sleep terrors, because they can also occur during daytime naps). They are a type of disruptive sleep disorder called parasomnia, like nightmares, sleepwalking and sleep-talking.

What do night terrors look like?

If your kid is having a night terror, they will appear to be overtaken by fear. “They’re really scary to witness,” says Michelle Ponti, a paediatrician in London, Ont. “However, it’s often scarier for the parents than the child themselves.” Some telltale signs include inconsolable crying, screaming, kicking and thrashing, incoherent talking and sometimes sleepwalking.

While researchers don’t fully understand night terrors, Ponti says they tend to peak between three and four but could start as early as 18 months. Night terrors happen during non-REM sleep, in the transition between sleep cycles, and will usually occur within 90 minutes of falling asleep. They can last from a few seconds to a few minutes, until your child falls back asleep. And although there’s no consensus on how common night terrors are in kids (since parents often don’t report them), estimates range from as low as one percent to as high as 40 percent.

Night terror versus nightmare

While they may look similar, a night terror is very different from a nightmare because you can’t comfort your kid out of it. Your kid will also have no recollection of the event. Parents can take comfort in knowing that even though it looks horrible, a night terror is not traumatizing. “Kids can actually remember night-mares but they cannot remember a night terror,” says Ponti. “It’s not like a vivid, scary dream. It’s just this subconscious fear reaction to the transition of sleep.”

What causes night terrors?

Genetics play a role in night terrors, with kids more likely to experience them if sleep disorders run in the family. Some triggers for night terrors include a change in routine, feeling overtired and anxiety. Events such as potty training, divorce, a new caregiver or starting school can possibly set them off—or even a new medication. Laidman says her son is working through some anxiety issues, and she believes his most recent recurrence of night terrors was prompted by starting kindergarten, combined with her returning to work after mat leave with a second child.

How to help

It’s important to make sure your child isn’t hurting themselves during an episode. You should also not wake them up while it’s happening, because it just makes it harder for them to fall back asleep, says Ponti. “You can sit there and give them a hug and gently guide them back to sleep.”

As with most sleep problems, night terrors can also be lessened by keeping a routine. Pam Edwards-Wipf, a certified paediatric sleep consultant in Kamloops, BC, suggests parents look at their kid’s overall schedule: “What are the routines before sleep? Do we have a consistent, calming, soothing routine predictable for the child? Are there any stressors in that child’s life, or have there been major changes lately?”

It’s not unusual for night terrors to happen only once or twice, but if they start occurring regularly, it’s a good idea to check in with your doctor. You can also ask for a referral to a sleep specialist if the terrors become disruptive and you’re concerned about other sleep disorders, too, such as sleep apnea. “It helps to remember night terrors go away and they’re really nothing to be too concerned about,” says Ponti.

For Laidman’s son, the episodes continued, happening more frequently and for longer periods of time until he was about three and a half. Laidman’s son is now five, and he’s going through another spell of these fits in the night.

Laidman’s had some success predicting when night terrors might be triggered, based on how overexcited or overtired her son is, but for now, it’s just about trying to minimize them. “We started to try to be really aware of what his routines are and we try to keep him on those routines as a way to manage the night terrors as much as we can.”