For many people, dreaming can be a surreal and exciting experience. For others, it can be a gateway to unnatural terror, confusion, and powerlessness. Bad dreams are commonly referred to as nightmares and are experienced by about 10 to 50 percent of children between the ages of three and five and 50 percent of adults.

For a child, a simple nightmare can be terrifying, but another type of sleep disturbance can cause agitation and fright to the point of inconsolability. Known as a “night terror,” they are a more dramatic, realistic, and frightening version of a nightmare. At times, they are considered part of any child’s normal development and a reflection of a child’s attempt to cope with typical childhood fears and problems. Other times, they may require medical attention.

The Normal Sleep Rhythm

Throughout a person’s sleep period, the brain goes through rapid eye movement (REM) and non-REM sleep stages. About every 90 minutes, the brain switches between these stages, and with each successive sleep cycle, the duration of REM sleep increases.

During REM stages of sleep, a person’s eyes will move back and forth under closed eyelids. It is during this stage of sleep that a person has dreams and nightmares. In contrast, night terrors occur during non-REM sleep stages and are technically not referred to as dreams. Night terrors have been categorized as sudden reactions or intense sensations of fear that replace the normal, smooth transition from a REM sleep phase to a non-REM sleep phase.

Nightmares and Children

A nightmare is a dream that occurs within REM-stages of sleep and causes negative feelings like fear, anxiety, or sadness. Almost everyone regardless of age, occasionally experiences nightmares. In fact, one out of every four children has a nightmare once a week. This likely occurs because normal fears of young children begin to develop and their imagination is extremely active. The contents of these bad dreams can include scary situations, danger, loss of control, and other frightening themes.

Nightmares frequently occur in children between the hours of 2 a.m. and 6 a.m., the time when they experience the deepest period of REM. During this interval, the body’s muscles go into a natural paralysis, so moving or screaming is uncommon. A way to tell if a child may be suffering from nightmares is if he or she wakes up following the episode and vividly remembers the dream. Most types of nightmares should be easy to remember and typically cause agitation or fear. A child may sometimes talk about the nightmare and seek out comfort from parents.

Nightmares can be attributed to several causes. Antidepressants, illness, fever, and periods of stress and change may be to blame. Some children may experience nightmares throughout their lives while others outgrow them upon reaching adolescence.

How to Help

In many cases, a child who suffers from nightmares or night terrors will not require medical assistance. However, some children may need a psychological evaluation or counseling if a night terror is especially severe, frequently disrupts their sleep pattern, negatively affects their daily function, lasts for a long time, or causes children to injure themselves or others.

It is very difficult to develop foolproof preventive measures for night terrors because, although abnormal sleep schedules, exhaustion, and stress can play a role, their cause is still uncertain. A child may be examined by a doctor to rule out physical triggers such as enlarged tonsils or adenoids that make breathing difficult.

One of the best ways to help a child eliminate sleep problems is to ensure that he or she has a regular bedtime with a calming routine and sufficient sleep. Researchers believe that anywhere from 10 to 12 hours of sleep per day is healthy for most children under the age of 12. If a child gets frequent night terrors and it is possible to chart when they occur, the parent can try to wake the child before the night terror sets in. This can interrupt the sleep cycle and, over time, minimize the likelihood of recurrence.

If a child is having an acute night terror episode, do not try to wake him or her. It is also not advised to hold the child in place as this can make the episode more severe. A child experiencing a night terror cannot be calmed, so do not attempt to intervene or offer comfort unless the child is in physical danger. Wait for the acute episode to subside, and position yourself between the child and potentially harmful items.

Get rid of items that may cause injuries at night. Remove toys or objects that the child could tumble on while sleepwalking, fasten a gate on top of the stairs, and make sure that all doors and windows are closed. Sleep medications rarely need to be administered unless a child has frequent night terrors.

A child will typically outgrow these conditions by the age of 12 or as he or she reaches adolescence. There is no need for extensive treatment unless frequent episodes pose a danger to the child. If that is the case, seek out counseling to identify probable causes and ways they may be dealt with.

Researchers refer to night terrors as mysterious glitches in the otherwise smooth transition between sleep stages. As the names suggests, they are far more terrifying for both the child and observer than a typical nightmare. Night terrors are considered to be more intense than standard nightmares and occur in the first few hours of the night when deeper REM stages of sleep are least likely to occur.

Night terrors affect about 15 percent of children beginning in their toddler and preschool years and continue up to the age of 12. Only two percent of adults experience night terrors, so the likelihood that someone who experiences night terrors as a child will continue to experience them as they grow older is rare. In many cases, an adult who has them also has a history of bipolar disorder, depression, or anxiety disorders.

According to research, night terrors are slightly more common in boys than in girls. Typically, night terrors are seen in kids who are tired, ill, stressed, taking a new medication that affects the central nervous system, or are sleeping in a new environment. There may also be a genetic component. Children with family members who experienced night terrors are also more likely to experience them. A child who suffers from night terrors may suddenly bolt upright in bed, cry, violently scream, moan, mumble, and thrash about with eyes wide open. This occurs without the child being truly awake. In these circumstances, a child is not aware of anyone else’s presence and is unlikely to respond to others.

A night terror episode usually lasts about two to 40 minutes, after which a child may fall back asleep abruptly with no memory of the incident. No recollection of the episode is a key trait of night terrors. Children may remember bits and pieces if they fully wake in the middle of a night terror but typically remember nothing. Children who experience night terrors also have a tendency to sleepwalk or urinate in bed.