Quick Answer: Night terrors and nightmares are fundamentally different events. Night terrors occur in deep NREM (non-REM) sleep, usually in the first third of the night. The person appears awake and distressed but is not conscious and will have no memory of the episode. Nightmares occur in REM sleep, typically in the second half of the night, and are remembered. Night terrors peak in children aged 4-12 and almost always resolve on their own. Both adults and children can experience nightmares, particularly during stress or with certain medications. Neither requires treatment in most cases, though persistent or severe episodes warrant a physician assessment.
In This Guide
Reading Time: 8 minutes
This article provides general educational information. If a child or adult experiences frequent, severe, or injurious episodes of night terrors or nightmares that significantly disrupt sleep or daily functioning, consult a physician or paediatric sleep specialist.
Night Terrors vs Nightmares: The Core Differences
| Feature | Night Terrors (Sleep Terrors) | Nightmares |
|---|---|---|
| Sleep stage | NREM deep sleep (N3, slow-wave) | REM sleep |
| Timing in night | First third (1-3 hours after sleep onset) | Second half (closer to waking) |
| Consciousness | Not conscious; appears awake but is asleep | Fully awakens and is alert |
| Memory | No memory of episode | Remembers the dream |
| Response to comfort | Does not respond; may resist touch | Responds to comfort; can be reassured |
| Eyes | Often open, glassy, unfocused | Closed or opens upon waking |
| Physical behaviour | May scream, thrash, sit upright, run | May startle awake but limited movement |
| Duration | 5-20 minutes typically | Short (person wakes quickly) |
| Peak age | Ages 4-12; rare in adults | All ages |
| Classification | Parasomnia (NREM arousal disorder) | Parasomnia (REM-related) |
8 min read
Night Terrors Explained
Night terrors (clinically called sleep terrors) are a type of parasomnia that occurs during the transition from deep NREM sleep to lighter sleep stages. They are classified alongside sleepwalking as NREM arousal disorders in the International Classification of Sleep Disorders. During a night terror, the brain partially arouses from deep sleep but does not transition fully to wakefulness, creating a state where the person appears awake and distressed but is not consciously experiencing the event.
The typical presentation in a child is striking for parents: the child suddenly sits upright in bed, screams or cries loudly, may have wide open eyes that appear glassy or unfocused, sweats, breathes rapidly, and appears terrified. Yet the child is not awake, does not recognise parents, and cannot be comforted by reassurance or touch. The episode usually lasts 5 to 20 minutes and then the child simply returns to normal sleep. In the morning, there is no memory of the episode.
Night terrors affect approximately 1-6.5% of children, with peak prevalence between ages 4 and 12, according to studies published in Pediatrics. They are more common in boys than girls and have a familial pattern suggesting a genetic component: children with a parent who sleepwalked or had night terrors as a child are more likely to experience them.
Why Night Terrors Don't Require Comforting in the Moment
The natural parental instinct is to hold, comfort, and wake the child during a night terror. Sleep medicine research and clinical guidance from the American Academy of Sleep Medicine consistently advise against attempting to wake the child during an episode. Waking a child mid-terror often prolongs the episode and can leave the child confused and distressed upon fully waking. The child is not experiencing the terror consciously and does not benefit from the attempted comfort. The recommended approach is to stay nearby to prevent injury (particularly if the child moves around the room), remain calm and quiet, and allow the episode to resolve naturally. The child will return to sleep on their own.
Nightmares Explained
Nightmares are disturbing dream experiences that occur during REM (rapid eye movement) sleep, predominantly in the second half of the night when REM periods are longest. Unlike night terrors, nightmares involve conscious experience of the dream content, which typically involves perceived threats to safety, wellbeing, or survival. Upon waking, the person is oriented and alert and can recall the dream with reasonable vividness.
Occasional nightmares are a normal part of human sleep at any age. The brain processes emotional and threatening information partly through dream content, and nightmares may serve an adaptive function in emotional processing. Research by Revonsuo (2000), published in Behavioral and Brain Sciences, proposed the "threat simulation theory" of dreaming: that the REM system specifically rehearses responses to threatening scenarios as a form of emotional preparation. This theory remains debated but has some empirical support.
Nightmare disorder is the clinical term for nightmares that are frequent (multiple per week), intense, and significantly disrupt sleep or daytime functioning. It is more common than most people realise: approximately 4% of adults experience nightmare disorder. Nightmare disorder is particularly prevalent in people with PTSD (post-traumatic stress disorder), where nightmares directly replay traumatic events.
Causes and Triggers
Night Terror Triggers
- Sleep deprivation: The most consistent trigger. When a child or adult is overtired, the subsequent sleep contains more and deeper slow-wave sleep, increasing the probability of incomplete arousal from N3 (the mechanism of night terrors). Irregular sleep schedules, missed naps, and late bedtimes all increase risk.
- Fever and illness: Febrile illness increases the depth and intensity of slow-wave sleep, which can trigger terrors in susceptible individuals.
- Stress and anxiety: While night terrors are not a psychological disorder, stress can disrupt normal sleep architecture and increase N3 arousal events.
- Sleep environment disruptions: Noise or other stimuli that partially arouse the child during deep sleep without fully waking them can trigger a terror episode.
- Medications: Certain medications (sedative hypnotics, antihistamines) that affect sleep architecture can increase NREM arousal frequency in adults.
- Full bladder: A need to urinate that partially arouses the child during deep sleep is a recognised trigger.
Nightmare Triggers
- Stress, anxiety, and trauma: The most common cause of increased nightmare frequency. Major life stressors, trauma exposure, and anxiety disorders all increase nightmare prevalence.
- Medications and substances: Several medications increase nightmare frequency, including beta-blockers, certain antidepressants, and drugs that increase REM sleep intensity. Alcohol withdrawal produces REM rebound with intensified, often disturbing dreams.
- Sleep deprivation and REM rebound: After periods of reduced REM sleep, the brain compensates with more intense, prolonged REM periods. These rebound REM periods often contain more vivid and disturbing dream content.
- Irregular sleep schedules: Disrupted circadian rhythms and inconsistent sleep timing alter REM distribution and intensity.
- Screen content and media: Consuming disturbing or violent media before sleep may influence dream content, particularly in children. The evidence is moderate; the effect is real but variable across individuals.
What to Do During and After an Episode
During a Night Terror
- Do not try to wake the child or hold them forcibly.
- Stay nearby and speak in a calm, quiet voice without demanding a response.
- Gently guide them back to bed if they've gotten up and moved around, but without restraining them.
- Ensure the environment is safe: no sharp corners, clear path if they're moving around.
- Wait for the episode to end naturally, usually within 5-20 minutes.
- The child will return to sleep on their own with no memory of the event.
After a Night Terror
No follow-up is needed with the child in most cases, since they have no memory of the event and no distress associated with it. Parents often need more reassurance than the child does. If night terrors are frequent or increasing, focus on sleep hygiene: consistent bedtime, adequate total sleep hours for the child's age, and a calm pre-sleep routine.
During a Nightmare
The child wakes from a nightmare oriented and alert. Comfort, reassurance, and a calm return to sleep are appropriate. Briefly discuss the dream if the child wants to, without dismissing the feelings or making it a prolonged conversation that increases arousal. A comfort object (stuffed animal, familiar blanket) provides sensory reassurance.
Night Terrors in Adults
While much less common than in children, night terrors do occur in adults. Adult night terrors may be associated with stress, PTSD, sleep deprivation, certain medications, or in some cases with other sleep disorders (obstructive sleep apnea, restless legs syndrome). An adult who begins experiencing night terrors without a clear precipitant warrants a physician assessment to rule out underlying conditions.
For adults with PTSD, a related but distinct phenomenon called REM sleep behaviour disorder (RBD) can occur, where the normal muscle paralysis during REM sleep is absent, causing the person to physically act out their dreams. This is different from night terrors and is a neurological condition that requires specialist evaluation.
The Sleep Environment's Role
For children prone to night terrors, the sleep environment plays a supporting role in prevention. Since sleep deprivation is the primary trigger, anything that supports consistent, adequate sleep helps reduce frequency:
- A consistent bedtime that ensures the child gets the full recommended hours for their age
- A dark, cool, quiet room that supports uninterrupted deep sleep
- A mattress and bedding appropriate for the child's age, weight, and temperature preferences
- A pre-sleep routine that winds the child down rather than increasing arousal (avoid screens in the hour before bed)
Brad Grose, founder, Mattress Miracle, family owned in Brantford since 1997, with 40+ years in the mattress industry: "We have families come in for children's mattresses and the parents sometimes mention that their child is having night terrors. We always make sure to find something that's comfortable enough that the child goes to sleep quickly and stays asleep. A child fighting a hot, uncomfortable mattress doesn't get the deep sleep they need, and that's a night terror waiting to happen."
Night terrors involve screaming, thrashing, and apparent fear during deep non-REM sleep with no memory of the event, while nightmares are vivid, frightening dreams during REM sleep that the sleeper remembers upon waking. Mattress Miracle at 441½ West Street in Brantford notes that improving sleep quality can reduce the frequency of both night terrors and nightmares. Brad recommends a comfortable, supportive mattress as part of an overall sleep improvement strategy, as deeper, less fragmented sleep reduces the arousals that trigger night terrors. Call (519) 770-0001.
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Call 519-770-0001Frequently Asked Questions
What is the difference between a night terror and a nightmare?
Night terrors occur in deep NREM sleep in the first third of the night. The person appears awake and distressed but is not conscious and has no memory of the episode. Nightmares occur in REM sleep, usually in the second half of the night. The person wakes up oriented and remembers the dream. Night terrors peak in children aged 4-12; nightmares can occur at any age.
Should I wake my child during a night terror?
No. Clinical guidance from the American Academy of Sleep Medicine advises against waking a child during a night terror. The child is not consciously experiencing the event and does not benefit from being woken. Waking them mid-episode can prolong the episode and leave them disoriented and distressed. Stay nearby for safety, keep your own voice calm and quiet, and allow the episode to end naturally. Your child will return to sleep with no memory of the event.
Do night terrors mean my child has a psychological problem?
No. Night terrors are a developmental feature of NREM sleep in children, not a sign of psychological disorder, trauma, or emotional problems. They have a strong familial component and almost universally resolve on their own by adolescence. The main predisposing factor is sleep deprivation, not psychological distress. A child experiencing night terrors has nothing wrong with them psychologically; they are simply a deep sleeper whose brain occasionally has difficulty transitioning between sleep stages.
What can I do to reduce night terror frequency?
Ensuring the child consistently gets adequate sleep for their age is the most effective prevention. A 4-year-old needs 10-13 hours; a 6-10 year-old needs 9-11 hours. A consistent bedtime, limiting screens in the hour before bed, and a calming pre-sleep routine all help. If your child has a predictable time when terrors occur, scheduled awakenings (waking the child briefly about 30 minutes before the usual terror time) can interrupt the sleep cycle and prevent the episode. This technique, sometimes recommended by paediatric sleep specialists, can be effective for frequent cases.
When should I see a doctor about night terrors?
Occasional night terrors in a child aged 4-12 are normal and do not require medical assessment. See a physician if: the episodes are very frequent (several times per week), the child is injuring themselves during episodes, terrors are beginning in an older teenager or adult with no history, or the episodes are accompanied by other sleep disturbances. In adults, new-onset night terrors without a clear trigger always warrant assessment to rule out sleep apnea, medications, or neurological conditions.
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If your child's night terrors or sleep disturbances have you questioning the whole bedroom setup, come in and let's talk. A mattress that's the right temperature and comfort for your child's age makes a real difference in getting the consistent, deep sleep that keeps night terrors away. Brantford families have been trusting us since 1997.
Related Reading
- Baby Sleep Regression Guide: 4, 8, 12 and 18 Month
- Insomnia Symptoms and Natural Treatment Guide
- Sleep Inertia: Why You Feel Groggy After Waking
- Magnesium for Sleep: Does It Work and How Much to Take?
- Night Terrors in Children: Mattress Safety, Bed Setup, and Parent Guide
Sources
- American Academy of Sleep Medicine. (2014). International Classification of Sleep Disorders, 3rd edition. Darien, IL: AASM.
- Leung, A.K.C., et al. (2020). Sleep terrors: an updated review. Current Pediatric Reviews, 16(3), 176 to 182.
- Mindell, J.A., & Owens, J.A. (2015). A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems. Lippincott Williams & Wilkins.
- Revonsuo, A. (2000). The reinterpretation of dreams: an evolutionary hypothesis of the function of dreaming. Behavioral and Brain Sciences, 23(6), 877 to 901.
- Aurora, R.N., et al. (2010). Best practice guide for the treatment of nightmare disorder in adults. Journal of Clinical Sleep Medicine, 6(4), 389 to 401.
- Canadian Paediatric Society. (2020). Healthy sleep for your child. cps.ca
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