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Nightmares and Night Terrors

What are nightmares?

Nightmares are scary dreams that awaken children and make them afraid to go back to sleep. Nightmares may happen for no known reason, but sometimes occur when your child has seen or heard things that upset him/her. These can be things that actually happen or are make-believe. Occasional bad dreams are normal at all ages after about 6 months of age. Nightmares often relate to developmental stages of a child: toddlers may dream about separation from their parents; preschoolers may dream about monsters or the dark; school-aged children may dream about death or real dangers. Nightmares usually happen during the last third of sleep, during REM (dream time) sleep.

How to help a child with nightmares:

  • Comfort, reassure, and cuddle your child.
  • Help your child talk about the bad dreams during the day.
  • Protect your child from seeing or hearing frightening movies and television shows.
  • Leave the bedroom door open (never close the door on a fearful child).
  • Provide a "security blanket," or toy for comfort.
  • Let your child go back to sleep in his/her own bed.
  • Do not spend a lot of time searching for “the monster."
  • During the bedtime routine, before your child goes to sleep, talk about happy or fun things.
  • Read some stories to your child about getting over nighttime fears.

When to call your child's physician:

Consult your child's physician if you notice any of the following:

  • the nightmares become worse or happen more often
  • the fear interferes with daytime activities
  • you have other concerns or questions about your child's nightmares

What are night terrors?

A night terror is a partial waking from sleep with behaviors such as screaming, kicking, panic, sleep walking, thrashing, or mumbling. Night terrors usually occur within two hours of the time a child goes to sleep. They are harmless and each episode will end in deep sleep. They are considered normal until age 6.

The following are common characteristics of a night terror:

  • Your child is frightened but cannot be awakened or comforted.
  • Your child's eyes are wide open but he/she does not know that you are there.
  • Your child may think objects or persons in the room are scary.
  • The episode lasts from 10 to 30 minutes.
  • Your child often does not remember the episode in the morning.

How to help a child during a night terrors:

  • Try to help your child return to normal sleep. You will not be able to awaken your child, so do not try. Turn on the lights so that your child is less confused by shadows. Make soothing comments. Hold your child if it seems to help him/her feel better. Shaking or shouting at your child may cause the child to become more upset.
  • Protect your child against injury. During a night terror, a child can fall down a stairway, run into a wall, or break a window. Try to gently direct your child back to bed.
  • Prepare babysitters for these episodes. Explain to people who care for your child what a night terror is and what to do if one happens.
  • Try to prevent night terrors. A night terror can be triggered if your child becomes overly-tired. Be sure your child goes to bed at a regular time, and early enough to give him/her enough sleep. Younger children may need to return to a daily nap.
  • For several nights, note how many minutes it is from the time your child falls asleep until the start of the night terror. Begin to awaken your child every 15 minutes before the expected time of the night terror. Keep your child fully awake and out of bed for 5 minutes. Continue waking your child like this for seven consecutive nights. If the night terrors return when you stop waking your child, repeat as needed.

When to call your child's physician:

While night terrors are not harmful, they can resemble other conditions or lead to problems for the child. Consult your child's physician if you notice any of the following:

  • the child has drooling, jerking, or stiffening
  • terrors happen after the seven nights of waking
  • terrors last longer than 30 minutes
  • your child does something dangerous during an episode
  • terrors are happening during the second half of the night
  • your child has daytime fears
  • you feel family stress may be a factor
  • you have other questions or concerns about your child's night terrors

Click here to view the
Online Resources of Pediatrics

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