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Nightmares & Night Terrors

by Sue Hubbard, M.D.

I have been receiving a few emails about the difference between nightmares and night terrors. First off, nightmares and night terrors are common occurrences during the toddler, pre-school and early elementary years.

Nightmares are scary dreams that occur during REM sleep (which occurs towards the end of sleep when REM sleep is most intense) and dreams are vivid. A child awakens after a nightmare being scared, anxious and afraid to go back to bed.

Night terrors on the other hand occur during the first few hours after a child falls asleep, when non-REM sleep is the deepest. During a night terror your child may cry out, have dilated pupils, an increased heart rate, sweating and heavy breathing. They appear to be awake but in reality are only partially aroused and will have no memory of the event.

During a night terror a child will not recognize you or allow you to comfort them and may become even more agitated if you try to hold them. Parents are often equally frightened by the event, as it is disconcerting trying to decide why your child has awakened in such distress. Just like other familial traits, sleep disturbances (parasomnias) seem to run in families. A lot of work is being done to isolate genetic loci related to sleep habits.

Both nightmares and night terrors seem to be more frequent in children who have not had a good night’s sleep.

Try to have a regular bedtime routine, and limit television exposure prior to bedtime. Read books to your children about dreams and nightmares that incorporates their favorite characters in the same situation (one of our favorites was Franklin in the Dark, there was not a cuter turtle with a nightlight!).

Be creative and make a dream catcher to catch the bad dreams and keep them away, or discuss soothing images prior to bed. WE had “monster dust and wands ” that our boys used to spray the room before bed and they all had a favorite night light (how they slept with three nightlights blazing was beyond me).

Our middle son was the most creative; he blew up an alligator pool toy that he placed outside his bedroom door each night. When asked what he was doing he replied, “my alligator will eat the monsters before they come into my room! How can a parent argue with that?

That’s your daily dose, we’ll chat again tomorrow.

Send your question to Dr. Sue!

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