Nightmares No More!

Photo by Lawrence Sawyer / iStock
Photo by Lawrence Sawyer / iStock

It’s the wee hours of the morning, and your child is standing at your bedside, tugging at your arm, wide-awake and scared: She’s had a nightmare. While witnessing it can tug at your heartstrings, know that it’s also quite typical for children.

“Dreams, even disturbing ones, are a part of normal development,” says Dr. Elizabeth Super, a pediatrician and children’s sleep specialist with the Pediatric Sleep Medicine program at OHSU Doernbecher Children’s Hospital in Portland, Oregon.  “Nighttime fears are very common between ages 3 and 6 and often appear as children develop the ability to imagine.”

NIGHTMARES

It’s not usual for little ones to have one or two nightmares per week, which might seem like a lot compared to adults. REM, an active sleep state, is the stage of sleep when nightmares and dreams occurand children actually spend  a lot more time in REM sleep than adults (25 percent of a total night’s sleep for young children versus mom's 10-15 percent). These REM periods get longer as the night progresses, which might explain why 2 a.m. seems to be the witching hour.

Have a freaked-out 5-year-old on your hands every few nights? Check out Dr. Super’s sensitive approach:

Offer brief comfort

With most children, simple reassurance will likely be enough. If your child wakes up in the middle of the night, help her settle back down with a hug, a glass of water, and kind words, and then lead her back to bed.

Give the fear a name

Younger children can have a difficult time describing what scared them, so asking your preschooler to explain the nightmare probably won’t help get him settled. Instead, provide reassuring words that describe and help him understand the scary experience: You’re safe—it was a bad dream. It wasn’t real; it was pretend. With time he will be able to use these words to calm himself.

Talk about it in the morning

Some children are able to describe bad dreams in the morning. The light of day is a great time to talk, epecially if you suspect that the cause for her nightmare might be something in her waking life: scary movies, TV, or books; a big transition, like starting a new school year; or a trauma, such as losing a pet. Ask her about what is bothering her. A simple discussion may help alleviate bad dreams.

Dream and discard

If your child is still rattled by his dream in the morning, invite him to draw it. Did the monster eat his dog? Help your child imagine another ending to the dream (the barking dog scares the monster away!) and draw it together. Discard the drawing and, hopefully, the nightmare.

NIGHT TERRORS

Unlike a nightmare, which wakes a child and leaves her feeling fearful, night terrors happen while children continue to sleep. Children may even scream, cry out, or become agitated without waking, and may not remember the incident in the morning.

Night terrors are a type of parasomnia, like sleep walking or talking. Unlike dreams, night terrors occur in deep sleep, during a stage called N3: It’s the type of sleep where you can transfer your child from car seat to crib and she never stirs. Kids spend more time in N3 sleep than adults do, which may make them more likely to have night terrors. Longer stretches of N3 sleep typically happen in the first half of the night, which makes night terrors more likely at 11:30 p.m.

"If it offers a little comfort, know that night terrors are often scarier for the parents than they are for the child," says Dr. Super. Here’s how to handle them:

Make sure your child is safe

A sharp cry in the middle of the night will send any parent racing into their child’s room. First things first, check that your sweetie is safely tucked in bed.

Decide if it’s a night terror

He may be breathing quickly, tossing and turning, or have a racing heartbeat. If he only briefly rouses and then quickly goes back to sleep, or never seems to wake up at all, then he could be having a night terror.

Minimal interaction

Because your child is still asleep, the simple reassurance that helps for nightmares can actually do more to agitate her. That said, you may want to wait out the episode by her side to reassure yourself that all is fine.

Review her sleep routine

Night terrors are more common if kids aren’t getting enough sleep, or have had a shift in their sleep schedule. If you suspect the latter, work on getting your child back to his normal routine, with an emphasis on plenty of quality sleep.

When to speak to your doctor

If nighttime fears are starting to affect your child’s ability to fall asleep in the first place (for example, if he’s too scared of bad dreams to get into bed), if the terrors are persistent, or if you as a parent don’t feel that you are dealing adequately with the problem, speak to your child’s pediatrician.

Remember that this too will pass! This is a developmental stage that most children will grow through with your support and simple reassurance.




Meet Dr. Super

A member of the general pediatric team at OHSU Doernbecher Children’s Hospital in Portland, Oregon, Dr. Elizabeth Super has a strong interest in sleep and pursued fellowship training in Sleep Medicine. When she’s not caring for children in her job, she enjoys exploring the outdoors with her husband and her two young children.

Read more articles by Dr. Super. 

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