Dealing with Nightmares and Night Terrors
Another frequently asked question at our physical exams is the concerned parents have
separating a nightmare from a night terror. A nightmare is a scary dream, it takes place
during a REM sleep and is followed by full awaking as compared to a sleep terror which
is a partial arousal phenomenon.
The time of occurrence of the nightmare is really late into the sleep, the second half of the
night. Night terrors, they occur in the first one to four hours after falling asleep. The
behavior of the child during a nightmare is that of crying, crying in younger children,
fright in children and behaviors persist even though the child has woken up. The night
terror is a very scary thing to look at in the sense that the child is thrashing, sitting up.
And they can even have eye movement, heart rising, perfuse sweating, they scream, they
cry, they talk. There’s apparent fright but everything disappears when the child wakes up.
The treatment of this is usually rapidly wake the child up and you’ll end the night terror.
There is no memory of the terror or the dream, the yelling or thrashing and the child then
can go back to sleep. Interventions for nightmares are to accept the dream as a real fear,
you sit with the child, you comfort and you assure. This are two different entities
approached in a different way both benign but both need parent awareness of how to
approach each one.
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