Express Sleep Plan

How to Handle Your Toddler’s or Preschooler’s Nightmares and Night Terrors: Part Two

Nightmares And Night Terrors

This week, we’re continuing our 2-part series about your toddler or preschooler’s nightmares and night terrors. Last week, we looked carefully at nightmares — when they begin, what causes them, and how we as parents can help our children through them.

This week, we’re taking a look at night terrors. While night terrors may not sound different from nightmares, in truth, night terrors are quite different, and are far less common. They also tend to be far more terrifying and intense than nightmares, making them upsetting for parents.

In today’s article, we’ll explore what night terrors are, the ages at which they typically start and stop, and why children have them. We’ll also walk through some helpful tips to coping with a toddler’s or preschooler’s night terrors.

When and Why Do Night Terrors Happen?

It might seem odd to discuss the cause of night terrors before we actually look at what night terrors are, but stay with me here. 😉 It’s important to start with the ‘why’ behind night terrors, because once we understand what’s happening to our little ones’ bodies and brains during particular sleep stages, we’ll better understand their night terrors.

If you read last week’s article, you’ll remember that nightmares happen during REM sleep — specifically, the longer REM cycles that happen in the second half of the night. Night terrors are closely linked to our sleep cycles, too. Nicole explains it this way, in a past article:

You might remember beginning around 4 months old, when we first fall asleep, it’s a transition into the deepest sleep of the whole night. This process takes approximately 30 minutes from bedtime for babies as they go into deep sleep faster than adults. The first sleep cycle lasts about 60 to 90 minutes and your baby (and you) will wake briefly as she transitions into the second sleep cycle, which is also deep sleep. The first few hours of sleep of the night is (supposed to be) the deepest. It is during this transition between sleep cycles that you wake briefly. You might roll over or you might pull the cover up over you. It is usually brief and you go right back to sleep. This is NORMAL to wake briefly. Sometimes, however, this process is not so smooth and not so quick and explains why your baby sometimes wakes up crying.

Night terrors typically happen at the tail end of this first sleep cycle, as your toddler or preschooler is transitioning from her deep sleep to lighter sleep. Some kids seem to get “stuck” between sleep cycles; they’re not fully asleep, but they’re not awake, either. Nicole explains it this way:

What happens is part of your mind is trying to go back to sleep and part of your mind is trying to wake up and they are both trying to win.

This is the moment when night terrors occur.

What Are Night Terrors? (And How Are They Different From ‘Confusional Events’?)

We can’t discuss night terrors without discussing ‘confusional events’ as well. Why? Because they represent two sides of the same coin. True night terrors aren’t common; it’s estimated that just 1% of people ever experience them. Confusional events are far more common, especially for toddlers and preschoolers.

Like night terrors, confusional events usually happen in the first few hours after bedtime, as a child is transitioning from deep sleep to lighter sleep between sleep cycles. Confusional events may be mild: your toddler or preschooler may mumble or moan, toss and turn for a moment, and then go back to sleep. But they can also be fairly intense. As Nicole explains,

If the event is a bit more intense, your toddler might sleep walk. She may walk up to you and seem to see right through you. Her eyes might be open, but she is still mostly asleep. Most kids won’t ever remember this happening. It could be a bit more pronounced such as a child jumping out of bed and moving around the room. She might seem upset or confused and may even say things like “No! Stop!” but not really appear too frightened. She might not recognize you and might push you away if you try to hug or touch her. It will likely be virtually impossible to either wake her or console her.

Confusional events like this can be short (a minute or so), but sometimes, they can last for 30 or even 40 minutes.

Night terrors are very, very intense confusional events. A person who’s in the midst of a night terror will look terrified, and may actually be violent. Night terrors don’t typically last very long; most night terrors are between 1 and 5 minutes long.

What Causes Confusional Events and Night Terrors?

It’s important to remember that mild confusional events are normal, and are simply a part of how we as humans sleep. Nicole puts it this way:

Partial wakings and confusional events are normal and happen from birth. The “confusion” comes in when your body’s drive to sleep is met with your body’s drive to wake. An example is when you are asleep and you hear the baby crying. You get up, walk to her room and start to feed her before you are fully awake. You might not even remember how you got into the room. Part of your mind was awake and part of it was asleep. If you are confused, you might go in the bathroom instead of the baby’s room and then wonder what you’re doing up when you hear the baby crying and finally your brain starts to wake up. From birth, there will be times during sleep transitions that your baby’s drive to sleep is being challenged by the drive to wake up and your baby might cry or fuss between sleep cycles. This is why it’s important to not interrupt the process of going back to sleep, if you can help it. We want the drive to sleep to win.

If your child’s confusional events are mild and irregular, then there’s nothing to worry about. If they’re intense, however, or if they’re happening frequently, then you’ll want to figure out what’s causing them, and make a change (if possible.)

No one can say for sure what causes confusional events and night terrors in some children and not in others, but experts agree that the following factors definitely contribute:

  • Overtiredness. This is a big one. Children who are overly tired or exhausted are more prone to confusional events and night terrors.
  • Disruption to sleep schedules and routines. If your toddler or preschooler’s bedtime and sleep schedules have been thrown out of whack for several days in a row, he’ll be more likely to experience a confusional event or night terror.
  • Heredity. Interestingly, tendencies toward night terrors and confusional events (as well as sleep walking and sleep talking) seem to be genetic. So if others in your family have experienced these, then it increases the odds that your toddler or preschooler will, too.
  • Sleep disorders. Children who have other sleep disorders, like sleep apnea and Restless Leg Syndrome, are more likely to have confusional events and night terrors.
  • Bladder awareness. This one doesn’t apply to night terrors, but it definitely applies to confusional events. I couldn’t find any hard evidence to confirm this, but there’s plenty of anecdotal evidence out there that seems to indicate a link between a toddler or preschooler having a full bladder and experiencing a confusional event. On his website, Dr. Alan Greene explains,

    Recently, my youngest son was having a confusional arousal [event], and his mother observed that these events are most common at the same ages that children are becoming aware of the bladder feeling full during sleep. Perhaps some of these kids just need to go to the bathroom? We stood him in front of the toilet, and he urinated, still not awake. The episode faded abruptly, and he returned to sleep. The calm was dramatic.

    Was this a coincidence? Or might this be a revolutionary new help for parents whose kids have these frightening episodes? A number of readers have tried this approach. Most said it worked wonders; a few said it had no effect.

How To Handle Confusional Events and Night Terrors

At best, it’s unsettling for parents to witness these episodes; at worst, it’s downright terrifying. And here’s the hardest part: parents, there is literally nothing you can do to make a confusional event or a night terror stop once it’s started. Nothing. You just have to ride it out with your child.

However, these tips and insights might make the “riding it out” part a bit easier for both of you:

  • Don’t touch your child. I know, I know — this runs counter to every parental instinct you have! But picking your child up, hugging her tight, trying to rock her, etc. will probably just make things worse. Many parents report that night terrors and confusional events are shorter when they (the parents) don’t touch their children. Instead, try lying near your child. This is a way for you to provide some comfort without actually touching your little one.
  • Don’t try to wake your child up, or make him “snap out of it”. Again, this is a totally normal instinct. But shouting at your child, or shaking him, in an effort to wake him up may just startle him even more, and make the night terror worse. Instead, try turning on a dim light and talking or singing softly. This may gently, gradually rouse your little one and provide some comfort.
  • Dress your child lightly for bed. This is more of a preventative tip. Some parents share that their children seem prone to confusional events and night terrors when they’re overheated. (Some is true for nightmares, actually.) So dress your child lightly for bed, and make sure she sleeps under light blankets.
  • Try waking your child a few hours after bedtime. Again, this is another preventative tip. Around the time that your child would normally have a night terror, wake her from sleep. Make sure she’s fully awake; ask her to sit up, or to get up and walk around; offer her a small drink. Then, put her back to bed. Some parents report that this really does work — it serves to reset the child’s sleep clock, in a way, and prevents the night terror from happening at all.
  • Make sure your child is getting the sleep he needs. A final preventative tip: take a good, long look at your toddler’s or preschooler’s sleeping habits and schedules, and be sure that your little one is getting enough sleep. Remember, overtiredness and chronic exhaustion contributes hugely to nightmares and night terrors, so ensuring that your little one is well-rested and has good nighttime routines in place can go a long way towards warding off night terrors.

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Have you dealt with night terrors and confusional events? What has your experience been like? What have you learned, and what advice can you offer other parents who are experiencing the same thing?

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  1. Taci says

    My daughter is now 19 months and has generally been an ok sleeper. However somewhere between 8 and 12 months, she would wake up an hour or two after she went to sleep screaming with what I thought were nightmares. I’d go pick her up and try to calm her down, but she would just scream and cry, apparently panic stricken, for several minutes. Then she’d seem to wake up and realize she was with me. Then I’d nurse her for a few minutes before putting her back to bed where she’d fall right back to sleep. It worried me some, but not overly so since I had just assumed it was nightmares (first time mom here 😉 ). It didn’t happen every night and seemed to happen mostly if she had a long or busy day. She hasn’t had an episode in several months now. Hopefully that’s behind us!

  2. Emily DeJeu says

    @ Taci — this definitely sounds a confusional event, especially given the fact that it usually happens an hour or two after your daughter falls asleep. No fun at all, is it? But hopefully, as you say, it’s behind you.

    Thanks for weighing in and sharing your experience, Taci! :)

  3. Alicia says

    I believe my son was having night terrors between age 1 and 4. At one point in time it was so bad he had it every other night, always at 1-2am for 2 months in a row. He was very verbal and violent, kicking and screaming while eyes were closed for 15-30 minutes, until he woke himself by choking up after screaming with a dry throat. It was mainly due to his eczema and rhinitis I think that disrupted his sleep pattern. Just only recently, he seems to have gotten better (knock on wood!) Could be him growing out of it I hope or us working tirelessly to fix his ENT problems. I just hope it doesn’t ever come back!

  4. Angela says

    My son has always been prone to night terrors. When he was younger (toddler/pre-school), we noticed that when he didn’t get a nap, he would always have one that night. As he grew older, we knew that if he had had a very hard, tiring day, he would have night terrors that night. I’m fairly certain these were terrors, as he would scream, cry, run, and thrash around. He wouldn’t recognize anything and mistake common objects out of fear.

    My husband and I found a trick to gently wake our son out of these episodes. We would put on a cartoon on television, something not violent or too action packed at a low volume. Once he noticed the show, he would slowly wake until he was just watching the program. Then we would tell him it was time to go to bed.

    Our son is now 12 years old. He no longer has night terrors on a regular basis, but sometimes one crops up when he is running a fever. We still use the same TV technique to gently wake him.

  5. Emily DeJeu says

    @ Alicia — this sounds awful :( So sorry you and your guy had to suffer through this, but glad to hear that it’s getting better now! Hope you’re right, and that it’s over for good.

    Thanks for commenting, Alicia! :)

    @ Angela — awesome tip! Thanks so much for sharing this. I’ve said it before, but the tips and tricks that come from our community of parents are just invaluable to our readers. Thanks again for chiming in and sharing this bit of wisdom!!

  6. Delphine says

    If your child is experiencing repeat terrors, you may want to see a specialist! My oldest (now 7) began experiencing night terrors when he gave up his pacifier at age 3. The terrors were AWFUL! My normally docile and calm boy would scream, punch, and sometimes even run around his room multiple times a night. Once he even broke his collarbone when he thrashed so hard he fell out of bed. He could never go without a pull-up because he also wet the bed several times a night, even if I got him up to use the bathroom. He always took his naps and always went to bed by 7:00 p.m., but it had little effect on his terrors. It was a HUGE strain on our family! I consulted with the pediatrician, who said it was a phase especially for boys, but I had a hunch it was more than that. For two years I waited for him to outgrow the phase, but nothing changed. I finally followed my mother’s intuition and took him to a specialist, he was ultimately diagnosed with sleep apnea. The remedy was to remove the tonsils, adnoids, and shave out some tissue in his sinuses. Within two weeks (after the swelling went down), the terrors were gone. He has not wet the bed since, and he only has the occasional “screaming in the night” if he is overtired.

  7. Emily DeJeu says

    @ Delphine — thanks so much for sharing your story! Insights like this are so helpful to moms and dads who are suffering through night terrors with their toddlers and preschoolers.

    Thanks for sharing, Delphine! :)

  8. Jill says

    My 4 year old daughter wakes up in the middle if the night all the time and gets in bed with me. The past few months on occasions she tells me she has clovers in her eyes and is scared. She climbs in bed and tells her she is fine go back to bed. She then falls asleep in a few minutes. Last night she was up saying the same thing. It took me an hour to get her to go to sleep. She kept saying it over and over and said she was seeing spots, covering her eyes, holding her arms out to keep them away and looking constantly around the room. She seemed like she was truly awake and really scared. I held her and told her nothing was there but she insisted there was. Do you think this was a night terror?

  9. Emily DeJeu says

    @ Jill — could be. Do you think there’s anything real behind her complaints of seeing spots? It may be worth a visit to an eye doctor, just to make sure all is fine there. Honestly, though, this is probably nothing. Could very well be a confusional event, in which she’s semi-awake but not fully awake.

    Keep us posted on what happens, Jill! And thanks for commenting. :)

  10. Carola says

    My five year old daugther started with night terrors last year. After experiencing several of them, my husband and I realized it always happens when she needs to pee. She always wakes up crying (with a terrified look) calling for me, so we take her to the bathroom and then stay with her singing softly and hugging her until she falls asleep.

  11. Emily DeJeu says

    @Carola – I’m sure that witnessing your daughter’s night terrors had to be a bit alarming! I’m sorry to hear that she experienced them, but glad to hear you and your husband were able to find a trigger. Keeping my fingers crossed that she’s free and clear of them now! Thanks for sharing!