Characteristics | Nightmares | Sleep terrors |
Description | A scary dream; takes place during REM sleep and is followed by full waking | A partial arousal from very deep sleep (state IV, non-REM) sleep |
Time of distress | After dream is over, child wakes and cries or calls; not during nightmare itself | During terror itself, as child screams and thrashes; afterward is calm |
Time of occurrence | In second half of night, when dreams are most intense | Usually, 1 to 4 hours after falling asleep, when non-REM sleep is deepest |
Child’s behavior | Crying in younger children, fright in all; behaviors persistent even though child is awake | Initially may sit up, thrash, or run-in bizarre manner; may cry, scream, talk, or moan; shows apparent fright, anger, or obvious confusion, which disappears when child is fully awake |
Responsiveness to others | Is aware of and reassured by another’s presence | Is not aware of another’s presence, is not comforted, and may push person away and scream and thrash more if held or restrained |
Return to sleep | May be considerably delayed because of persistent fear | Usually rapid; often difficult to keep child awake |
Description of dream interventions | Accept dream as real fear Sit with child; offer comfort, assurance, and sense of protection Avoid forcing child back to his or her own bed Consider professional counseling for recurrent nightmares | Requires little intervention No memory of dream or of yelling or thrashing Intervene only if necessary, to protect child from injury Guide child back to bed if needed |