Nightmares (Adapted from Healthy Steps)

Sleep disturbances like nightmares are very common during the toddler years. Toddlers can have bad dreams because of stressful events. They can also have bad dreams because of regular toddler stresses like toilet training. Toddlers can also have something called night terrors. Night terrors are different from nightmares. A nightmare is a scary dream that completely wakes up a child after he has been asleep for a while. Nightmares usually happen in the early morning hours. Night terrors usually happen after a child has been sleeping for between 1 and 1 1/2 hours. Night terrors occur as the child is moving from non-REM (rapid eye movement) sleep to REM sleep. Children are not really awake during night terrors; therefore, they can be glassy-eyed and not respond to parents. The child looks aroused-often pale and sweaty with a pounding heart. He may cry, scream, thrash about and generally act very afraid. This can last from 5 to 20 minutes at a time and is hard to stop. Night terrors are more common when a child is overtired, goes to bed with a full bladder, or is too cold at night. They come in clusters, sometimes dozens per night for several nights, then none for weeks. The night terror ends when the child wakes up or goes back to sleep. Usually children remember nightmares the next day; however, they don't remember night terrors. Experts aren't sure what causes night terrors, but lots of children have them and grow out of them. There is nothing wrong with a child who has night terrors, but it can be very disturbing to parents.

What can you do to help with nightmares?

• First, stay calm. It is scary to see your child so upset, but that doesn't mean that there is something wrong with your child.
• Comfort your child. The best way to help is to hold your child gently and reassure her that everything is OK. She will probably fall back asleep with your comforting words. It may not be a good idea to feed her or take her to bed with you, because she may begin to expect that all the time.
• Take your child's concerns seriously. If she thinks that there is a monster under the bed, reassure her that there will never be any monster there. But create a ritual to get rid of monsters: yell "Go away monsters-all gone"; spray under the bed with "monster spray"; or wave a bat as part of the bedtime routine. This will give your child some control over her fears.
• Talk with your child. If your child remembers a bad dream the next day and wants to talk about it, it might help to calm his fears.
• Read a book together. If your child remembers nightmares, there are many books to read together that may help to calm her fears. In the Night Kitchen, by Maurice Sendak, and Bedtime for Francis, by Frances Hoban, are two great stories about nighttime. The videotape "It's Sleepy Time" shows children how to handle bedtime fears. You can get this video from 1-800-23-POTTY.

What can you do to help with night terrors?

• If your child has a night terror, she won't remember it, so talking won't really help.
• Make sure your child is getting enough sleep, urinates before bed, and has a warm, quiet place to sleep.
• When a cluster of night terrors has started, begin waking your child up to half an hour after she falls asleep. Then tell her to go back to sleep. This lightens sleep so that the deep sleep transition is smoother. Do this for a week, and then stop until the next cluster starts.
• Sleeping in the same room with your child may also stop a cluster of night terrors.

Adapted from Healthy Steps. Edited and Compiled by the Center for Promotion of Child Development Through Primary Care 2011