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Diseases & Conditions

Nightmares

What are nightmares?

Nightmares are scary dreams that generally wake your child up from sleep and seem very real to him or her. Depending on your child's age, it is often difficult for children to separate a nightmare from reality, even after your child awakes from the nightmare. Nightmares can often make your child upset and afraid to go back to sleep and may be a reason for bedtime struggles or refusal.

What causes nightmares?

Nightmares can happen for no known reason although they sometimes appear to stem from your child seeing or hearing something that upset him or her during the daytime. The exact reasons why nightmares occur is unknown. In some cases nightmares may follow traumatic experiences or be associated with psychopathology. Certain drugs that alter brain neurotransmitters or cause dream sleep rebound may be associated with nightmares.

Nightmares can occur in children as young as toddlers but generally start between the ages of 3 and 6 years. It is estimated that 10 to 50 percent of children at this age have nightmares significant enough to disturb their parents. The developmental stage of life often is reflected in the type of nightmare. For example, toddlers may have nightmares about being separated from their parents; young children may have nightmares about getting lost, about death or other real dangers; and older children may have nightmares related to scary movies they've seen.

Nightmares generally occur in the second half of the night and are associated with full awareness and clear recall if the child wakes up after the episode. Little or no confusion is involved. These features distinguish nightmares from night terrors which occur in the first half of the night and are associated with little or no recall and a confused state of awareness.

How to help your child who experiences nightmares

There are several steps you can take to reduce your child's likelihood of nightmares. Among them:

  • Ensure adequate sleep. Is your child getting enough sleep and maintaining his or her regular bedtime schedule and routine? Doing so will likely cut down on the number and intensity of nightmares.
  • Keep the bedtime routine ‘light,' happy, and fun. In the 30 to 60 minutes before bedtime, don't expose your child to scary movies, TV shows, frightening bedtime stories, scary music or other stimuli that may be upsetting to your child.
  • Discuss the nightmare during the day. Try to determine if there might be a theme to the nightmares – especially if they are occurring frequently. If there is, this could mean there is something bothering your child. Try to determine what it is. Identify what the stressors are in your child's life. Talk about these stressors and work with your child to reduce them.
  • Comfort, coddle, and reassure your child. This is one time when providing brief comfort and cuddling is very much the best solution for this sleep-related problem. Stay with your child for a short period of time following the nightmare. Most will still be tired and able to fall back to sleep soon. Let your child go back to sleep in his or her own bed. Avoid excessive attention or pampering. To provide additional comfort, it is also helpful to allow your child to snuggle with his or her favorite soft toy or security blanket throughout the night. If your child would like the light on, leave it on in its dimmest setting, or use a night light for comfort. Consider leaving the bedroom door open. Reassure the child that the home is safe and that you are there for security.
  • Working out ways to overcome nightmares. Some children and adults have developed some creative ways to help children outgrow nightmares. Some have tried reading stores about getting over nighttime fears. Others have drawn pictures of nightmares and then have torn them apart and thrown them away as a symbolic gesture. Still others have hung Native American charms over their beds. Whatever creative solution works for you and your child can certainly be tried.

When should a call to the doctor be considered?

Consider calling your doctor if any of the following occur:

  • Your child's nightmares become worse or increase in frequency.
  • Your child's fear interrupts daytime activities.
  • Your child's nightmares are very distressing and repetitious or psychological issues are involved. In such cases, psychological techniques like desensitization and relaxation strategies may work. In adolescents, guided dream imagery training may be helpful.
Additional Sleep Information and Suggested Readings

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 5/17/2013…#14297