Night Terrors: How to Care for Your Child

A child having a night terror (also called a sleep terror) wakes up screaming and thrashing and is impossible to comfort. Eventually they go back to sleep and usually won't remember the night terror when they wake. Night terrors can be scary for parents to see but are not harmful to children. Most kids outgrow them before the teen years. Here are some ways to help prevent night terrors and to comfort your child if they happen.

• If your child has a night terror:

  • Sit quietly near your child.

  • Move anything sharp or hard away from your child.

  • If your child gets out of bed and is running around, stay near them so they don't get hurt.

• Don't try to wake your child. If they do wake, they might be confused and take longer to settle down and go back to sleep.

• If your child has a night terror around the same time every night, you can try waking them up about 15–30 minutes before then to see if that helps prevent it.

• Getting enough sleep can help prevent night terrors. Help your child:

  • Keep a regular bedtime and wake-up time.

  • Get about 10–13 hours of sleep daily (including naps) if 3–5 years old and 9–12 hours of sleep each night if older.

  • Have a relaxing nightly bedtime routine and avoid high-energy activities just before bed.

  • Turn off phones and other devices to avoid screen time (including social media, videos, and messaging) at bedtime. 

  • Avoid caffeine (found in coffee, tea, chocolate, and sodas), which can disturb sleep.

• Helping your child manage stress can help prevent night terrors. You can:

  • Have a calm bedtime routine.

  • Help your child go to sleep and wake up at around the same times every day.

  • Teach your child coping skills such as calm breathing, meditation, or talking about their feelings.

  • Make sure they have plenty of time to do relaxing activities such as being with family and friends, drawing or painting, spending time in nature, and reading.

  • Limit time on social media and screens in general.

  • Make an appointment for them to talk to a counselor.

• Gastroesophageal reflux (when food and acid from the stomach back up into the esophagus, causing heartburn and other symptoms) and obstructive sleep apnea (when someone has pauses in breathing) can make night terrors more likely. If your child has one of these conditions, follow your health care provider's advice about treatment.

• Tell your health care provider about any medicines your child takes.

• To prevent injury, kids who get night terrors should not sleep on the top bunk of a bunk bed.

The night terrors:

• last longer than 30 minutes or happen more than once a week

• prevent your child from getting enough sleep

Also talk to your health care provider if your child:

• seems very sad, fearful, or stressed during the day

• has jerking of the arms and legs, body stiffening, or drooling during the night terror

• snores

• has heartburn or frequent burping

What happens in night terrors? Night terrors happen when a child partially awakens and the part of the brain that controls "fight-or-flight" responses becomes overexcited. This makes the child feel panicked and terrified. They will act very upset and may scream, thrash around, or get out of bed. This usually happens about 2–3 hours after a child falls asleep when the brain is in the non-REM (non-rapid eye movement) stage of sleep.

What causes night terrors? The exact cause of night terrors is not known. They tend to run in families so there's probably a genetic link. Some things can trigger night terrors, such as:

• not getting enough sleep

• being sick

• taking certain medicines

• sleeping in a new place or away from home

• anxiety or stress

• having too much caffeine

• gastroesophageal reflux

• obstructive sleep apnea

What's the difference between a night terror and a nightmare? Night terrors and nightmares happen during different sleep stages. Night terrors usually happen in the first few hours after a child falls asleep, while nightmares tend to happen later. A nightmare often will wake a child, but kids usually don't fully wake during night terrors. Children rarely remember anything about a night terror the next day but usually can remember parts of a nightmare. Night terrors are very rare in adults, but people of any age can have nightmares.