Key differences at a glance
- Sleep stage: nightmares in REM sleep; night terrors in deep non-REM sleep.
- Timing: nightmares later in the night; night terrors in the first hours.
- Awareness: after a nightmare the person is awake and alert; during a night terror they are not truly awake.
- Memory: nightmares are remembered; night terrors are not.
- Comfort: people want comfort after nightmares; during night terrors comforting may not help.
- Return to sleep: harder after nightmares; quick after night terrors.
What nightmares are
Nightmares are vivid, frightening dreams that wake the person. They are common in children between 3 and 6 years old and also occur in adults, especially with stress, anxiety, trauma, some medicines and alcohol. Occasional nightmares are normal.
What night terrors are
Night terrors are partial awakenings from deep sleep. The person may scream, sit up with eyes open, look terrified, sweat, breathe fast and have a racing heart. They may not recognise parents and may push away comfort. Episodes last a few minutes, then the person settles back to sleep. They are related to sleepwalking and sleep talking.
Night terrors in children
- Most common between ages 3 and 8.
- More likely when the child is overtired, ill or feverish.
- Triggered by irregular sleep, stress, a full bladder or noise.
- Often run in families.
- Usually stop by adolescence.
Night terrors in adults
Night terrors are less common in adults and may be linked to stress, sleep deprivation, alcohol, some medicines, sleep apnoea, restless legs or other sleep disorders. Adults may injure themselves or others during episodes. A doctor can check for underlying causes.
See insomnia.
What to do during a night terror
- Stay calm and wait; most episodes end within minutes.
- Do not try to wake the person; it may confuse or upset them.
- Keep them safe, removing objects they could hit.
- Gently guide them back to bed if they get up.
- Do not talk about it in a way that worries the child the next day.
What to do after a nightmare
- Comfort and reassure the child.
- Let them talk about the dream if they want to.
- Use a night light or comforting object.
- During the day, help them draw the dream with a better ending.
Reducing episodes
- Keep a regular bedtime and wake time.
- Avoid overtiredness: earlier bedtime or a nap if needed.
- A calm bedtime routine without screens.
- Go to the toilet before bed.
- Reduce stress and frightening content before bed.
- For adults, limit alcohol and caffeine.
Scheduled waking
If night terrors occur at the same time most nights, gently waking the child about 15 minutes before the usual time for 7 days can break the pattern. This can be discussed with a doctor or health visitor.
Nightmares after trauma
Frequent, distressing nightmares after a traumatic event may be part of post-traumatic stress disorder (PTSD). Trauma-focused therapies and imagery rehearsal therapy, in which a person rewrites the nightmare and rehearses the new version, are effective.
Night terrors, sleepwalking and confusional arousals
Night terrors belong to a group of deep-sleep events called non-REM parasomnias, which also includes sleepwalking and confusional arousals, in which a person wakes partially and seems confused. They share triggers and often occur in the same child. Safety measures such as locking outside doors, using stair gates and keeping floors clear are important if sleepwalking occurs.
Tips for parents
- Remember that your child is not aware and is not suffering as it appears.
- Keep a diary of the time of episodes, bedtime and possible triggers.
- Make sure babysitters and relatives know what to do.
- Avoid long or late naps that shift bedtime too much.
- Address daytime worries, such as starting school or family changes.
When to seek help
- Night terrors happen several times a week or most nights.
- Episodes are dangerous or involve injury.
- They cause daytime sleepiness or problems.
- Snoring or pauses in breathing suggest sleep apnoea.
- Nightmares follow trauma or cause significant distress.
- Episodes start in adulthood.
Key points to remember
- Nightmares are remembered; night terrors are not.
- Night terrors occur in deep sleep early in the night.
- Do not wake someone during a night terror; keep them safe.
- Regular sleep and avoiding overtiredness reduce episodes.
Questions about night terrors and nightmares
These answers are general information and do not replace an examination or individual medical advice.
What is the difference between a night terror and a nightmare?
Nightmares are remembered dreams that wake you; night terrors happen in deep sleep without memory.
Should you wake a child having a night terror?
No. Keep them safe and wait for it to pass.
At what age do night terrors stop?
Most children grow out of them by adolescence.
Can adults have night terrors?
Yes, often linked to stress, sleep deprivation, alcohol or sleep disorders.
Are night terrors a sign of a problem?
Usually not in children, but frequent episodes should be checked.
What causes nightmares?
Stress, anxiety, trauma, some medicines, alcohol and frightening content.
Do night terrors cause harm?
They are not harmful in themselves, but injuries can happen during episodes.
Are night terrors linked to stress?
Yes, stress and overtiredness can trigger them.
Can medicines cause nightmares?
Some medicines, including certain antidepressants and blood pressure medicines, can.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.