Nightmares vs. Night Terrors: Know the Difference

Nightmares and night terrors can interfere with healthy sleep in adults and children, but if they occur frequently their underlying causes should be investigated.

When most people fall asleep, they expect a restful night. Unfortunately for many, nightmares and night terrors can interrupt crucial sleeping hours. Knowing the difference between nightmares and night terrors can help you determine the right remedies if these occurrences negatively affecting your life. Nightmares and night terrors may look different for adults and children, but they can still be bothersome. These sleep disruptions may be a sign that there are significant stressors in your life.

What Are Nightmares?

Nightmares are vivid dreams that are frightful and disturbing. These dreams occur during very specific times. REM nightmares happen during the rapid eye movement phase of sleep, which lasts the longest in the early hours of the morning. Therefore, nightmares are more common during the second half of the night.

Common Nightmare Symptoms:

Common nightmare symptoms experienced by a person diagnosed with a nightmare disorder include:

• Memorable dreams that involve avoiding a threat
• Rapid alertness upon waking
• Impaired work or social function the next day
• Bad dreams that cannot be explained by substance use or co-occurring mental health conditions

What Are Night Terrors?

Night terrors, sometimes referred to as sleep terrors, are much more dramatic than nightmares. When someone is having a night terror, they may act out their dream. Even though they may seem to be conscious, they are not. During this period it may be very difficult if not impossible to wake them. Night terrors are commonly experienced by children, but can still occur in adults.

Common Night Terror Symptoms:

Some common night terror symptoms include:

• Suddenly sitting upright in bed
• Screaming
• Being inconsolable
• Sleepwalking
• Acting scared or upset
• Kicking or thrashing

Notably, a child or adult who suffers from night terrors will have no recollection of them the next day.

Recognizing the Difference Between the Disorders

Night terrors and nightmares seem similar, but experts have categorized them as separate conditions. There are several differences between nightmares and night terrors. If you or a loved one struggles with either condition, it is helpful to understand the differences.

Some key differences between individuals experiencing nightmares versus night terrors include:

How to Help Someone With Sleep Disturbances

How to best support a person with nightmares or night terrors can depend on many factors, such as age, stressors and temperament and any other mental or physical health conditions they may be dealing with.

Helping With Nightmares:

Knowing how to help someone with nightmares is critical, especially if the nightmares are starting to affect their daily life. Reassuring someone that they are safe may not be enough, especially if there is an underlying reason for the nightmares, such as trauma. If nightmares negatively impact someone’s daily life, they may want to seek nightmare disorder treatment. This type of treatment involves a multi-step approach including counseling and medication.

A more involved treatment plan may be necessary when determining how to help someone with PTSD nightmares. Image rehearsal therapy is one method for treating nightmare disorder, where the nightmare image is replaced with more positive imagery. Cognitive behavioral therapy and certain medications are also effective therapies.

Help for Night Terrors:

Helping with night terrors requires a slightly different approach than helping with nightmares since the symptoms of this condition are different. If you are wondering how to help someone with night terrors, one of the healthiest things to do is to encourage the person to seek help from a sleep specialist. The sleep specialist may have the person struggling with night terrors undergo a sleep study. The goal of a sleep study is to assess if there are any underlying physiological problems, specifically pertaining to sleep. Adults who experience night terrors may also want to see a professional who can help them determine if there is an underlying problem contributing to the night terrors. While children often grow out of night terrors, if the issue continues into adulthood, professional treatment can help.

Tips for Parents:

For parents, seeing a child suffering due to night terrors can be upsetting, especially if the child cannot be easily awoken and reassured. Knowing how to help a child with night terrors may seem daunting, but there are some simple steps that any parent can take, starting with staying calm, ensuring the child is safe, and not trying to wake them if possible.

With respect to how to help your child with nightmares, go to them quickly, reassure them, have them recount the events of the nightmare and leave a nightlight on if necessary.

Prevention

Understanding how to prevent nightmares can seem like a challenging task, but there are some strategies that can decrease the likelihood of nightmares and night terrors. To prevent nightmares in both adults and children, it is helpful to keep a steady sleep routine. Maintaining a comfortable sleep environment is also important.

Other Prevention Strategies Include:

• Talking about the dream (if the person remembers it)
• Changing the ending of the dream so that it is better
• Discuss stressful life situations with the person
• Maintain a sense of comfort (e.g. a pillow, toy, dog or cat)

In regard to how to prevent night terrors, a therapist may help you get to the root of the problem. A person with night terrors may have experienced a traumatic event or developed another mental health condition that requires treatment.

Editor – Renee Deveney

As a contributor for Advanced Recovery Systems, Renee Deveney is passionate about helping people struggling with substance use disorder. With a family history of addiction, Renee is committed to opening up a proactive dialogue about substance use and mental health. Read more

Medically Reviewed By – Hillary Webster, ND

Dr. Hillary Webster is a board-certified Naturopathic Doctor and a self-proclaimed Hormone Advocate. Read more