Night terrors in toddlers: What to do

Night terrors are different from common nightmares, which happen during REM sleep. You might have a hard time waking your child during a night terror episode. Your child likely won’t remember the episode the next morning.

Night Terrors

Night terrors are episodes of intense screaming, crying, thrashing, or fear during sleep that happen again and again, usually in children ages 3 to 12. New cases peak at age 3 1/2.

There are two main types of sleep: rapid eye movement (REM) and non-rapid eye movement (non-REM). Night terrors happen during non-REM sleep, usually about 90 minutes after a child falls asleep.

About 1 to 6 in 100 children have night terrors, also known as sleep terrors. They happen to both boys and girls, and to children of all races. Night terrors tend to run in families.

Night terrors vs. nightmares

Night terrors are different from common nightmares, which happen during REM sleep. You might have a hard time waking your child during a night terror episode. Your child likely won’t remember the episode the next morning.

Night Terror Signs and Symptoms

Children with night terrors may also have:

During a night terror episode, a child might:

• Sit up in bed
• Flail around in bed
• Scream
• Look awake but be confused
• Seem like they don’t know that a parent is there
• Not talk
• Not respond when a parent comforts them

Most episodes last only a few minutes, but it may take up to 30 minutes before the child relaxes and goes back to sleep.

When to call your doctor

Night terrors aren’t dangerous, but they can disrupt your child’s sleep. About half of children have sleep problems that are serious enough for medical help.

It might help ease your anxiety to talk to your child’s doctor. Let them know if your child’s night terrors keep them up often or for more than half an hour. They might be able to rule out other health conditions that can cause night terrors.

Night Terror Causes and Triggers

Night terrors tend to run in families. Most of the time, they have no specific cause. But certain things might play a role, including:

• Sleep deprivation
• Stress
• Depression or anxiety
• Fever
• Too much caffeine
• Sleeping in a different place or away from home
• Lack of sleep
• Sleep problems like sleep apnea
• Restless legs syndrome
• Medications that affect the central nervous system (the brain)
• Recent anesthesia for surgery

Continued

Night Terror Diagnosis

Your child’s doctor can usually diagnose night terrors based on their medical history and a physical exam.

If they suspect other health problems, they might give tests including:

• An EEG, which measures brain activity, to check for a seizure disorder
• A sleep study (polysomnography) to check for a breathing disorder

Night Terror Treatment

There’s no treatment for night terrors, but they tend to stop as a child gets older.

In rare cases, if the episodes are affecting your child’s daily activities (for example, how they’re doing in school or their relationships with friends and family), their doctor might prescribe low-dose benzodiazepines (such as clonazepam) or tricyclic antidepressants (such as imipramine).

Home Remedies for Night Terrors

Parents might take one or more of these steps:

• Make your child’s room safe so they aren’t hurt during an episode.
• Get rid of anything that might disturb their sleep, like electronic screens or noises.
• Try to lower your child’s stress levels.
• Make sure your child gets enough rest. Don’t let them become too tired or stay up too late.
• Create a relaxing bedtime routine, and stick to it.
• Keep the same wake-up time every day.

Don’t wake your child during an episode. It can make them even more confused, and they might take longer to go back to sleep. Try to wait it out, and make sure they don’t get hurt by thrashing around or tripping on something in their room.

Night Terror Prevention

If your child has a lot of night terrors, there are things you can try that might help. Breaking up their sleep is one example.

• First, note how many minutes after bedtime the night terrors start.
• Wake your child 15 minutes before the expected night terror, and keep them awake and out of bed for 5 minutes. You may want to see if they’ll use the bathroom.
• Continue this routine for a week.

Night terror episodes are short and usually happen over several weeks. Most children outgrow them by their teen years.

WebMD Medical Reference Reviewed by Renee A. Alli, MD on December 04, 2020

Sources

eMedicineHealth: “Night Terrors.”

KidsHealth/Nemours: “Night Terrors.”

StatPearls: “Night Terrors.”

Stanford Children’s Health: “Nightmares and Night Terrors.”

Mayo Clinic: “Sleep terrors (night terrors).”

American Academy of Family Physicians: “Nightmares and Night Terrors.”

© 2020 WebMD, LLC. All rights reserved.

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Night terrors in toddlers: What to do

Many toddlers experience night terrors. They are different than nightmares and do not have a lasting effect. Night terror triggers include tiredness, a fever, needing to pee, and sudden noise.

A night terror is a common sleep disorder that happens while a child is in slow-wave sleep. This is the stage of deepest sleep during the first third of the night.

During a night terror, a child may panic, scream, or make sudden movements. If this happens, stay calm, and do not wake them. A toddler is not fully awake during a night terror, and they are unlikely to remember it the next day.

If night terrors often occur, ensure that the toddler has a good bedtime routine and see whether things improve. In most cases, toddlers grow out of them.

For children, night terrors present in a number of ways:

• screaming or shouting unintelligible words
• flailing or kicking in bed
• sitting up in bed
• making sudden movements
• jumping out of bed
• seeming panicked, distraught, or afraid
• sweating or breathing heavily

It is difficult to wake a toddler if they have a night terror. They are unlikely to respond if a person tries to comfort or speak to them. They may even push someone away if they try to help.

Although a child may have their eyes open during a night terror, they are not fully awake. If they wake up, they are likely to be confused and may not know what has happened.

Most toddlers will not wake up during a night terror. After an episode, they will usually go into a deep sleep, and they probably will not remember it the next morning.

Frequent night terrors can also disrupt sleep, so a toddler may seem more tired than usual the next day.

Night terrors do not always have an apparent cause, but they are more common if other people in the family sleepwalk or have night terrors.

Night terrors are more likely if a toddler wakes from a deep sleep. Other common triggers can include:

• tiredness
• fever
• getting less deep sleep
• some medications
• needing to pee
• excitement
• anxiety
• a sudden noise
• periods of stress or change

Occasional night terrors are a normal part of a child’s development and are most common between the ages of 3 and 7 . Toddlers almost always grow out of having them.

If a child has a night terror, remain calm and stay with them until it passes. Do not try to wake them up, as this can cause more distress and confusion. However, it is fine to hold or soothe them if it seems to help. It is also crucial to protect them against injury, particularly if they are out of bed.

Night terrors do not cause any long-term harm, and most children will not remember an episode the next day. It can help to ask gently if anything is worrying them, without mentioning the night terrors.

A bedtime routine and sufficient sleep can help prevent night terrors. Try to put a toddler to bed at the same time every evening. Dim the lights, read a story, and limit screen time before bed.

Night terrors can happen if a child has worries or goes through a significant change, for example, starting at a new school. Try to talk to them about future changes such as this. Reassure a worried child and encourage them to talk about how they feel and what could help.

Although both nightmares and night terrors can disturb sleep and cause distress, they are not the same. They happen during different stages of sleep.

There are two types of sleep: rapid eye movement (REM) and non-REM. Non-REM sleep has three stages :

1. falling asleep
2. light sleep
3. deep sleep

Every person cycles through stages of REM and non-REM sleep throughout the night.

Most dreams and nightmares happen during REM sleep . A toddler may wake from a bad dream, remember what happened, and be able to explain it. Causes of nightmares include worries or scary experiences.

In contrast, night terrors happen during non-REM sleep , early in the night. When they occur, a toddler will not be fully awake and may have their eyes open or closed.

A night terror usually lasts up to 15 minutes and may occur more than once during the night. Toddlers may wake up with little memory of the episode or fall into a deep sleep again.

Night terrors do not need treatment unless they regularly disrupt sleep, last longer than 30 minutes, or cause a child to drool, jerk, or stiffen. In these cases, a pediatrician can offer help and advice.

Children rarely need medication to treat sleep problems. However, a doctor may recommend techniques to disrupt their sleep pattern for a short period.

For example, if a toddler has a night terror at the same time each night, the doctor may advise waking them 15 minutes before their next episode for 7 consecutive days. Doing this could help break the cycle of night terrors.

In some cases, frequent night terrors can have a medical cause. A child may have a full bladder, a fever, or breathing problems that wake them in the night.

Night terrors can be alarming or upsetting to watch. However, they do not have an adverse effect, and children are unlikely to remember them.

Try to resist the urge to wake or shout at a child if they have an episode, but keep them safe and soothe them if necessary.

Toddlers should grow out of night terrors as they get older. If they have persistent episodes or the night terrors affect their sleep, a pediatrician can help.

Last medically reviewed on June 30, 2020

• Pediatrics / Children’s Health
• Sleep / Sleep Disorders / Insomnia
• Parenthood

How we reviewed this article:

Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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• Carter, K. A., et al. (2014). Common sleep disorders in children.
  https://www.aafp.org/afp/2014/0301/p368.html
• Nightmares and night terrors in preschoolers. (2018).
  https://www.healthychildren.org/English/ages-stages/preschool/Pages/Nightmares-and-Night-Terrors.aspx
• Nightmares and night terrors. (n.d.).
  https://www.stanfordchildrens.org/en/topic/default?id=nightmares-and-night-terrors-90-P02257#:~:text=A%20night%20terror%20is%20a,t%20be%20awakened%20or%20comforted.
• Night terrors and nightmares. (2018).
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• Van Horn, N. L., & Street, M. (2019). Night terrors.
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What Causes Night Terrors in Toddlers?

When your toddler is in the middle of a night terror, it can make you feel helpless. But there are things you can do to help — both in the moment and to prevent them going forward.

If you’ve never witnessed them, night terrors in toddlers can seem frightening at first. Your toddler might scream, cry, thrash, or throw themselves off their bed. They will not accept soothing, and they won’t remember any of it in the morning.

Your toddler may demonstrate extreme behavior and seem terrified during an episode like this, even though they’re still technically asleep when it happens.

Night terrors can be very unsettling for parents and caregivers. If you feel like you don’t know how to help your little one, don’t fret: You’re not alone. Here’s what we know about the causes of night terrors in toddlers and how to handle them.

A toddler who is having a night terror might:

• sit up in bed or get out of bed
• scream, cry, or yell
• kick, punch, or thrash
• have an elevated heart rate
• have rapid breathing
• be sweaty
• have their eyes open but are unresponsive to your soothing
• appear terrified
• calm down and fall back asleep without any effort on your part

Night terrors in toddlers are associated with elevated body temperature (e.g., fevers), illness, caffeine, emotional and physical stress, a lack of sleep, a full bladder, and sleep disorders.

They occur during non-rapid eye movement (non-REM) sleep stages, which means a toddler experiencing a night terror is between a state of wakefulness and sleep.

They can begin at about age 3 and can continue until about age 12. Night terrors in toddlers are related to central nervous system (CNS) immaturity. Children tend to outgrow night terrors as the nervous system matures.

Night terrors and nightmares are not the same.

While night terrors are arousals that occur during non-REM sleep, nightmares occur during REM, or dream, sleep. Night terrors commonly occur in the first few hours after bedtime, whereas nightmares can occur at any time throughout the night.

Your toddler will likely accept soothing when they have woken up from a nightmare and may even be able to answer questions about their bad dream.

Unlike night terrors, your toddler can remember their nightmares the following morning and — if they are verbal — may be able to speak about them.

• Safety first: Ensure that your toddler’s room environment is free of dangerous objects, furniture is tethered to the walls, and blind cords are removed. You may want to consider putting a gate at the top of any stairs.
• Ride it out: Avoid trying to wake your toddler during a night terror, as this can cause further confusion and distress.
• Stay close but don’t interfere: Your toddler may not accept soothing. Offer loving words and stay nearby to make sure they’re safe.
• Go to the bathroom: If your child is potty trained, take them to the toilet. Many toddlers will immediately relax once they have emptied their bladder.
• Stand by until they’re calm: Night terrors in toddlers often resolve on their own within a few minutes, but they can last up to 45 minutes in some cases.

You may be able to prevent night terrors in your toddler by addressing the possible causes of night terrors, like lack of sleep, emotional or physical stress, or elevated body temperature.

Keep your child’s room temperature cool. The ideal sleep environment is no warmer than 68 to 70°F (20 to 21°C). Your toddler should wear no more than two layers of cotton material sleep clothing.

Ensure that your toddler has an age-appropriate sleep schedule. Children between ages 3 and 5 need an average of 11 to 13 hours of sleep in 24 hours. This may be distributed across daytime naps and nighttime sleep.

Implement a consistent, calming bedtime routine that consists of the same relaxing activities done in the same order every night, such as teeth brushing, stories, songs, cuddles, loving words, and then bed.

Encourage your child to empty their bladder before bed if they’re potty trained. Try including a trip to the potty in your consistent bedtime routine.

Avoid caffeine — yes, even chocolate — and screens before bed.

There’s evidence that physical stress (e.g., illness or a tooth infection) and emotional stress (e.g., changing caregivers or starting a new school) can cause night terrors. Do your best to address extra stress to help alleviate your toddler’s night terrors.

Pay attention to the exact timing of your toddler’s night terrors. Try gently rousing them (not fully waking them) about 20 to 30 minutes before they usually have a night terror. This may work to reset their sleep-wake cycles so that they don’t wake at the usual time. Try this for a few days before deciding whether it’s working.

Although melatonin can help children fall asleep, it can also worsen night terrors in children prone to them, so it’s best to consult with your child’s doctor before using melatonin to treat night terrors.

Some alternative healthcare professionals recommend essential oils like juniper for calming night terrors. There is no evidence that essential oils help night terrors in toddlers.

Some essential oils may be harmful to children, and all essential oils must be used safely to avoid harm. Always consult with your child’s healthcare professional about medications and alternative therapies.

If night terrors are frequent, last longer than 30 minutes, increase in frequency, or are accompanied by other concerning behaviors either during the day or at night, seek the advice of a healthcare professional.

If a healthcare professional has ruled out a medical concern like a sleep disorder, you may want to reach out to a certified sleep professional such as a sleep coach or consultant. A certified sleep professional can help you optimize your toddler’s sleep hygiene and habits and improve the quality of their sleep.

There is evidence that increasing sleep hours over 24 hours can help prevent night terrors in toddlers. A healthcare professional can help you rule out behavioral, lifestyle, and environmental triggers for night wakings.

When should I be concerned about a night terror?

If night terrors are frequent, increase in frequency, or are accompanied by other concerning behavior, seek the advice of a healthcare professional.

Should I wake my child from a night terror?

Avoid trying to wake your child when they’re experiencing a night terror.

Can you prevent night terrors in toddlers?

There are ways to reduce the possibility of night terrors in toddlers, including the following:

• Keep your child’s room temperature cool.
• Encourage them to empty their bladder before bed if they’re potty trained.
• Ensure that they have an age-appropriate sleep schedule.
• Implement a consistent bedtime routine.
• Avoid caffeine and screens before bed.
• Address physical and emotional stress.
• Try gentle rousing 20 to 30 minutes before they usually have a night terror.

What age do night terrors start?

While there are reports of night terrors in babies, night terrors usually occur in toddlers, preschoolers, and school-aged children between ages 3 and 12. They’re equally common among genders.

Are night terrors dangerous for toddlers?

Night terrors in toddlers are not inherently dangerous, but it is important to keep toddlers safe during night terrors by keeping their environment safe.

How common are night terrors in toddlers?

Night terrors in toddlers are uncommon. They occur in 3% to 6% of all children.