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Toddler Night Terrors

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:

In the U.S., healthcare spending accounts for 17.7% of the Gross Domestic Product (GDP), or the total value of goods and services produced by the entire nation for the entire year, according to the Centers for Medicare & Medicaid Services.

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.”

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Toddler Night Terrors

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on March 2, 2022

Latest update:

That crying and thrashing you witness from your toddler could be a night terror. Here’s what these sleep episodes are and some easy ways to handle them in your child.

What are night terrors?
What’s the difference between nightmares and night terrors?
What causes night terrors in toddlers?
How to stop night terrors in children
When to call a doctor

You’re probably familiar with the occasional toddler nightmare. But few things can prepare a parent for the screaming, kicking, crying and even sleepwalking that tend to accompany night terrors in toddlers. Fortunately, these intense nighttime moments aren’t usually a big concern since, like most stages of childhood, kids will outgrow them.

Still, night terrors in children are downright scary for parents and, of course, you’ll want to soothe your tot when she has one. For some help with this, here’s more about the causes of night terrors, how they differ from nightmares and easy ways to try and stop them from happening.

What are night terrors?

A night terror is a generally harmless sleep episode that occurs when your child is partially awake but also in a panic and possibly yelling, kicking, talking gibberish or sleepwalking. Night terrors tend to happen in the deepest part of sleep early in the night, often before you’ve probably gone to bed yourself.

A night terror may last just 30 seconds, but they can also continue for much longer, even up to 45 minutes, though this is rare. Your child’s eyes may be open during a night terror, but she’s not awake at this moment, nor will she remember anything about it once she does wake up. Other common signs of night terrors include:

Screaming and shrieking
Uncontrollably crying
Bolting upright in bed
Sweating, shaking or breathing rapidly
Pushing you away as you try to comfort her
Kicking, punching or flailing about
Staring, yet she doesn’t see you
Looking confused or afraid, but you can’t wake her
Getting out of bed, trying to run or sleepwalking

What’s the difference between nightmares and night terrors?

You can tell the difference between nightmares and night terrors based on when they take place at night, their intensity and their frequency. Nightmares happen during the second half of the night during the REM (rapid eye movement) stage when dreams occur. During a nightmare, your child will appear as if she’s a little bit restless in the bed while dreaming, perhaps tossing and turning.

It’s only when she’s fully awake that the fear, screaming and crying tend to begin. And when you go to her room to comfort her, she may cling tightly since she’ll likely remember parts of the bad dream and may even tell you about them if she’s verbal enough. Your toddler may also feel afraid and have difficulty settling down and falling back to sleep.

But a night terror happens in the first third or half of the night during lighter sleep — and it’s more dramatic. Your tot may seem to be awake (her eyes are usually open), and she’ll yell and kick. But after it ends, she won’t recall the night terror and will head back to sleep rather quickly since she wasn’t actually awake in the first place.

Nearly every child has a nightmare once in a while during childhood, but night terrors are less common, occurring in about 3 to 6 percent of kids. Night terrors may happen to toddlers as young as 18 months, but they usually take place in kids between the ages of 4 and 12.

What causes night terrors in toddlers?

It’s not exactly clear what causes night terrors, but the over-arousal of the central nervous system during sleep is one physical element. Here are some other causes of night terrors in toddlers:

Stress. Anxiety due to significant life changes, like a new sibling or starting preschool, may be behind terrors.
Excess fatigue. Too few Zzzs or an erratic sleep schedule can play a role.
Sickness. A fever or certain medications are two other potential causes.
Family history. If you or your spouse had night terrors, your child may be prone to them. In fact, 80 percent of kids who have night terrors also had a family member who did or sleepwalked as well.
Sleep disorders.Sleep apnea or restless leg syndrome can interfere with your child’s sleep and may up the risk of night terrors too.
Caffeine. While particular foods aren’t known to cause night terrors, kids who consume too much caffeine may be more likely to experience them.

How to stop night terrors in children

The good news is that once night terrors start, they usually last only a few weeks. In the meantime, here’s what you can do to help:

Be calm. A night terror is definitely more terrifying for you than it is for your toddler. Still, try to relax when it happens and patiently wait it out at her side.
Don’t force her to wake. Shouting or shaking your child to wake up may only worsen the situation and confuse your child when she does come out of it. And your reaction may also make it harder for her to head back to sleep.
Reassure her. If she’s disoriented or worried when she emerges from a night terror, let her know everything’s fine, and then offer some cuddles and quiet talk so she can relax.
Clear the decks. Since night terrors may be accompanied by attempts to get up, run around or sleepwalk, it’s smart to gently hold her so she can’t get hurt. If she does rise and move about, direct her back to her room and away from stairs or walls. (You may want to add gates to stairwells if your child sleepwalks regularly.)
Stick to the tuck-in routine. Keep your toddler’s bedtime and routine sacred (bath, story, songs) so she gets enough sleep each night. And nix staying up late on weekends.
Let the sitter know. If night terrors happen more than once or twice, inform the babysitter, grandparents or other caretakers in case they’re with your tot when they occur.
Wake her beforehand. Does the night terror happen at about the same time each evening? Many pediatricians recommend waking your child 15 to 30 minutes prior to when night terrors usually occur to help prevent them.
Reduce her stress. Talk over any shifts in your family’s routine, whether it’s a new job or a move to a different house. And check with your kid’s babysitter or preschool teacher to see if anything’s bothering her. Your goal: reducing your child’s anxiety before bed.
Avoid caffeine. A light snack before bed is fine or simply a little water, but definitely skip chocolate, soda or anything with this buzzy stimulant.

When to call a doctor

Start by keeping a diary of your child’s sleep patterns. Make a note of how much sleep she gets (both at night and naps), how long it takes her to fall asleep, how often she wakes and any changes or stressors that have occurred at home. After tracking this information for a week or two, bring it to your pediatrician so you can discuss your child’s sleep issues and learn some strategies for handling them.

Call the doctor if sleep terrors last longer than 30 minutes, or they’re accompanied by a stiffening of the body, jerky movements or drooling. And if your child’s nightmares or night terrors continue despite your efforts or if she’s experiencing daytime dream-related anxiety, talk to your pediatrician. He or she may check for other potential causes (like swollen tonsils) or recommend a sleep specialist.

While night terrors are super scary for parents, keep in mind that nearly all tots outgrow them by adolescence, and they often fade away as a child’s nervous system matures. In the meantime, keep your cool and comfort your child when they happen so she knows you’re there for her.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.

View Sources

What to Expect the Second Year, Heidi Murkoff.
WhatToExpect.com, Toddler Nightmares, March 2022.
American Academy of Pediatrics, Nightmares and Night Terrors in Preschoolers, October 2018.
KidsHealth From Nemours, Sleepwalking, August 2018.
KidsHealth From Nemours, Night Terrors, June 2017.
Mayo Clinic, Sleep Terrors (Night Terrors), April 2021.
National Library of Medicine, National Center for Biotechnology Information, Night Terrors, July 2021.
National Sleep Foundation, What Is a Night Terror?, March 2021.
Stanford Children’s Health, Nightmares and Night Terrors, 2022.

Toddler Night Terrors

Night Terrors

Night Terror Signs and Symptoms