Night Terrors vs. Nightmares: How to Tell Them Apart
Medically reviewed by Dr. Sarah Chen, MD, FAAP · Board-Certified Pediatrician
Content reviewed against published AAP, NSF, NIH guidelines
Last reviewed:
Sleep concerns affect nearly every family at some point. When it comes to night terrors vs. nightmares: how to tell them apart, here is what the guidelines recommend.
The short answer
Night terrors and nightmares are very different events. Nightmares happen during REM sleep (second half of the night), your child wakes up fully and can be comforted. Night terrors happen during deep non-REM sleep (first third of the night), your child appears awake but is actually asleep and cannot be comforted. Night terrors look scarier to parents but are harmless - your child will not remember them.
Key takeaways
- Night terrors and nightmares are very different events. Nightmares happen during REM sleep (second half of the night), your child wakes up fully and can be comforted. Night terrors happen during deep non-REM sleep (first third of the night), your child appears awake but is actually asleep and cannot be comforted. Night terrors look scarier to parents but are harmless - your child will not remember them.
- Usually normal when: Your child has occasional nightmares that respond to comfort
- Call your doctor if: During an episode, your child has rhythmic jerking movements, stiffening, or lip smacking that could indicate a seizure
- Varies by age — see the age-by-age breakdown below
“To reduce the risk of sleep-related infant deaths, the AAP recommends that infants sleep on their backs, on a firm, flat surface, without any soft bedding.”
Parents everywhere have the same worry. You are doing the right thing by looking into it.
What Parents Should Know
According to AAP, NSF, NIH guidelines, night terrors and nightmares are very different events. Nightmares happen during REM sleep (second half of the night), your child wakes up fully and can be comforted. Night terrors happen during deep non-REM sleep (first third of the night), your child appears awake but is actually asleep and cannot be comforted. Night terrors look scarier to parents but are harmless - your child will not remember them. At 12-24 months, night terrors can begin as early as 18 months but are uncommon before age 2. They typically happen 1-3 hours after falling asleep and may involve screaming, thrashing, sitting up, or appearing terrified with eyes open. The key difference from nightmares: your child is not actually awake and will push you away if you try to comfort them. The best response is to keep them safe, stay nearby, and wait for it to pass (usually 5-20 minutes). They will have no memory of it. It is generally considered normal when your child has occasional nightmares that respond to comfort. However, you should contact your pediatrician promptly if during an episode, your child has rhythmic jerking movements, stiffening, or lip smacking that could indicate a seizure.
Normal vs. Concerning
By Age
What to expect by age
12-24 months
Night terrors can begin as early as 18 months but are uncommon before age 2. They typically happen 1-3 hours after falling asleep and may involve screaming, thrashing, sitting up, or appearing terrified with eyes open. The key difference from nightmares: your child is not actually awake and will push you away if you try to comfort them. The best response is to keep them safe, stay nearby, and wait for it to pass (usually 5-20 minutes). They will have no memory of it.
2-4 years
Both nightmares and night terrors peak during this period. To tell them apart: Nightmares happen in the second half of the night, your child wakes up scared and wants comfort, and may describe the dream. Night terrors happen in the first few hours of sleep, your child seems awake but is unresponsive to you, may thrash or scream inconsolably, and then suddenly falls back into quiet sleep with no memory. Overtiredness is the top trigger for night terrors.
4-6 years
Nightmares remain common but night terrors begin to decrease for most children. If night terrors are frequent (several times per week), the most effective prevention is ensuring your child is getting enough total sleep, as sleep deprivation is the primary trigger. Some parents find that briefly waking their child 15-30 minutes before the typical terror time (called scheduled awakening) can prevent episodes.
6+ years
Night terrors typically resolve by age 6-7. Nightmares may persist but should be infrequent. If your child continues to have frequent night terrors beyond age 6, or if they occur along with sleepwalking, mention this to your pediatrician to discuss whether further evaluation is needed.
What to Tell Your Pediatrician
- Describe when you first noticed night terrors vs. nightmares: how to tell them apart and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if night terrors happen several times per week.
- Mention if night terrors last longer than 30 minutes.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Your child has occasional nightmares that respond to comfort
- Night terrors happen once or twice a month and your child has no memory the next day
- Night terrors occur during periods of overtiredness or schedule disruption
- Both nightmares and night terrors are in the expected age range (2-6 years)
- Night terrors happen several times per week
- Night terrors last longer than 30 minutes
- You are unsure whether your child is having night terrors, nightmares, or seizures
- Night terrors are accompanied by sleepwalking into dangerous areas
- During an episode, your child has rhythmic jerking movements, stiffening, or lip smacking that could indicate a seizure
- Your child is injuring themselves during night terror episodes
What You Can Do at Home
- Keep track of when you notice night terrors vs. nightmares: how to tell them apart — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that your child has occasional nightmares that respond to comfort — this is generally within the range of normal.
- At 12-24 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Maintain a consistent bedtime routine. Keep the sleep environment cool, dark, and quiet.
- While monitoring at home, seek immediate care if during an episode, your child has rhythmic jerking movements, stiffening, or lip smacking that could indicate a seizure.
Related Conditions
Toddler Night Terrors
Night terrors are a common and harmless sleep phenomenon where your child appears terrified - screaming, thrashing, or sitting up - but is actually still asleep and will not remember the episode. They are caused by a partial arousal from deep sleep and are not a sign of emotional distress or psychological problems.
Toddler Waking from Nightmares
Nightmares are a normal part of development and typically begin between ages 2-4 as your child's imagination grows. Unlike night terrors, your child wakes fully and can describe feeling scared. Comfort them calmly, reassure them they are safe, and most children settle back to sleep with your gentle presence.
How Often Are Nightmares Normal for Toddlers?
Nightmares are common in children ages 2-6, with a peak around ages 3-4. Occasional nightmares (a few times a month) are a normal part of brain development and emotional processing. Nightmares happening nearly every night or causing significant daytime anxiety warrant attention, as they may be related to stress, scary media, or rarely, an underlying anxiety issue.
My Baby Wakes Up Confused and Crying
Confusional arousals happen when your baby partially wakes during a transition between sleep stages but isn't fully conscious. They may cry, seem upset, push you away, or not recognize you for several minutes before either fully waking or returning to sleep. This is a type of parasomnia that's developmentally normal and not harmful.
Related Resources
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Baby Sleep Guide
Age-by-age sleep needs, schedules, and evidence-based sleep strategies.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is night terrors vs. nightmares: how to tell them apart normal?
When should I call the doctor about night terrors vs. nightmares: how to tell them apart?
When is night terrors vs. nightmares: how to tell them apart normal?
What causes night terrors vs. nightmares: how to tell them apart?
What should I mention to my pediatrician about night terrors vs. nightmares: how to tell them apart?
Is night terrors vs. nightmares: how to tell them apart normal at 12-24 months?
Is night terrors vs. nightmares: how to tell them apart normal at 2-4 years?
Should I go to the ER for night terrors vs. nightmares: how to tell them apart?
Does night terrors vs. nightmares: how to tell them apart go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Night Terrors vs. Nightmares: How to Tell Them Apart.
Things to mention
- Describe when you first noticed night terrors vs. nightmares: how to tell them apart and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if night terrors happen several times per week.
- Mention if night terrors last longer than 30 minutes.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Night terrors happen several times per week
- Night terrors last longer than 30 minutes
- You are unsure whether your child is having night terrors, nightmares, or seizures
Urgent signs to report immediately
- During an episode, your child has rhythmic jerking movements, stiffening, or lip smacking that could indicate a seizure
- Your child is injuring themselves during night terror episodes
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of night terrors vs. nightmares: how to tell them apart are normal. Talk to your pediatrician if during an episode, your child has rhythmic jerking movements, stiffening, or lip smacking that could indicate a seizure.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Related Sleep Concerns
Toddler Night Terrors
Night terrors are a common and harmless sleep phenomenon where your child appears terrified - screaming, thrashing, or sitting up - but is actually still asleep and will not remember the episode. They are caused by a partial arousal from deep sleep and are not a sign of emotional distress or psychological problems.
Toddler Waking from Nightmares
Nightmares are a normal part of development and typically begin between ages 2-4 as your child's imagination grows. Unlike night terrors, your child wakes fully and can describe feeling scared. Comfort them calmly, reassure them they are safe, and most children settle back to sleep with your gentle presence.
How Often Are Nightmares Normal for Toddlers?
Nightmares are common in children ages 2-6, with a peak around ages 3-4. Occasional nightmares (a few times a month) are a normal part of brain development and emotional processing. Nightmares happening nearly every night or causing significant daytime anxiety warrant attention, as they may be related to stress, scary media, or rarely, an underlying anxiety issue.
My Baby Wakes Up Confused and Crying
Confusional arousals happen when your baby partially wakes during a transition between sleep stages but isn't fully conscious. They may cry, seem upset, push you away, or not recognize you for several minutes before either fully waking or returning to sleep. This is a type of parasomnia that's developmentally normal and not harmful.
How Long Should Baby Be Awake Between Naps?
The ideal awake time between naps (called a "wake window") increases as your baby grows. Newborns may only handle 45-90 minutes awake, while toddlers can manage 4-6 hours. Getting wake windows right is one of the most effective ways to improve nap quality, because both too-short and too-long wake times lead to poor sleep.
Is a Bath Before Bed Really Necessary?
A nightly bath is not medically necessary and some babies with sensitive skin do better with less frequent bathing. However, a warm bath can be a powerful sleep cue because the subsequent body temperature drop triggers melatonin production. If you include a bath, keep it calm and warm rather than stimulating.