Night Terrors vs Nightmares in Babies and Toddlers

Watching your child scream, thrash, or cry inconsolably during sleep is terrifying for parents. Understanding whether you are witnessing a night terror or a nightmare determines how you should respond. These are fundamentally different events with different causes and different management strategies.

Content reviewed against published AAP, NIH, NINDS guidelines

Editorial policy

Last reviewed:

Key takeaways

  • Night terrors and nightmares are different events that occur in different sleep stages.
  • Night terrors happen in deep sleep (first third of night); child appears awake but is not.
  • Nightmares happen in REM sleep (second half of night); child wakes fully and remembers.
  • Do not try to wake a child during a night terror -- keep them safe and wait it out.
  • Night terrors peak at age 3-4 and are often triggered by overtiredness or irregular schedules.
  • Nightmares become common around age 2-3 as imagination develops; comfort and reassurance help.

How to tell the difference

Night terrors

  • Timing: First 2-3 hours of sleep
  • Sleep stage: Deep (stage 3/4) sleep
  • Awareness: Child appears awake but is not
  • Eyes: Open, glazed, unseeing
  • Response to you: Does not recognize you, pushes away
  • Duration: 5-30 minutes
  • Memory: No memory in the morning
  • After episode: Falls back to sleep immediately
  • Age of onset: 18 months to 4 years

Nightmares

  • Timing: Second half of the night
  • Sleep stage: REM (dream) sleep
  • Awareness: Fully awake after episode
  • Eyes: Normal, awake, seeking comfort
  • Response to you: Seeks comfort, clings to you
  • Duration: Wakes up quickly, may need time to calm
  • Memory: Can describe the dream (if verbal)
  • After episode: May struggle to return to sleep
  • Age of onset: 2-3 years

What causes night terrors

Night terrors are classified as a parasomnia -- a disorder of arousal. They occur when the brain gets "stuck" transitioning from deep sleep to a lighter stage. The child is not awake, not dreaming, and not aware of what is happening. The brain is in a confused state between sleep and wakefulness.

  • Overtiredness/sleep deprivation: The single most common trigger. When overtired, children spend more time in deep sleep, making disordered arousals more likely.
  • Irregular sleep schedule: Inconsistent bedtimes or nap disruption increases risk.
  • Fever or illness: Fever-related night terrors are common and resolve when the illness passes.
  • Genetics: Night terrors run in families. If a parent experienced them, children are more likely to as well.
  • Full bladder: A full bladder can trigger partial arousal from deep sleep in some children.
  • Sleep apnea: Obstructive breathing during sleep can trigger arousals that manifest as night terrors.

What to do during a night terror

  • Do not try to wake them: This typically intensifies and prolongs the episode.
  • Ensure safety: Make sure they cannot fall out of bed, hit furniture, or hurt themselves during thrashing.
  • Stay nearby: You can sit close and speak in a calm, quiet voice but do not restrain them unless they are in danger.
  • Wait it out: Most episodes last 5 to 15 minutes and end with the child settling back to peaceful sleep.
  • Do not discuss it: Since your child has no memory of the event, bringing it up the next day can create anxiety about sleep.

Preventing night terrors

  • Prioritize adequate sleep: Ensure your child is getting enough total sleep for their age. An earlier bedtime often reduces or eliminates episodes.
  • Maintain a consistent schedule: Same bedtime and wake time daily, including weekends.
  • Scheduled awakening: If episodes occur at a predictable time, gently rouse your child 15 to 30 minutes before the typical episode. This resets the sleep cycle and can prevent the disordered arousal.
  • Address sleep-disordered breathing: If your child snores, breathes through their mouth, or has restless sleep, discuss with your pediatrician as this can trigger night terrors.

Managing nightmares

Unlike night terrors, nightmares involve a child who wakes fully, is scared, and needs comfort. Nightmares are a normal part of developing imagination and become common around age 2 to 3.

  • Respond promptly: Go to your child, offer comfort, hold them, and reassure them they are safe.
  • Validate their feelings: "That sounds scary. You are safe now. I am here." Do not dismiss their fear.
  • Keep it brief: Comfort and return to sleep without lengthy discussions or turning on bright lights.
  • A comfort object: A special stuffed animal or blanket (for children over 12 months) can provide ongoing reassurance.
  • Address content if recurring: If the same nightmare recurs, you can use daytime play or drawing to process the fear and create a "different ending" to the story.

Frequently asked questions

At what age do night terrors start?
Night terrors most commonly begin between 18 months and 4 years of age, with a peak around 3 to 4 years. They are rare before 18 months. About 3 to 6% of children experience night terrors. They typically resolve on their own by age 5 to 7 as the nervous system matures.
Should I wake my child during a night terror?
No. Attempting to wake a child during a night terror usually makes the episode worse and can extend it. The child is not aware of what is happening and will not remember the episode. The best approach is to stay nearby, ensure they are safe (cannot fall out of bed or hit anything), speak in a calm quiet voice if you wish, and wait for the episode to pass. Most last 5 to 15 minutes.
Can babies have nightmares?
Babies under 12 months are unlikely to have true nightmares because nightmares require the cognitive ability to form complex mental imagery and narrative. Night waking with crying in babies under 12 months is more likely due to hunger, discomfort, sleep cycle transitions, or separation anxiety. True nightmares become possible around 18 to 24 months as imagination develops.
Are night terrors caused by trauma or anxiety?
Night terrors are not typically caused by psychological trauma or anxiety. They are a parasomnia -- a disorder of arousal that occurs during the transition from deep (stage 3) to lighter sleep. They are more common when children are overtired, have irregular sleep schedules, are sleep-deprived, or have a fever. There is also a genetic component; they run in families.
When should I talk to the doctor about night terrors?
Consult your pediatrician if: episodes occur more than 2 to 3 times per week, they last longer than 30 minutes, your child is getting hurt during episodes, they are accompanied by stiffening or jerking that could indicate seizure activity, daytime behavior is affected, or they begin after age 7 (which warrants evaluation for other causes).

Bottom line

Night terrors and nightmares are different events requiring different responses. Night terrors occur in deep sleep -- your child is not aware and will not remember. Keep them safe, do not try to wake them, and focus on ensuring adequate total sleep to prevent future episodes. Nightmares occur in REM sleep -- your child wakes fully and needs your comfort and reassurance. Both are normal parts of childhood development and typically resolve with time.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources