Night Terrors vs. Nightmares: What’s the Difference?
Dr. Nayantara Santhi, PhD
Dr. Nayantara Santhi is an associate professor of psychology at Northumbria University in Newcastle. Santhi’s body of work includes numerous articles on how circadian rhythms regulate an individual’s sleep-wake cycle. Santhi’s articles have also focused on related elements such as bright light exposure and melatonin production.
The occasional bad dream happens to all of us. They’re scary and can ruin our sleep. Sleeping is your body’s opportunity to relax, but night terrors and nightmares are incredibly disruptive, worsen the quality of your sleep, and can have an overall negative impact on your health.
One of the largest differences between nightmares and night terrors is how they impact the sleeper. Someone who experiences night terrors often won’t remember having an episode, though their partner or family members may bear witness to them flailing and screaming in bed. Nightmares generally have little impact on other people, though they’re stress-inducing and frightening for the individual experiencing them.
While night terrors and nightmares differ, the treatment of both ailments is similar. In this article, we discuss the difference between nightmares and night terrors and how you can better manage these sleep disturbances.
What Are Night Terrors?
Night terrors are middle-of-the-night episodes characterized by intense screaming, crying, and thrashing during sleep. Sleepers often have the tendency to sleepwalk or sit up in bed, though they remain unconscious.
Night terrors are not dreams, as the sleeper is unaware of what is happening and will not remember their episode in the morning. Most often, night terrors occur in non-REM (non-rapid eye movement) sleep between stages 3 and 4, known as slow-wave or deep sleep. It’s unusual for a person to have more than one night terror in one evening, and it usually happens within an hour or two of falling asleep.
Children are most commonly affected by night terrors, with approximately 40 percent of children having the occasional episode. Most children who get night terrors are between the ages of 4 to 8 because they are too young to properly handle stressors such as anxiety or a lack of sleep. It’s less common for older children, teens, and adults to get night terrors, though not impossible.
Symptoms of Night Terrors
When having a night terror, an individual enters a state of panic and distress while asleep. Even if the sleeper appears conscious, they are unaware of what is happening. They may sit upright, open their eyes, and even stand up and sleepwalk. While amidst a night terror episode, a person may also:
- Mumble incoherently
- Sweat, hyperventilate and have a fast pulse
- Have a flushed face or dilated pupils
- Shout, kick, thrash about, or cry out
What Are Nightmares?
Nightmares are intense and frightening dreams happening to sleepers of all ages. The content of nightmares seems to draw from daily life, but other common themes include feelings of helplessness, a threatening source, and unresolvable events.
“Nightmares are typically vivid dysphoric dreams about threats to survival, security or self-esteem, and they cause awakening,” says Dr. Nayantara Santhi. “Bad dreams in contrast are also similarly negative in content but do not cause an awakening. Recent advances in technology now allow researchers to identify brain activity markers of dreaming and dream content, which opens the way or advancing our knowledge of dreaming.”
Nightmares often occur during REM (or rapid eye movement) sleep when the brain is most likely to have vivid dreams. These nightmares are easily recalled, similar to other dreams during REM sleep—this is one reason why sleepers recall nightmares but have no recollection of night terrors.
Roughly 50 percent of adults have an occasional nightmare, while 7 to 8 percent experience recurring nightmares. Women appear to get nightmares 2 to 4 times more frequently than men; however, it’s unclear if this data stems from women reporting more often than men. 1 in 4 children between the ages of 5-12 experience occasional nightmares.
Symptoms of Nightmares
Nightmares are distressing and vivid dreams. Unlike night terrors, the sleeper will remember their nightmare and can easily recall the contents of it in detail. Some individuals can sleep through nightmares, though other times, they may jolt awake. Upon waking up, a person may struggle to return to sleep and have a heightened heart rate or blood pressure.
Causes of Night Terrors and Nightmares
Nightmares and night terrors can occur spontaneously and for seemingly no reason at all. However, both can be caused by sleep deprivation, mental health conditions, or sleep disorders such as sleep apnea, Restless Legs Syndrome, or insomnia. Other potential causes include:
- Eating late
- Stress and anxiety
- Post-traumatic stress disorder (PTSD)
- New medication
- Overconsumption of caffeine
- New or foreign sleeping environment
- Family history of sleep disturbances
Strategies for Handling Night Terrors and Nightmares
Although there is no cure for either sleep disturbance, you can take some steps to better manage you or your loved one’s night terrors or nightmares.
Address Potential Triggers
When trying to minimize the number of night terrors or nightmares you experience, start by considering why you may be having episodes. Possible triggers for night terrors and nightmares include medications, sleep deprivation, and stress.
If you pinpoint a pattern causing your nightmare or night terror episodes and hone in on a common variable, you can then take action to address the problem and prevent these sleep disturbances.
Anxiety and fear commonly trigger nightmares and night terrors in young children. Ensure children do not have access to frightening TV shows, movies, books, or video games. In the event that your child does come across something scary, reassure them the content is merely fictional and not something they should fear.
If you have a sporadic sleep schedule and are constantly tired, this lack of sleep may be causing your night terrors or nightmares. A sleep calculator can help you determine if you’re getting to bed on time.
Sleep deprivation also causes excessive hunger and may have you eating quite a bit, even before bed. We don’t recommend sleeping hungry; however, heavy meals before bed can put stress on your body, inducing a nightmare or night terror.
Night terrors are sometimes hereditary. If you’re unsure your family members have ever had night terrors, it’s worth asking to discover what’s causing yours. By recognizing the causes of your nightmares and terrors, you can better understand how to relieve them.
Develop Better Sleeping Habits
For some, the cause of nightmares and night terrors is rooted in sleep deprivation or a poor sleeping schedule. The lack of rest from bad sleep habits puts stress on our bodies and manifests itself through a nightmare or night terror.
Develop a consistent sleep schedule to ensure you get enough rest—roughly 7 to 9 hours for adults and 10 to 12 hours for children. Try to go to bed and wake up around the same time every day, including weekends, to nurture your circadian rhythm and promote better rest.
We also recommend setting aside 30 to 60 minutes each night for a relaxing bedtime routine. In the hour or so before sleep, put away any electronic devices to limit screen time, avoid stressors, and don’t eat heavy or greasy foods. Instead, take a warm bath or read a book to wind down and relax. By keeping a consistent nightly routine, you train your brain to shut down and drift off at the same time every night.
You can even look into lucid dreaming if you struggle with nightmares. It can be a difficult skill to learn and isn’t guaranteed to be successful, but for some patients it does help.
As a 2019 studyconcluded, “Lucid dreaming therapy may be efficient for treating nightmares, and even when lucidity is not achieved, the induction exercises assisted patients by helping them develop a critical thinking over dream content.” However, the conclusion does continue to note that “the available literature is still scarce and does not provide consistent results” with further research needed,
Don’t Wake Somebody Having a Night Terror
If your loved one experiences night terrors, it’s difficult seeing them acting erratically. It’s tempting to wake them up, though that’s not the best idea. In these situations, it’s best to wait the episode out. Eventually, the night terror will end and the sleeper will return to normal sleep without your aid.
So, why shouldn’t you wake someone during a night terror?
First and foremost, it can be tough to snap a person awake mid-night terror episode; plus, you may be potentially putting yourself (and the sleeper) at risk of injury in the process of attempting to wake them. Chances are, even if somebody experiencing a night terror does wake up, they’ll be left disoriented and upset, making it difficult for them to get back to sleep.
Configure Bedroom For Potential Sleepwalking
Night terrors may cause sleepwalking. Chances are, nothing will come of it and everything will be fine. Still, the sleeper may pose a risk to themselves and others while experiencing this parasomnia.
To provide peace of mind throughout the night, remove any potentially harmful objects from you or your loved one’s bedroom and keep the room’s doors and windows locked at night. It’s also sometimes a good idea to sleep on the ground, especially if you or the sleeper are worried about rolling off the bed at night.
If your bedroom is on the second floor, keep a gate at the top of any stairways to reduce the chance of falling down the steps. Although taking so many precautions may feel a bit irrational to some, it’s better to be safe than sorry.
When to Address Sleep Concerns With a Doctor
For many, nightmares and night terrors are infrequent and pass on their own, causing no concern. Nevertheless, if you or your family members are having recurring nightmares or night terrors or the sleeper poses a safety risk for themselves or others, we recommend contacting your doctor for assistance. Moreover, if frequent nightmares or night terrors begin to cause excessive daytime sleepiness, we recommend contacting a doctor.
Potential treatments for night terrors and nightmares include cognitive-behavioral therapy (CBT) and biofeedback. If your nightmares are likely caused by post-traumatic stress disorder (PTSD), stress counseling is a possible solution.
Are night terrors a sign of mental illness?
No, night terrors are quite random and do not appear to be correlated to any one mental illness. With this in mind, individuals with anxiety can tend to get night terrors because they commonly struggle with sleeping. This lack of sleep leads to sleep deprivation and sleep disorders, both potential triggers for night terrors. However, the anxiety itself is not what’s causing the night terrors to occur.
How long does a night terror last?
Night terrors can be quite short. They tend to last from 10 to 30 minutes. However, some night terrors can last upwards of 45 minutes.
Are night terrors worse than nightmares?
Neither are night terrors or nightmares are pleasant experiences, though both have different effects on the sleeper and those around them.
Individuals who have night terrors won’t remember it happening. Instead, those around the sleeper—a partner or family member—may see the sleeper sit up, cry out, or thrash about. It can be stress-inducing for your loved ones, but ultimately, the episode will end and you both can sleep soundly.
Contrarily, individuals who have nightmares will likely remember them in detail. Nightmares are stress-inducing and sleepers may wake up suddenly, feeling distressed and unable to go back to sleep. In most cases, however, people who suffer from nightmares can go back to sleep.
At what age do night terrors stop?
Night terrors are most common in young children and they’ll usually outgrow the issue by their teenage years. Though uncommon, night terrors may potentially last through a child’s adolescence and into adulthood. If the night terrors persist to no avail, contact a medical professional for assistance.
What foods cause nightmares or night terrors?
There aren’t any specific foods known to trigger nightmares or night terrors. However, eating meals late at night can upset your stomach and put stress on your body, and this can lead to nightmares or terrors. Heavy, salty, spicy, or sweet foods are common culprits to indigestion and heartburn, including dairy, candy, or fast food. If you’re hungry and want a snack to eat before bed, a light, high-carb food such as crackers is a good option.
Don’t let nightmares or night terrors plague your sleep. Constant sleep disruptions lead to fatigue and difficulty concentrating during the day, though these issues can be resolved if you manage your night terrors and nightmares. By addressing the potential causes of your sleep disturbances, you’ll most likely improve your sleep quality.
Generally, night terrors and nightmares are not a cause for huge concern. If your issues persist, turn to your doctor for professional care.