Nightmares are emotionally upsetting dreams that cause a child to wake up from sleep. While they can be scary, childhood nightmares are common. Around 60% to 75% of children experience the occasional nightmare.
When a child wakes up from a nightmare, they may be upset and have trouble going back to sleep, leaving many caregivers wondering about how best to help a child after a nightmare. While there isn’t a way to prevent nightmares in children, there are steps that parents and caregivers can take to help children cope and get back to bed.
When Do Kids Start Having Nightmares?
Children usually start having nightmares between the ages of 3 and 6, but nightmares can start as early as 2 years old. The frequency of nightmares tends to decrease as children get older, with fewer children reporting nightmares into their teens.
What Causes Nightmares in Children?
Childhood nightmares are driven by activity in the brain, though researchers aren’t exactly sure why kids have nightmares. In fact, why people dream at all is still a matter of scientific debate. Current theories suggest that nightmares may be related to processing emotions or due to a heightened level of activity in the nervous system.
Studies have found several contributing factors that make having a nightmare more likely.
- Daytime stress: Dreaming may be one of the ways the brain sorts through stressful events from the day. When stress from the daytime carries into the night it can lead to bad dreams. For instance, nightmares frequently occur in children with stress disorders like post-traumatic stress disorder (PTSD).
- Medication: Some medications may cause nightmares, including certain antidepressants, antihypertensives, and antihistamines.
- Anxiety: Childhood anxiety is associated with more frequent nightmares. Nightmares are also more common in children with generalized anxiety disorder and separation anxiety.
- Medical conditions: Several medical conditions are associated with nightmares in children, including fevers and diseases of the central nervous system. Children with an intellectual disability are also at an increased risk of nightmares.
How Do Nightmares Affect Children?
Nightmares can disrupt a child’s sleep by waking them up and triggering feelings of fear and anxiety. This can further interrupt their rest by making it difficult for a child to fall back asleep. Children with frequent nightmares may start to resist being put to bed, scared of experiencing another nightmare.
Children typically have nightmares in the early morning during a stage of sleep called rapid eye movement (REM) sleep. During a nightmare, a child may experience physical symptoms such as an elevated heart rate and rapid breathing.
While most children have occasional nightmares, less than 5% experience them on a regular basis. When nightmares persist and lead to other challenges, a child may be diagnosed with nightmare disorder. Nightmare disorder involves recurrent unpleasant dreams that interrupt sleep and lead to emotional, behavioral, or other disruptive symptoms.
Nightmares vs. Night Terrors
Night terrors are a sleep disorder in which a child awakens abruptly with intense distress. During these episodes, a child may wake up and yell, flail uncontrollably, and appear unaware of their environment. Night terrors typically last for less than 20 minutes and children are usually able to quickly fall back asleep. Most children will not remember the experience of a night terror the next day.
Both nightmares and night terrors are common in children. Up to 40% of children between the ages of 2 ½ to 6 years experience night terrors, though estimates vary widely.
Unlike nightmares, night terrors are usually short bursts of intense emotions that are forgotten by morning. Nightmares typically happen early in the morning before getting up, while night terrors generally occur earlier in the night after falling asleep.
How to Help Children with Nightmares
In most cases, helping a child with nightmares involves offering reassurance and support. However, in cases of frequent nightmares or extreme distress, it can be helpful to consult a child’s pediatrician.
Coping with Nightmares
The first thing to do when a child experiences a nightmare is to offer comfort. Listen to the child’s experience and reassure them that the nightmare is over, it wasn’t real, and that they are safe. If the child finds the nightmare particularly distressing, it may help to have them draw a picture of the dream or imagine a less distressing outcome.
Once a child has a nightmare, they may find it hard to get back into bed. Caregivers can help the child feel safe by offering them a favorite toy to sleep with or by taking additional time to talk or read until the child feels sleepy again.
Although nightmares are a normal part of childhood that can’t always be prevented, there are steps that parents and caregivers can take to reduce their frequency and impact.
- Reduce daytime stress: Caregivers can help children cope with stress by creating comforting daily routines, listening, and helping them develop skills to solve challenges on their own. Caregivers can also encourage regular physical activity and discuss in advance any large changes to a child’s routine.
- Limit evening TV: Experts recommend stopping children’s access to television within about two hours of bedtime to limit its effect on their dreams. Caregivers should also consider the type of content that children are exposed to, as violent or scary shows, books, or games may increase the chances of nightmares.
- Encourage healthy sleep habits: Good sleep hygiene protects against stress and supports children’s emotional health. For better sleep, caregivers can help children avoid caffeine, stimulants, and be encouraged to maintain a consistent bedtime routine.
Frequent nightmares should be addressed with the help of a doctor. Doctors may recommend therapeutic approaches for recurrent nightmares, such as hypnosis, cognitive behavioral therapy (CBT), or image rehearsal therapy, a talk therapy in which a child is asked to recall a recent nightmare while changing key aspects of the story.
When to Talk to a Doctor
When nightmares occur more than once or twice a month, or if they make it difficult to get sufficient sleep, a child may benefit from a trip to the doctor or a mental health provider. A health professional can help find the root cause of a child’s bad dreams, provide reassurance, and recommend any necessary treatment.