Night terrors in babies and toddlers, as parents often call them, are partial awakenings from deep sleep, most often in the first few hours of the night. Your child screams, looks terrified, doesn't recognise anyone, then falls back asleep and remembers nothing. They can start from 18 months, are common between two and a half and six years old, and almost always go away on their own. The right response is to stay close without waking your child, make the room safe and wait for the episode to pass.
Below, we explain how a night terror differs from a nightmare, what to do, which factors make episodes more likely, and when it's worth getting medical advice.
Night terrors in babies and toddlers: what does an episode look like?
The episode starts suddenly, usually two to three hours after your child falls asleep. They sit up or thrash about, scream, have their eyes open, their face full of fear, their heart and breathing racing. They often push away the parent trying to comfort them, talk incoherently or don't respond at all. The episode lasts a few minutes, sometimes longer, then your child lies back down and sinks into calm sleep. The next day, they remember nothing.
Researchers at the Centre d'études avancées en médecine du sommeil in Montreal (a sleep medicine research centre) wrote a review for the Encyclopédie sur le développement des jeunes enfants (an encyclopaedia on early childhood development). In it, they describe night terrors as “episodes of partial arousal from deep slow-wave sleep” that “start from 18 months and occur early in the night”. The child “is sometimes inconsolable”. It's the opposite of waking up: the brain stays in deep sleep while the body is agitated.
Night terror or nightmare: how can you tell the difference?
The two are often confused, but they work differently and call for a different response.
- The time of night. A night terror happens early in the night, during deep slow-wave sleep. A nightmare tends to happen in the second half of the night, during REM sleep, the dreaming phase.
- Your child's state. During a night terror, your child is still asleep: they don't recognise you and can't be comforted. After a nightmare, they're awake, look for you and calm down in your arms.
- Memory. In the morning, your child doesn't remember a night terror. They will often tell you about a nightmare, though, at least from the age of two or three.
- Getting back to sleep. After a night terror, your child falls back asleep quickly and on their own. After a nightmare, they need reassurance and may refuse to lie back down.
The Société canadienne du sommeil (Canadian Sleep Society) sums up the difference in a leaflet from the Centre du sommeil de l'Atlantique: night terrors are a “sudden arousal from deep sleep occurring early in the night”, which people “generally do not remember on waking in the morning”. Nightmares are “elaborate dreams with frightening content” that wake the sleeper.
At what age do night terrors appear?
They can start from 18 months, but they mainly affect preschool children. The Quebec review quoted above draws on a cohort of children followed from 2½ to 6 years old. Over that period, 39.8% of them had night terrors at least once. That figure tells us two things: night terrors are common, and a one-off episode doesn't point to any disorder.
Before 18 months, a baby who screams at night without really waking up is more often having a confusional arousal. It could also be waking linked to teething, a fever or separation anxiety, which peaks at around eight months. The classic picture of night terrors, dramatic and with complete amnesia, tends to emerge between two and four years old.
Nightmares follow a different timeline. The same Canadian leaflet states that “1% to 4% of parents report that their preschool children have nightmares often or always”. They become more frequent from childhood to early adolescence. As imagination develops and language allows children to describe things, the nightmare becomes something your child talks about.
What should you do during a night terror?
The advice below reflects that of paediatric services and sleep specialists. It's simple, and counter-intuitive on one point: don't wake your child.
- Don't wake them. Waking your child mid-episode leaves them disorientated and frightened, and often makes it last longer. The paediatric service Nemours KidsHealth puts it plainly: “don't try to wake your child”.
- Stay close, calmly. Sit beside the bed and speak softly, if you speak at all. Holding them firmly or picking them up can sometimes increase the agitation.
- Keep them safe. Make sure they can't hurt themselves by thrashing about or getting up: cot sides up, nothing hard within reach, bedroom door and stairs secured if they're walking.
- Wait. The episode ends on its own, usually within a few minutes. Your child lies back down, or lets you settle them, without any resistance.
- Don't bring it up the next day as if something serious had happened. Your child has no memory of it and doesn't need to be worried.
After a nightmare, the response is different: your child is awake and needs you there, reassuring words and soft light. For recurring nightmares, the Montreal specialists suggest letting your child tell or draw their dream, then imagining a different ending together.
What makes night terrors more likely?
The main factor is lack of sleep. The Encyclopédie sur le développement des jeunes enfants review lists “fatigue, sleep deprivation, a noisy environment, fever, certain medications” as well as sleep apnoea. Dropping a nap too early, several late bedtimes in a row or a night cut short by a journey are often enough to trigger a run of episodes.
Fever is a classic trigger: a child who is coming down with an infection may have a night terror the night before. Our article on fever in babies covers what to do and when to see a doctor.
There is also a family component. Night terrors and sleepwalking share the same predisposition: according to the same source, one sleepwalking parent triples the child's risk, and two sleepwalking parents multiply it by seven. On the other hand, the authors note that sociodemographic factors and family adversity have little or no influence: a night terror is not a sign of emotional distress.
How can you reduce how often episodes happen?
There is no treatment, but a few simple steps make a clear difference to how often they happen.
- Make sure your child gets enough sleep. Protect the nap for as long as your child needs it, and bring bedtime forward rather than pushing it back. Our guides to organising naps and to young children's sleep needs give rough figures by age.
- A short, predictable bedtime routine. Bath, story, low light, in the same order every evening. For many children, the evening bath marks the transition to night-time.
- A quiet room at a comfortable temperature. Noise and heat break up deep sleep. A temperature of 18 to 20 °C and a steady background sound level help.
- Plan ahead for high-risk periods. Travel, the clocks changing, illness, dropping the nap: these are the weeks when episodes come back. An earlier bedtime during these periods is often enough.
- Scheduled awakenings, for children whose night terrors happen at the same time every night. The method, described by the Montreal specialists, involves noting the time of the episodes for two to three weeks, then gently waking your child fifteen to thirty minutes beforehand, for about a month. It should be set up with advice from a professional.
When should you see a doctor about night terrors?
In the vast majority of cases, reassuring the parents is enough: parasomnias in early childhood are “benign and transient”. Medical advice is worthwhile in the following situations, listed by Nemours KidsHealth and by sleep specialists.
- Episodes last more than thirty minutes, or happen more than once a week over a long period.
- Your child gets hurt or risks getting hurt during episodes, or leaves the bedroom.
- They snore loudly, breathe through their mouth, sweat a lot at night or seem exhausted during the day: sleep apnoea can keep night terrors going.
- During the episode, you notice stiffening, rhythmic jerking or heavy drooling: these signs are not part of a night terror and should be shown to a doctor.
- Your child seems sad, anxious or very stressed during the day.
- Episodes continue beyond school age or start in a child who has never had them before.
Your GP or paediatrician will first look at your child's sleep as a whole, then refer you to a specialist if needed. In the meantime, a simple diary of episodes, with bedtime, the time of the episode and what happened during the day, is a great help to the doctor.
Key takeaways
A night terror is frightening for the parent and harmless for the child. It happens early in the night, from 18 months and mostly between two and six years old, and your child doesn't remember it. Don't wake them: stay close, keep them safe, wait. Prevention comes down to one main thing: enough sleep, on a regular schedule. See a doctor if episodes are long, frequent, dangerous or come with unusual signs.
Sources
- Petit D., Montplaisir J., “Parasomnies de la petite enfance”, Encyclopédie sur le développement des jeunes enfants, Centre d'études avancées en médecine du sommeil, Université de Montréal, revised edition, November 2020.
- Nemours KidsHealth, “Night Terrors”, medically reviewed by Amy W. Anzilotti, July 2023.
- Société canadienne du sommeil, Centre du sommeil de l'Atlantique, leaflet “Rêves et cauchemars”, revised 21 May 2020.
