It is important to distinguish night terror from nightmare. The word nightmare comes from the old Saxon word mara, meaning demon. Nightmares are true dreams that is, they occur during rapid eye movement sleep, not during deep sleep.

Thus they tend to occur later in the night, usually do not produce much physical reaction as opposed to the loud screaming, flushed face, rapid heart rate and breathing of the night terror.

Nightmares occur when the body is paralyzed in REM sleep and only some twitching is seen and garbled sounds are heard, not the piercing scream that begins a night terror. When a child wakes up after a nightmare, he or she is perfectly wide awake, and able to be reasoned with and talked to normally.

Usually the dream can be remembered in detail even in a young child, if questioning is done soon after the child awakens. With night terror, the child is very difficult awakes. With night terror, the child is very difficult to awaken and rarely will remember specific details and only the feeling of being frightened.

Nightmares are greatly influenced by the particular stressors and anxieties present in the child’s waking life. Typical childhood nightmares include dreams of abandonment of being lost of falling or being chased, bitten, or eaten by a monster or hostile animal.

Dream researchers have observed a developmental progression in the content and frequency of children’s nightmares. A two-year-old dreamer may recall a fearful dream, but be unable to give form to the source of the threat. By the age of five, the frightened young dreamer may identify the attacker as a monster or wild animal. Older children who have developed more of an understanding of real-life dangers report dreams of pursuit by mean or bad people.

When a child is awakened by a nightmare she will soon become fully alert and able to remember the scary dream in elaborate detail, expressing emotions appropriate to the dream content. The frightened child will resist returning to bed and often seek the comfort and reassurance of a parent or caretaker.

Nightmares are different than the non-dream sleep disturbance known as a night terror, which causes only a partial arousal from deep sleep and occurs during the first period of sleep known as slow-wave sleep (SWS). A child experiencing a night terror will be difficult to awaken or comfort, will not recognize her parent or caretaker, and will usually have no memory of the terrifying emotions that caused the sleep disturbance.

Keywords: night terror, insomnia, sleep, sleepless, sleep disorder, rem behavior disorder, sleepwalking, somnambulism

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