Nightmares — we have all experienced them in our lifetime. Some say they are a mirror of our subconscious mind.
The International Classification of Sleep Disorders Third Edition (ICSD-3) and the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) define nightmares as “repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that usually involve threats to survival, security, or physical integrity (1).”
Adults usually have bad dreams when they are disturbed or think deeply about something. But, did you know children also get nightmares? According to studies, 13.5% of nursery-school-aged children have bad dreams at least once per week, and the prevalence of it in seven- and nine-year-olds is 87% and 95.7%, respectively (2).
Nightmares can be disturbing and scary for children. If your child often complains about having nightmares, it is best to understand the cause. Peruse this post as we reveal some noteworthy pieces of information about nightmares in children.
Why Do Children Have Nightmares?
Although the exact cause of nightmares is unknown, children seem to experience more nightmares when they are stressed or scared of something. According to a cross-sectional study conducted on 6,359 children, hyperactivity, frequent temper outbursts, and poor academic performance are associated with recurring nightmares in children (3).
The same study suggests that frequent nightmares could result from various factors, including sleep problems, drastic changes in their lives, family economic status, and the atmosphere at home (3).
Sometimes, children can get nightmares after watching a horror movie or reading a scary book right before bedtime. Children might also experience nightmares when a significant change happens in their life, such as moving away from home, attending a new school, or experiencing a family tension.
Although occasional nightmares may be harmless and subside soon, chronic and recurring nightmares could cause personal distress and indicate a broad spectrum of psychopathological symptoms in children. These symptoms could include elevated anxiety traits, difficult temperament, and emotional and behavioral problems (3).
Nightmares Vs. Night Terrors
Nightmares are often confused with night terrors. Go through this table to learn how these differ (4).
|It occurs during non-rapid eye movement sleep.||It is likely to happen during REM sleep.|
|It is prevalent from two to four years, and rarely after ten years.||The onset is parallel with the development of dreams.|
|Each episode may last for three to five minutes, and the child cannot be easily consoled.||The child can be easily consoled.|
|The child falls back to sleep quickly after the episode.||The child may experience a prolonged period of wakefulness.|
|The child may not recollect the dream.||The child will be able to recollect the dream.|
Signs Of Nightmares In Children
Nightmares usually occur during REM sleep and can be identified with the following signs (5).
- The child will experience feelings of terror, fear, distress, and anxiety.
- The child will abruptly wake up in the middle of the night.
- They will be able to describe the details of the dream.
When To Call Your Doctor?
You should call your doctor if you notice the below signs.
- The nightmares become recurrent and aggressive.
- Your child is afraid to go to bed.
- The episodes are traumatic and interrupt your child’s sleep.
- Your child’s daytime activities are being interrupted.
Diagnosis Of Nightmares In Children
Your child’s doctor would do a thorough physical examination of your child and ask questions about their medical history. You can expect questions regarding:
- The time when the nightmare occurs
- The nature of the nightmare
- The occurrence of symptoms during daytime naps
- Symptoms observed during wakeful times
- Presence of stereotypic or rhythmic movements during the nightmare
In rare cases, your doctor might turn to an electroencephalogram (EEG). In case they suspect an epileptic disorder, they may try to record a video of the nightmare episode (4).
How Are Nightmares Addressed?
Uncomplicated and occasional nightmares triggered by external events usually subside as the child matures. If your doctor assures you that your child doesn’t have any psychological or neurological problems, the nightmares can be reduced by following the below steps.
- Maintain a consistent bedtime routine. To reduce episodes of nightmares, make sure your child follows a consistent bedtime routine. They also need to get the required hours of sleep, preschoolers (3–5 years) need 10–13 hours of sleep, children (6–13 years) need 9–12 hours of sleep, and teenagers (14–17 years) need 8–10 hours of sleep (6).
- Make day time naps shorter. This could help toddlers and preschoolers. If your child sleeps during the daytime, make sure it is not for more than an hour. This will help them stick to their bedtime routine.
- Create a pleasant environment. It is important to create a pleasant and quiet environment for your child to sleep. Keep the room dark and eliminate all distractions and noises. You can also sing a lullaby or tell a nice bedtime story to help them relax and have a good night’s sleep.
- Follow good sleep hygiene. It may also help reduce the frequency of nightmares. Ask your child to take a bath before going to bed. Make sure they have their dinner at least two hours before their bedtime. Also, restrict their intake of fluids one hour from bedtime, and ask them to visit the bathroom before bed.
- Talk to your child. If your child has gone through a drastic change in their life, such as leaving their friends to attend a new school, it might cause stress and nightmares. So, take out some time and sit with them to understand their feelings and assure them it’s okay and everything will be fine soon.
- Do not pamper them excessively. It is true your child is afraid of the nightmares and is having trouble falling asleep. However, you should make sure not to give in and pamper them excessively. Do not allow them to sleep with you. Instead, stay in their room for some time, cuddle and comfort them, and leave as soon as they fall asleep.
- Give them a soft toy or a blanket to snuggle and sleep with.
- Turn on a dim bed light if your child is afraid of darkness.
- Leave their bedroom door open to give them the assurance that they are safe and you are right in the next room.
- Answer their calls immediately if they call out during the night
- Help them overcome fear. Whatever your child’s anxieties are, you can help them get over them. Work along with your child to help them overcome them. You can ask them to write down their fears, rip the paper, and throw it into the dustbin. You can also share your childhood fears and how you overcame them.
- Help them build self-confidence. During their daytime play, include activities that can help boost their self-confidence. You can ask them to tell a story or draw about their fears. Discuss their fears and tell them the reality. You can also reward and appreciate them when they achieve something (4).
Occasional nightmares are common in children, and these could be a part of their developing minds. However, if your child wakes up often due to nightmares, it is important to understand the reason. Repeated nightmares can impact their childhood and development, so do not brush off or ignore your child when they are going through any stressful event. Instead, be there for them and give them time to get used to the change.
2. Valérie Simard, et al.; Longitudinal Study of Bad Dreams in Preschool-Aged Children: Prevalence, Demographic Correlates, Risk and Protective Factors; Sleep Research Society (2008).
3. Shirley Xin Li, et al.; Frequent Nightmares in Children: Familial Aggregation and Associations with Parent-Reported Behavioral and Mood Problems; Sleep Research Society ( 2011).
4. Dr. L Scribante; Nightmares and sleep terrors; South African Family Practice (2007).
5. Night terrors and nightmares; National Health Service UK
6. Jean-Philippe Chaput, Caroline Dutil, and Hugues Sampasa-Kanyinga; Sleeping hours: what is the ideal number and how does age impact this?; Nature and Science of Sleep (2018).
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