Nightmares and Other Sleep Problems in Children

A good night's sleep helps your child to grow, to form memories, and to learn. Sleep helps your child stay alert and focused at school and play.

Children who don't get enough sleep over time can have behavior problems and trouble learning. They may become moody, sad, or angry.

Most sleep problems occur when the child is only partly asleep. Problems may include:

• Sleep talking. Your child may talk loudly or shout for a few seconds and then fall back asleep. You may not be able to understand what your child says. Sleep talking is more common than sleepwalking, although some children do both.
• Nightmares. These are very common in preschool and school-age children. Your child may cry out for your comfort or go to your room after a nightmare. The child usually can be reassured and calmed.
• Confusional arousals. Your child may wake up crying, confused, and groggy. Your child may not recognize you or be comforted. As with sleep talking, your child may say mixed-up words that make no sense.
• Night terrors. Night terrors are more intense than confusional arousals or nightmares. They are not very common, but they can be very upsetting for parents. Your child may suddenly scream or yell in a terrified way. Your child may thrash around in bed. A night terror can go on for many minutes. Your child may not recognize you and won't be comforted.
• Sleepwalking. Your child may walk around their room or the house. Your child's eyes may be open, but your child is still asleep. Children who sleepwalk often can do very simple tasks, such as walking around furniture. But they can't do more involved things, such as eating a snack. Children may be in danger if they try to walk out of the house or climb out a window while sleepwalking.

Children spend more time than teens and adults in a deep stage of sleep that happens early in the night. Sleep problems such as night terrors often happen during the change from this phase of sleep into lighter sleep. Nightmares tend to occur later in sleep, in the early morning hours when children are dreaming.

It may take some time for your child to go back to sleep. Children usually remember a nightmare, but they don't tend to remember night terrors, confusional arousals, or sleepwalking.

What can you do to help your child?

Try these tips to care for a child who has nightmares.

• Avoid reading scary stories and watching scary programs. Scary stories and programs can cause your child to worry.
• Comfort your child with a hug and calming words. Remind your child that the nightmare isn't real.
• Ask your child to talk about anything they are worried about. Your child may remember the nightmare and want to talk about it. Worries and stress may make nightmares or other sleep problems more likely.

Most children who have night terrors or confusional arousals don't want comfort from parents. They usually will fall back asleep when it's over, and they won't remember the event the next morning. But a night terror can be very upsetting to watch.

• Don't try to wake up your child. Your child may become more confused and scared.
• Try to stay calm. In a short time, your child will probably fall back asleep.

These tips can help when you have a child who sleepwalks.

• Don't try to wake up your child while sleepwalking. Your child may become confused and upset and have more trouble getting back to sleep.
• Gently and quietly lead your child back to bed.
• Make sure all doors and windows are locked so your child can't leave your home. Put a gate at the top of stairs.
• Use a bed alarm, and put an alarm on your child's door. These will alert you when your child gets out of bed or leaves the bedroom.
• Try waking your child 15 to 30 minutes before sleepwalking usually occurs. Because sleepwalking usually happens at the same time at night, it may help to wake your child before the problem usually occurs. Then let your child fall back asleep. This may break the cycle of the sleep problem.

Talk with your child's doctor if these strategies do not help.

Watch closely for changes in your child's health, and be sure to contact your doctor if:

• Your child continues to have sleep problems.