Doctors’ Notes



As many parents can attest, there are many things that can cause a child to wake up during the night. However, one of the most frightening things for a child (and a parent) is waking up because of a nightmare.

Nightmares are scary dreams that usually happen during the second part of the night (when REM sleep occurs). They commonly occur in children between ages 3 and 5 years. Roughly 25-50% of children aged 3-5 experience nightmares.

Nightmares are not the same as night terrors, from which it is often difficult to wake a child. (It may be helpful to read Dr. Wolynn’s excellent Note on Night Terrors, so you can better understand the differences between the two.)  In the case of nightmares, children are usually wide awake after one of these episodes. Your child can usually describe the dream in great detail and even talk about it the next day. Your child may also seek out and be soothed by your presence. She may also have problems falling back to sleep after experiencing a nightmare.

Similar to night terrors, nightmares may occur after a long, tiring day. Nightmares can also be triggered by stress, trauma, anxiety, or some medications. Some kids, especially those with good imaginations, may experience nightmares after watching scary movies or TV shows, or even reading a scary story.

A whole host of characters and events may be present in your child’s nightmares, including monsters and other imaginary creatures, bad guys, animals, or even friends or family members. During the episode, your child may dream about being chased, gobbled up, lost, or punished. Nightmares may also include pieces of normal day-to-day activities, but with a scary twist.

Preventing Nightmares

Here are some good tips to help reduce the occurrence of nightmares:

• Have regular bedtimes and wake-up times;

• Have a sleep routine that helps your child wind down before bedtime. This may include a warm bath, snuggle time, a bed-time story, or some quiet chit-chat to talk about the fun things they did that day;

• Keep your child’s bedroom cozy and peaceful. Make sure they’re comfy in their bed, keep a favorite stuffed animal nearby, and try putting a night light or dream catcher in their room to keep the monsters and scary dreams away;

• Avoid scary movies, TV shows, and stories before bedtime;

• Reduce stressors to the best of your ability;

• Try to explain to your child that nightmares aren’t real, and that they’re dreams can’t hurt them. This may be harder for younger children to understand, especially since nightmares can seem so real.

What to Do After a Nightmare

Sometimes it’s impossible to prevent a nightmare, but the following tips may help your child cope with a nightmare a little easier:

Reassure your child that you’re there for him and offer comfort.

Do some magic. Many young children have vivid imaginations. Having a bottle of pretend monster spray to spritz around their room before bed or after experiencing a nightmare may ease your child’s troubled thoughts. Other more classic things like checking under your child’s bed or in her closet may also reassure her that everything is safe and sound.

Mood lighting: night lights in your child’s room or in the hallway can help kids feel safer in dark rooms. Keeping a flashlight by their bedside may also be a good way to chase away monsters and other scary thoughts.

Be a good listener. Sometimes all your child needs is someone to help him feel safe and protected. No need to talk in depth about the dream in the wee hours of the morning — save that for the daytime. Have your child draw out his dream or write about it (if he can). Many times, the daylight makes those scary images lose their power.

Keep a sleep diary. This may be more useful if your child seems to have a lot of nightmares, or you’re concerned about your child’s nightmares. Keep a log of where your child sleeps, how long she sleeps, how long it takes to fall asleep, what she needs to fall asleep (blankets, toys, etc.), how you comfort and console her after a bad dream, nap times and length of naps, and any changes or stressors that may be occurring in the home. Presenting this to your child’s doctor may help them better understand how to help her sleep better.

Though nightmares may be very stressful for you and your child, remember that this is a common problem for many children. Offering your love and support to your child may help them more than you realize. If you still have questions and concerns about nightmares, the providers at Kids Plus can also offer some other great resources on handling them!

Autumn Hodapp, PA-S, spent a rotation from Slippery Rock University with us at Kids Plus.