Is It a Nightmare or Night Terror? Here’s How to Tell Them Apart

Nightmares are vivid, distressing dreams, whereas night terrors are episodes in which you partially arise from sleep and may thrash or scream. Nightmares occur far more often.

Though the terms may seem interchangeable, nightmares and night terrors are distinct phenomena.

Nightmares are powerful dreams that can trigger intense fear, anger, or disgust. You usually remember them clearly. They’re common, but they’re only classified as a mental health disorder if they interfere with your daytime functioning.

Night terrors, sometimes called sleep terrors, are events during which you partially awaken from slow-wave sleep. They typically involve overt signs of extreme distress, such as screaming or wildly moving your limbs. You’re unlikely to recall them afterward, though a broken lamp or an alarmed housemate may signal that an episode occurred.

Continue reading for a concise guide to distinguishing nightmares from night terrors.

Nightmares vs. night terrors

Here’s a quick summary of the main contrasts between nightmares and night terrors:

What causes nightmares?

A number of influences can lead to nightmares, including:

Stress and trauma

Nightmares often reflect stress or traumatic experiences from waking life. One theory posits that nightmares serve as a way for the brain to simulate threats and practice responses.

Your nightmare might not mirror the real-world danger exactly. Instead it can be a symbolic, simplified version. For instance, if you fear losing touch with old friends, you might dream of a flood sweeping you away from your community.

Nightmares are common after trauma. About half of people seeking help for post-traumatic stress disorder (PTSD) report replicative nightmares that force them to relive the traumatic event. These recurring dreams can be highly distressing and can disrupt sleep dramatically.

Early childhood experiences

The stress acceleration hypothesis suggests a large portion of brain development occurs before age 3½. If a child encounters a distressing event, the brain may accelerate the maturation of fear-related systems. As an adult, the brain might then be less adept at regulating negative emotions during sleep, increasing susceptibility to nightmares.

The triggering experience needn’t be abuse; it only needs to provoke a significant stress response. For example, a severe case of diaper rash may be traumatic for an infant encountering intense pain for the first time.

Medication

Some drugs raise the likelihood of nightmares. These include:

• Beta-blockers, which are used for high blood pressure and irregular heartbeat.
• Dopamine agonists, which mimic dopamine’s effects to treat several conditions.
• Selective serotonin reuptake inhibitors (SSRIs), commonly prescribed antidepressants for depression and anxiety.

What causes night terrors?

Night terrors usually occur during deep sleep — the slow-wave phase — when brain electrical activity is dominated by larger, slower waves.

People prone to frequent night terrors often show mismatched brain-wave activity during this stage. When these waves clash, you can be pushed into a semi-awake state. Your body can switch from calm to highly activated — racing heart and tense muscles — while your conscious awareness remains offline.

Several elements can increase susceptibility to night terrors: Genetics. The HLA-DQB1*05:01 gene variant appears more often in people with sleep terrors. Family history. If you have night terrors, there’s a high likelihood a relative has similar sleep disturbances, such as night terrors or sleepwalking. Sleep disruption. Conditions like restless legs syndrome, sleep apnea, or fever can interrupt deep sleep and disturb brain-wave patterns. Medication. Drugs like lithium and sodium oxybate (Xyrem) may deepen sleep and raise the frequency of night terror episodes.

How common are they?

Nightmares are considerably more common than night terrors. Both occur more frequently in childhood than in adulthood.

Nightmares

As many as 75 percent of children report having experienced at least one nightmare. A 2016 study of kindergarteners indicates children may have nightmares more often and find them more upsetting than many parents assume.

Nightmares often begin around age 3 and typically decline after about age 10.

Adults report nightmares less frequently, though some experience them regularly. Between 35 and 45 percent of adults have nightmares at least monthly, while 2–6 percent have them weekly.

Roughly 4 percent of adults meet criteria for nightmare disorder, marked by vivid, upsetting nightmares. Other signs include:

• intrusive thoughts about the dreams
• waking anxiety that lingers into the day
• daytime tiredness from fragmented sleep
• hesitance to fall asleep due to fear of future nightmares

Night terrors

Night terrors are most common in early childhood, then decline quickly with age.

A 2015 Canadian study tracked 1,940 children from 18 months to 13 years and found 56 percent had experienced night terrors at some point.

• At 18 months, 34.4 percent of children had night terrors.
• By age 5, only 13.4 percent still experienced them.
• At 13 years, just 5.3 percent continued to have night terrors.

It’s uncommon to develop new night terrors after age 5; in the study, only 16.5 percent reported a first episode after that age. Most older children with night terrors had earlier histories of them.

By adulthood, only about 1–2 percent experience night terrors, and they’re most frequent before age 25.

Evidence suggests adults with night terrors are likelier to have anxiety or depression histories. It’s not clear whether mental health issues cause night terrors or if disrupted sleep worsens mental health — both directions are plausible.

How to recognize them

Nightmares and night terrors can resemble other sleep-related events. Here’s how to differentiate them.

Nightmare vs. bad dream

Nightmares typically evoke a clear sense of threat, while bad dreams are unpleasant but less fear-driven. A dream that awakens you with fear is likely a nightmare. Bad dreams often fail to rouse you, so you may not recall them well in the morning.

Nightmare vs. night terror

Most nightmares happen during REM sleep — often in the early-morning hours if you sleep at night — and you usually wake lucid and can recount the dream.

Night terrors occur during deep sleep, earlier in the night. They can last from about 30 seconds to 5 minutes, after which you often return to sleep. You’re unlikely to remember the episode the next day.

If you share a room, someone else might remember your night terrors. They’re often unmistakable because they can involve:

• screaming or loud crying
• violent thrashing or flailing
• rapid heartbeat
• rigid muscles
• heavy sweating

Sweaty bedding or oddly broken items can also hint at a night terror.

Night terrors vs. sleepwalking

Sleepwalking involves performing basic actions — leaving the bed and moving about the house — without conscious awareness. Like night terrors, it stems from disruptions in brain-wave activity during NREM sleep.

Night terrors are more associated with distress than purposeful movement. You might thrash in bed, but you generally won’t wander off. Sleepwalking usually lacks intense emotion, and actually getting out of bed is a distinguishing sign.

In the 2015 study, sleepwalking was less common than night terrors: around 29 percent of participants sleepwalked at least once, compared with 56 percent who had night terrors.

How to handle sleep disruptions

Although nightmares and night terrors are different, many triggers overlap. You can reduce the chance of experiencing them by:

• managing daytime stress
• avoiding alcohol and recreational drugs before bed
• keeping a dark, quiet bedroom and practicing good sleep hygiene
• ensuring you get adequate nightly sleep

See a list of 17 tips to improve your sleep.

Helping children cope

Young children distressed by nightmares may need calming support. Comfort them after a nightmare with soothing words, hugs, or a favorite toy.

After they’ve settled, try leaving the doors to their bedroom and your bedroom open. This can help them feel you’re nearby and accessible, which may encourage them to stay in their own bed rather than climbing into yours.

With night terrors, talking to a child during the episode is often ineffective. They may be hard to rouse, and shaking or shouting can heighten their panic. Unless they risk hurting themselves, it’s usually best not to intervene aggressively.

If they wander, wait a few minutes for the episode to pass, then gently escort them back to bed. They’ll likely resume normal sleep fairly quickly. If the child remains in bed during the terror, soothe them back to sleep with a soft song or quiet reassurance.

When to seek professional help

Occasional nightmares or night terrors generally aren’t alarming unless they’re frequent and interfere with daily life.

Consulting a therapist or sleep specialist may help if you experience:

• Sleep deprivation. Adults may show irritability and memory problems; children may have tantrums.
• Fear of sleep. Adults might delay bedtime or develop insomnia; children may refuse to go to bed.
• Ongoing stress. Waking-life anxiety often spills into sleep. Child nightmares often focus on concrete physical threats, while adult nightmares are more likely to reflect abstract or social concerns.
• Injury risk. Night terrors can lead to adults striking others, breaking objects, or colliding with furniture; children may bruise themselves on cribs or fall from beds.

Treatment for nightmares

Therapy for nightmares can identify likely triggers and help you process related emotions.

For example, if a child’s nightmares stem from their parents’ divorce, family therapy might help the child address abandonment fears. Once anxiety eases, the brain will likely stop replaying such scenarios in sleep.

For recurrent, trauma-related nightmares, the American Academy of Sleep Medicine recommends image rehearsal therapy. You recall the recurring nightmare’s storyline, then work with a therapist to create a more positive ending and rehearse it mentally. This approach can make the dreams less distressing over time.

Treatment for night terrors

Scheduled awakenings are a common solution for young children because night terrors often occur around the same time nightly.

For instance, if your child’s night terrors usually happen at 10 p.m., briefly waking them at 9:45 p.m. can interrupt the sleep cycle and prevent the episode.

For older children and adults, behavioral therapies that reduce stress and enhance sleep quality can help. Although research is limited, therapies that may be considered include:

• psychotherapy
• relaxation techniques
• hypnosis

Some studies indicate low-dose clonazepam (around 0.5–1.0 mg daily) might reduce night terrors, but evidence is limited. Clinicians usually avoid medication for night terrors unless there’s a significant risk of physical harm during episodes.

The bottom line

Nightmares are upsetting dreams you can usually recall upon waking, while night terrors are abrupt episodes of screaming and thrashing that you typically won’t remember.

Children are more likely to experience these disturbances, but adults can too. Treatment often focuses on stress reduction, trauma processing, and sleep improvement.

Knowing that occasional nightmares or night terrors are usually not dangerous can be somewhat reassuring, though they can still feel frightening. If you or someone you care about has endured difficult nights recently, it’s understandable to want extra comfort.