Nightmares in Children

Nightmares are a natural part of childhood, and many children experience them at one stage or another. Although they can be distressing and frightening for children and parents alike, understanding them and knowing how to respond allows you to give your child reassurance, calm and better sleep.

What are nightmares?

Nightmares are vivid, distressing dreams that occur during dream (REM) sleep. They can bring feelings of fear, anxiety or sadness, and may cause a child to wake suddenly with a racing heart, sweating and a fear that lingers after waking. Unlike night terrors, children usually remember the content of a nightmare and are aware that they woke from a frightening dream.

What’s the difference between nightmares and night terrors?

The two are often confused but are quite different. Nightmares happen during REM sleep, usually in the later hours of the night, and the child remembers the dream and can be comforted. Night terrors happen during deep (non-REM) sleep, usually in the first hour or two after falling asleep; the child appears terrified but is not truly awake, is hard to console, and has no memory of the event in the morning. You can read more on our night terrors page.

What causes nightmares in children?

Nightmares can have many causes, including:

• Developmental stage — nightmares are more common at preschool and school age, as imagination and thinking skills develop.
• Stress and anxiety — worries, fears or emotional pressures (such as starting a new setting, family changes or conflict).
• Exposure to frightening content — books, films, games or news that are not age-appropriate.
• Illness or medication — some conditions and medicines can affect sleep quality.
• Lack of sleep — tiredness, irregular hours or insufficient sleep raise the risk of nightmares.

It is worth noting that nightmares can sometimes be part of an anxiety difficulty. Children with general anxiety, separation anxiety, heightened worry or difficulty regulating emotions may have recurring nightmares that reflect their emotional world and everyday fears. In these cases, nightmares are not just a sleep phenomenon but a night-time expression of emotional distress.

How can you help a child cope with nightmares?

Helping a child with nightmares starts with a calm, supportive response:

• Reassure and provide safety — explain that it was a dream and that they are safe; a hug and a calm presence help a great deal.
• Encourage sharing — allow your child to talk about the nightmare and make space for their feelings.
• A calming bedtime routine — a consistent wind-down with pleasant activities such as reading, a warm bath or breathing exercises.
• Manage content — reduce exposure to frightening material, especially in the evening.
• A supportive sleep environment — a pleasant, familiar, quiet room, with a night light if needed.
• Coping tools — encourage your child to imagine a different, positive ending to the nightmare, or use a comfort object or “dream catcher” as a reassuring symbol.

When nightmares are linked to anxiety, treatment also addresses the sources of that anxiety: identifying worries, changing threatening thoughts, strengthening a sense of safety and building skills in relaxation and emotional regulation.

When should you seek professional help?

Most nightmares are temporary and can be managed at home. It is worth seeking a professional assessment when nightmares are frequent, intense or recurring on the same theme, when they come with daytime fears, reliance on a parent or avoidance, or when they affect sleep quality or daily functioning. A clinical assessment helps determine whether nightmares are a passing sleep phenomenon or part of a broader emotional difficulty, and allows for focused, effective treatment that is drug-free.

This online clinic is led by Dr Jonathan Kushnir, a clinical psychologist (HCPC PYL042430) whose doctorate examined sleep disorders and night-time fears in children, with more than 25 academic publications and 17 books.