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A nightmare is a bad dream that usually involves some imagined danger or threat to the child. The child may dream about danger or a scary situation. Nightmares may involve disturbing themes, images, or figures such as monsters, ghosts, animals, or bad people. Loss of control and fear of injury are common themes. Children do not usually cry out or move around while they are having a nightmare. When the child wakes up, he or she calms down and remembers what the dream was about.

Nightmares are different from night terrors. Children with night terrors experience episodes of extreme panic. They are confused and often cry out and move around. During a night terror, waking the child is difficult, and the child often does not remember the dream that caused the terror.

What Causes Nightmares?

Exactly how or why nightmares occur is not known. However, being too tired, not getting enough sleep, having an irregular routine for sleep, and having stress  or anxiety  may all increase the risk of having nightmares. Nightmares can be related to the child’s stage of development. Most nightmares are a normal part of coping with changes in our lives. For children, nightmares could be related to events such as starting school, moving to a new neighborhood, or living through a divorce or remarriage.

Some genetic and psychological factors can also lead to nightmares. About 7% of children who have nightmares have a family history of nightmares (their brother or sister or parents had nightmares). Nightmares are more common in some children, including those with mental retardation, depression, and certain diseases that affect the brain. Nightmares may also be associated with fevers. Some medicines can cause frightening dreams, either during treatment or after the treatment has stopped. Conflicts and stress that happen during the day can affect a child’s sleep and lead to nightmares. Nightmares can also occur after a trauma. These nightmares may indicate post-traumatic stress disorder.

What can you do about your Child’s Nightmares?

  • After a nightmare, comforting your child is the only “treatment” required.
  • You should talk to your child in a relaxed tone.
  • Avoid turning on all the lights and remind your child that you are sleeping nearby.
  • Try helping your child imagine a good or funny ending to a scary dream. Your child will learn to use his or her imagination and to feel safe and in control.
Nightmare prevention

preventing all bad dreams may be impossible, but some steps may help. Remember that your child will experience some stress during the day, but you can help your child relax before bedtime.

  • Establish a bedtime routine that starts at the same time every evening.
  • Make bedtime a safe and comfortable time by reading to your child or relaxing and talking with your child before bedtime.
  • Try using a night-light or singing a lullaby
  • At age 3-6 years (when nightmares are most common), children are just beginning to understand the difference between fantasy and reality. Teach your child that nightmares and monsters are not real.
  • Encourage your child to imagine positive scenarios before bedtime. Talk about positive endings to your child’s nightmares.

If comforting your child and having a relaxed bedtime routine do not help or if your child has more than 2 nightmares per week for several months, getting a psychological evaluation may be necessary. For most children, medications  are not helpful or recommended.


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