Children's Hospital Colorado

Nightmares

What are nightmares?

Nightmares are scary dreams that awaken a child. Occasional bad dreams are normal at all ages after about 6 months of age. When infants have a nightmare, they cry and scream until someone comes to them. When preschoolers have a nightmare, they usually cry and run into their parents' bedroom. Older children begin to understand what a nightmare is and put themselves back to sleep without waking their parents.

What causes nightmares?

The content of nightmares usually relates to the developmental challenges of growing up: toddlers have nightmares about separation from their parents; preschoolers, about monsters or the dark; and school-age children, about death or real dangers. Frequent nightmares may be caused by violent TV shows or movies.

Who gets nightmares?

Everyone has the occasional bad dream because everyone dreams four or five times each night. Some dreams are good, some are bad. Dreams help the mind process complicated events or information. Dream sleep typically happens in the early morning hours, so this is when children are most likely to experience nightmares.

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What are the signs and symptoms of nightmares?

  • Screaming
  • Kicking
  • Fear  

When a child has a nightmare, he or she can tell you what the dream was about and will have memory of the dream. This is different than a night terror, which looks the same, but the child sleeps through the event and has no memory of it.

What tests are used to diagnose nightmares?

While nightmares generally don’t need testing, they are events that occur during the dream stage of sleep (Rapid Eye Movement or REM sleep) and can be detected on a sleep study if needed. Rarely, other medical problems might need to be ruled out.

How do providers at Children’s Hospital Colorado make a diagnosis?

If children have recurrent nightmares, sleep specialists at the Children’s Colorado can provide testing and treatment, which includes counseling with our sleep psychologist.

Call your child's physician during office hours if:

  • The nightmares become worse.
  • The nightmares are not minimal after 2 weeks.
  • The fear interferes with daytime activities.
  • Your child has several fears.
  • You have other concerns or questions.

How are nightmares treated?

A close-up view of a baby's arm and hand.

To help your child work through recurring nightmares, try following these steps:

  • Reassure and cuddle your child.
    • Explain to your child that he or she was having a bad dream.
    • Sit on the bed until your child is calm.
    • Offer to leave the bedroom door open (never close the door on a fearful child).
    • Provide a night-light, especially if your child has fears of the dark. Most children return to sleep fairly quickly.
  • Help your child talk about bad dreams during the day.
    • Your child may not remember what the dream was about unless you can remind him of something he said about it when he woke up.
    • If your child was dreaming about falling or being chased, reassure her that lots of children dream about that.
    • If your child has the same bad dream over and over again, help him imagine a good ending to the bad dream.
    • Encourage your child to use a strong person or a magic weapon to help her overcome the bad person or event in the dream.
    • You may want to help your child draw pictures or write stories about the new happier ending for the dream.
    • Working through a fear often takes several conversations about it.
  • Protect your child against frightening movies and TV shows.
    • For many children, violent or horror movies cause bedtime fears and nightmares.
    • These fears can persist for months or years.
    • Strictly avoid these movies before 13 years of age.
    • Between 13 and 17 years, the maturity and sensitivity of your child must be considered carefully in deciding when he is ready to deal with the uncut versions of R-rated movies.
    • Be vigilant about avoiding frightening media at slumber parties or Halloween parties.
    • Tell your child to call you if the family he is visiting is showing scary movies.

Why choose Children’s Hospital Colorado for your child’s nightmares?

The Children’s Colorado Sleep Team is an excellent resource for treating children and adolescents with sleep disorders. Our providers are known internationally for their expertise in sleep research and sleep treatments. Our team is made up of sleep specialists trained in different aspects of sleep treatments, including sleep physicians who specialize in children’s breathing issues and children’s ear-nose-and throat problems, a sleep-specialized psychologist, two sleep-specialized nurse practitioners, a sleep-specialized respiratory therapist and a dedicated sleep nurse.

Our sleep psychologist is specifically trained in helping families and children who suffer from recurring, disruptive nightmares. Using the techniques listed above, as well as other cognitive behavioral strategies, we help children learn to calm their own fears and get the restive sleep they need to support development.

Sleep specialists at Children’s Colorado often coordinate care with other specialists and primary care physicians involved in each family’s treatment. Most importantly, we have very caring staff members who are willing to listen to families and “go the extra mile” to improve your child’s sleep and optimize development.


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