Parenting Advice From Your Physicians at Kaiser Permanente

Night terrors can be scary for a parent to witness, but the first thing I want you to know is this: your child is safe.

I’ve been there—awakened in the night by a screaming, inconsolable 3-year-old, wishing I could comfort him somehow. Even as a pediatrician, I felt helpless in those moments. The good news is that night terrors are usually harmless, and most children outgrow them naturally. Here is a guide to understanding night terrors:

What Are Night Terrors?

Night terrors usually occur in toddlers and preschoolers. They tend to happen in the first part of the night, when sleep is deepest. During an episode, a child might suddenly sit up, cry or scream, breathe fast, sweat, or look scared and confused. They often don’t recognize you or respond to your comforting, and the next day, they don’t remember them happening.

It’s easy to confuse night terrors with nightmares. Nightmares usually happen later in the night, during dream-filled sleep. After a nightmare, children are alert and respond to your comforting and often remember the experience the next day. Night terrors, by contrast, occur in deep sleep, and your child has no memory of them.

Why Night Terrors Happen

To learn more about night terrors, I talked with my colleague Dr. Iqbal Rashid – a specialist in pediatric sleep disorders. He explained that they can be triggered by anything that causes a child to have poor quantity or poor quality of sleep. Night terrors happen when a child’s brain “partially wakes up” from deep sleep.

Genetics seem to play a role, as these episodes often run in families. Other factors can contribute, such as:

• Not getting enough sleep or having an inconsistent sleep schedule
• Stress or big life changes (like travel, which often triggered episodes in my own child)
• Fever or illness
• Certain medications (including some antihistamines)
• Breathing problems during sleep, like snoring or pauses in breathing

Even though they can be frightening to watch, night terrors are usually harmless, and most children outgrow them naturally. And be reassured: you haven’t done anything to cause night terrors, and they aren’t caused by any trauma your child has experienced.

How to Support Your Child When They Have a Night Terror

The most important things you can do during a night terror are stay calm, remind yourself that your child will be okay, and focus on safety. Remove anything nearby that could cause injury and gently guide them back if they get out of bed.

Reassure your child that they are safe, but remember that they probably can’t be “comforted” in the usual way. They aren’t aware of what’s going on, and they may even try to push you away if you try to hug or reassure them – which is so hard to experience as a parent! Trying to wake or restrain them can sometimes make the episode longer or more intense, so it’s usually best to let it ride out.

Prevention of Night Terrors and Sleep Tips

Good sleep habits can help prevent night terrors. Try to make sure your child gets the recommended number of hours sleep per day – which we know isn’t always easy. For example, the American Academy of Pediatrics recommends that preschool-aged kids get 10-13 hours of sleep (including naps).

We also recommend you:

• Keep a consistent bedtime and wake time, even on weekends.
• Minimize stressful or stimulating activities before bed.
• Avoid electronics for 1 to 2 hours before bedtime.
• Avoid letting your child get overtired.

Medications and Supplements

Most children don’t need medicine for night terrors. Some supplements like melatonin or L-tryptophan have been tried, but evidence for their benefit is limited, and safety is always a concern—especially if your child takes other medications. Prescription medications are generally not recommended because they can have serious side effects. Behavioral strategies, like good sleep routines and scheduled awakenings, remain the safest and most effective approach.

Plan for Safety in Advance

While night terrors are usually harmless, it’s still important to make your child’s sleep space safe. Remove sharp objects, secure windows, and block stairways if you live in a two-story home. Most episodes are short, and children usually return to normal sleep afterward without any awareness of what happened.

When to Talk to Your Pediatrician

Most night terrors don’t need medical treatment. But you should reach out to your child’s doctor if:

• Episodes happen often or are very intense.
• Your child seems unusually tired during the day.
• You notice signs of breathing problems at night (snoring, pauses, struggling for air).
• You’re not sure whether it’s a night terror or a seizure.

In some cases, a sleep specialist or a sleep study may be recommended to make sure nothing more serious is going on.

Takeaways to Understand Night Terrors

Night terrors can be scary to watch, but your child is safe. With patience, reassurance, and good sleep habits, most families see episodes fade over time. Remember: the fear you feel is normal, but your child is not in danger!