Article: Dr Alison Bentley from Your Baby magazine
Image: Ablestock

But, while the REM sleep required to experience dreams is present from birth, there is little evidence that babies are capable of experiencing the frightening dreams we call nightmares before the age of 2½ years old. This is partly because babies are unable to tell us about their dream experiences and so all evidence is estimated, and because they may not be able to think in the abstract way required to create the nightmare.

But this doesn't mean that they don't dream – just that we're not sure of the content. Dreams occur during REM sleep, which has very particular characteristics such as body paralysis, eye movements and dreams. REM sleep occurs about 90 minutes after falling asleep and recurs every 90 minutes throughout the night, with the REM periods steadily lengthening as the night progresses.

Interestingly, although we appear to dream for a long time during the night, we only remember our dreams if we wake up in the middle of them. If we sleep soundly without waking during the night we may not remember any dreams at all.

What to do
Nightmares occur when the visual content of a dream provokes a feeling of anxiety and fear. Usually a young child will be woken by feelings of fear and will start crying, in desperate need of some reassurance. Even if you don't understand the content of your child's nightmare and the content appears to be rubbish, it's extremely important to your child that you take it seriously and comfort him.

He may cry and cling to you and in this case, just hold him until his clinging is less fearful. Sometimes your child may be happy to go back to sleep and sometimes not. Sleeping in your child's bed for one night, or having him sleep on the floor of your room after a really scary dream will certainly not create a bad habit and will help soothe him.

Often the night fears are significant enough that your child will still feel them the next day, unable to tell the difference between dreams and reality.

He may talk about the dream as if it has really happened, continuing to believe that "Daddy has been run over" while Daddy is at work and not at home to prove that he is okay. Deal with the fears, even if it means that your child has to phone Daddy at work to check that he is fine.

The content of sporadic nightmares is usually not important and of little significance. Sometimes items from TV programmes or books can emerge in dreams.

Children between the ages of 2 to 3 years tend to be "attacked" by indefinite things while 5 to 6 year olds know exactly what is chasing them – either ghosts, monsters or "baddies". Part of the anxiety of the dream is created by the feeling of not being able to move – because the body is in fact paralysed during REM sleep.

Nightmares that occur often and have a similar content may indicate the presence of severe stress. These repetitive nightmares were first described in veterans of the Vietnam War and are a characteristic feature of post–traumatic stress disorder.

There is a childhood version of this that occurs with children who have survived traumatic experiences such as kidnapping, hijacking or physical abuse. The content of the dreams often reflects the actual stressor encountered and the disorder requires professional help.

What are night terrors?
Due to the distribution of REM sleep during the night, nightmares tend to occur in the later part of the night or early morning. A very different type of “nightmare” may occur very soon after your child goes to sleep.

Usually, you'll be alerted by hearing your child’s sudden screaming. Your child may look terrified but will be very difficult to console and may fight you off, often hitting and punching anyone who comes close or tries to restrain him. You may get understandably upset by this rejection and continue to comfort him or try to wake him up, but it’s unlikely you’ll be successful.

After 10-15 minutes the screaming should stop abruptly and your child will go back to sleep as if nothing has happened. By this stage you'll usually be exhausted, wondering what is frightening your child, but the answer is usually nothing.

Children woken up during episodes like this don’t report any frightening experience or nightmare but are often confused and disorientated. This “nightmare” is actually a night terror, which is very different to a nightmare. About 3% of children have night terrors, which reach a peak between 5 to 7 years and decrease markedly by 9 years.

Up to three episodes per week can be normal. Night terrors are classified as a disorder of arousal and totally different in origin and expression to nightmares.

The terrors are triggered by sudden waking from very deep sleep in a child who has a family history of night terrors or sleepwalking. These children are neither fully awake nor asleep but stuck halfway between the two states in a “twilight zone”.

Unlike nightmares, the child who experiences night terrors has no memory of these events the next day and experiences no anxiety on waking. It’s best not to tell your child about these events unless another sibling asks about it, as this will just cause undue anxiety on his part.

Terrors will often worsen during stressful times such as when your family go on holiday or move house. Happily there is usually no change in the quality of your child’s sleep – he should still bounce out of bed in the morning.

What to do
Unfortunately, there is no way to prevent night terrors happening, so it’s best to let your child scream until he stops naturally.

Amazingly, when the terror ceases your child will continue sleeping as if nothing has happened. The only time to be concerned and go to a specialist for advice is if the terrors occur every night or if your child seems very sleepy the next morning.

These events will usually disappear gradually, as your child gets closer to puberty. Because there is a close association between night terrors and sleepwalking your child may change to walking instead of the night terrors but this is not guaranteed.

Sometimes night terrors disappear at around the age of 11 and then reappear during a stressful period such as entering high school. The tendency is always there but may only express itself during stressful times.

It’s important that you correctly define the type of screaming attack your child experiences at night, handle it sensitively as advised, and wait for it to disappear.