Here are tips from the National Sleep Foundation that can help if

a child you know is having nightmares.

Suggestions on how to help your child if they are having nightmares:

There are times that fears and nightmares are the result of a frightening experience, from being scared by a large dog to being in a car accident to watching the news, but other times they seem to come out of the blue. Family conflict and parental anxiety can also play a role. Anything that makes a child more emotionally aroused is going to make his fears worse and make him feel more anxious. Children also typically have different fears at different developmental stages. Young children are often afraid of monsters and other imaginary creatures, whereas older children are more likely to fear being hurt by more realistic dangers, such as burglars or a natural disaster.

Nightmares can happen for no known reason although they sometimes appear to stem from your child seeing or hearing something that upset him or her during the daytime. The exact reasons why nightmares occur is unknown. In some cases nightmares may follow traumatic experiences like the death of a loved one.

 Nightmares can occur in children as young as toddlers but generally start between the ages of 3 and 6 years. It is estimated that 10 to 50 percent of children at this age have nightmares significant enough to disturb their parents.

 How should I respond to my child's nightmare?

Your child is going to need reassurance after having a nightmare. This is especially the case with younger children. As your child gets older, though, you will want to start teaching him coping skills that he can use when he is anxious or scared. Unfortunately, you may not always be there when he has a bad dream, such as at a sleepover or at overnight camp. No matter how old your child, though, reassurance is going to go a long way to helping him feel safe and secure

        Ensure adequate sleep. Is your child getting enough sleep and maintaining his or her regular bedtime schedule and routine? Doing so will likely cut down on the         number and intensity of nightmares.

        Keep the bedtime routine ‘light,' happy, and fun. In the 30 to 60 minutes before bedtime, don't expose your child to scary movies, TV shows, frightening bedtime stories, scary music or other stimuli that may be upsetting to your child.

        Discuss the nightmare during the day. Try to determine if there might be a theme to the nightmares – especially if they are occurring frequently. If there is, this could mean there is something bothering your child. Try to determine what it is. Identify what the stressors are in your child's life. Talk about these stressors and work with your child to reduce them.

        Comfort, coddle, and reassure your child. This is one time when providing brief comfort and cuddling is very much the best solution for this sleep-related problem. Stay with your child for a short period of time following the nightmare. Most will still be tired and able to fall back to sleep soon. Let your child go back to sleep in his or her own bed. Avoid excessive attention or pampering. To provide additional comfort, it is also helpful to allow your child to snuggle with his or her favorite soft toy or security blanket throughout the night. If your child would like the light on, leave it on in its dimmest setting, or use a night light for comfort. Consider leaving the bedroom door open. Reassure the child that the home is safe and that you are there for security.

        Working out ways to overcome nightmares. Some children and adults have developed some creative ways to help children outgrow nightmares. Some have tried reading stores about getting over nighttime fears. Others have drawn pictures of nightmares and then have torn them apart and thrown them away as a symbolic gesture. Still others have hung Native American charms over their beds. Whatever creative solution works for you and your child can certainly be tried.

.    Especially with younger children, a security object such as a favorite stuffed animal or a blanket can help a child feel relaxed and safe in bed. Other things that can help are leaving a low nightlight on in your child’s bedroom and teaching him relaxation techniques. Have your child imagine a relaxing scene, such as a being on the beach or watching a sunset, will help him relax after a scary dream. Children can also use their imagination to help them settle down and fall back to sleep. Have your child imagine a different ending to the nightmare, hang a dream catcher over your child’s bed which helps catch the “bad dreams,” or have your child draw pictures of his nightmare that he crumples up and throws away.

When should a call to the doctor be considered?

Consider calling your doctor if any of the following occur:

        Your child's nightmares become worse or increase in frequency.

        Your child's fear interrupts daytime activities.

        Your child's nightmares are very distressing and repetitious or psychological issues are involved. In such cases, psychological techniques like desensitization and relaxation strategies may work. In adolescents, guided dream imagery training may be helpful.

Children who are having serious problems with grief and loss may show one or more of these signs: 

  • an extended period of depression in which the child loses interest in daily activities and events
  • inability to sleep, loss of appetite, prolonged fear of being alone
  • acting much younger for an extended period
  • excessively imitating the dead person
  • repeated statements of wanting to join the dead person
  • withdrawal from friends, or
  • sharp drop in school performance or refusal to attend school

If these signs persist, professional help may be needed. A child and adolescent psychiatrist or other qualified mental health professional can help the child accept the death and assist the others in helping the child through the mourning process.

Additional Sleep Information and Suggested Readings

Mindell, JA and Owens, JA. A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems. Philadelphia, PA: Lippincott Williams and Wilkins, 2003. 

www.sleepeducation.com and other educational links on the American Academy of Sleep Medicine website www.aasmnet.org 

The National Sleep Foundation at www.sleepfoundation.org