Night Terrors vs Nightmares - How To Tell The Difference

Night terrors (also called sleep terrors) are parasomnias. Parasomnias can occur during rapid eye movement (REM sleep), or they can occur during the non-REM sleep.
Most of your sleep is non-REM and only a portion of your sleep is REM and that's when you do most of your dreaming.
Night terrors are different from nightmares. Night terrors occur during non-REM sleep, usually in the deep sleep phase. When you’re in deep sleep, you have slower brain waves. We get the bulk of our slow wave sleep during the first ½ or 1/3 of the night. So most times night terrors occur in the first 2 -3 hours after going to sleep.
Normally your body prepares you to wake up by having fewer and shorter phases of deep sleep until you finally wake up from the lighter stages of sleep. But with night terrors, you abruptly wake up from deep sleep. It’s like going from a near coma to being shaken awake. You wake up with a lot of confusion and disorientation. You can wake up screaming, sweating with your heart racing, almost like you’re having a panic attack.
This is a central nervous system arousal that is involuntary. It’s not a reaction to a bad dream. Remember, before you woke up, you were in deep sleep which is a stage of sleep where not much dreaming happens. I say this because I’ve heard people say, I have PTSD and it gives me night terrors. You can have both conditions, but the night terrors are not triggered by having an upsetting dream.
Night terrors can be dangerous because you can do things like thrash in the bed, walk around and do things without being fully aware of what you’re doing.
Nightmares versus Night terrors
1. Nightmares occur during REM sleep. This is a lighter stage of sleep where you do most of your dreaming. Your brain waves are faster and if you wake up from this stage, you’re not as confused and you can remember that you were dreaming. You may only remember parts of the dream or you may remember most of it.
2. Nightmares tend to happen in the latter half of your sleep cycle because that’s when you have more REM sleep. The first half of your sleep is front loaded to get in your deep sleep and the second half is lighter with more dream sleep. But you can still have a night terror later in the night.
What causes night terrors?
They’re common in children and can be due to brain immaturity and not necessarily a sign of a medical problem. But if they persist, you should see a medical professional for an evaluation.
In adults, night terrors can be caused by stress, depression, anxiety, sleep apnea, pain and alcohol. Also sleep deprivation can cause this as well.

What can you do about this?
The first thing to do is make sure you have good sleep hygiene like going to bed at a regular time each night and limiting food and drink before bed. If you tend to wake up to go to the bathroom during the night, you can help this by not having anything to drink one hour before bed, then emptying your bladder just before you go to sleep. It’s okay to go to bed thirsty. It may not feel good, but even if you drink a swallow of water just before bed to wet your whistle, your bladder could wake you up several hours later. That breaks up your sleep, leading to a disrupted sleep pattern. This may not make a huge difference for most people, but if you have sleep problem, you want to make all the tweaks you can.

Another thing you can do is if you have frequent night terrors and they occur around the same time each night, you can have someone wake you up or set your alarm to wake up 30 minutes before to break the pattern. This is a sleep intervention called scheduled awakenings. It’s used for children who are not sleeping through the night and keep waking up around the same time each night. You interrupt the pattern by waking them before they wake up. This helps them sleep through that wake up time.

Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

[nickyv]

I was told by my old therapist in my early 20s that the reason for my night terrors as a child were due to "being molested". I was never molested but she was so persistent about it and it really screwed me up for a while. Thank you for sharing actual information thats correct!!

[Valdagast]

The only night terrors I get is when the cat suddenly decides that it's time to walk on my back.

[sahpem]

My son literally just woke up crying from one. My daughter used to have them too. It’s comforting knowing it’s not caused by nightmares.

[Crybabys_exe]

I’ve had night terrors, I was so confused cuz I thought I woke into a panic attack

[JB-lmxt]

Cured my son of night terrors by waking him up 45 minutes after asleep to go to the bathroom. Changed all of our lives.

[christopherkline]

I feel like it often occurs when I’m very stressed or anxious about something

[BeingBetter]

I've had no nightmares at all since when I did the rescripting your nightmares exercise. I will see if I ever get any again. Thanks Dr. Tracey🙂

[cynthiasarah]

Finally someone explained it properly!! I have had them since childhood and have them as an adult. I learned the way you explained it 30 years ago.. my Dad head of a Psychology Deptn anyways. Finally a video I can refer people too. Most people have no idea what I am talking about!

[mysticraven]

I’m glad this clears things up, because I told this to my parents and they just laughed at me when I told them that last night I woke up trying to defend myself against a dark figure that wasn’t there while trying to turn on my lamp, hurting my leg in the process which I don’t remember doing, and then still freaked out I searched my room to make sure no one was there. I suspect it was maybe a first night terror but I’m not sure what triggered it. My dad coughed it up as a normal nightmare or a rare dream event. But I was still paranoid for like 10-15mins afterwards trying to calm myself down before falling back asleep eventually.

[honesttruth]

OMG, OMG, you are amazing. Everything that you are telling us is right on the dot. For the first time in 15 years, without any answers, now a doctor who understands . Ps thx u for sharing your knowledge with us. I wish you were my doctor.

[healthyone]

i have major depression i'm 69 dr. tracy makes informative videos and gets better looking as she gets older!

[tommypitcher]

I’ve been having violent night terrors frequently due to PTSD from my military days. I always curse myself awake really loud and physically punching my lamp and the walls really hard. I’ve had both nightmares and night terrors all the time and the night terrors are the ones that scare me the most. I always wake up with panic attacks with my heart racing and breathing fast and sweaty and feeling of impending doom. I’ve been on 5 different medication for my PTSD, severe manic disorder, nightmares, anxiety, stress, suicidal tendencies, and many other symptoms. I take one Venlafaxine capsule every morning for mood and cognitive issues and 1/2 pill of Lamotrigine. At night I take 2 capsules of Prazosin for nightmares, and 700 mg capsules of Quetiapine, and 1 tablet of Lamotrigine. I still get terrible nightmares and night terrors. The night terrors are the ones I get mostly and it really feels so terrible. My psychiatrist is always trying her best to make the right medication and dosage for my issues. Any suggestions you can give me or anyone reading this? I live alone and I don’t do well socially. I get my help from the VA. Thank you for this video. I understand more of my issues from night terrors now. I appreciate it so much.😥

[sayeileen]

This was very informative, thank you! I had night terrors as a child for several years and never knew much about it. Sometimes I would wake up in the middle of the night in a fit of rage (kicking, screaming, ripping things apart) and other times, I had no recollection of the event even though my parents reported that I would go to the bathroom, drink water, walk around, etc. with their guidance. My parents tried a bunch of Eastern medicine methods as well as taking me to see a psychologist (who I wasn’t completely honest with regarding my night terror experiences because I was ashamed of letting my mom know that I was aware I woke up insanely angry sometimes and continued the violent behaviour after waking up) but all my parents were told was that I would grow out of it. I wish they had this information back in the day because it would’ve relieved them of a lot of stress and given them strategies to help with my night terrors.

[DanielE]

Thanks again Dr Marks. I sent my dad some of your videos on bipolar and it really helped him understand my condition. You rock. ❤️

[umcub]

What causes people to jump out of their sleep and unable to go back and if they do, they have the same reaction

[lauramack]

I have narcolepsy as well as ADD. I was DX by a sleep study but the doctor knew before the study and used the study to confirm it. Sleep hygiene has changed my life with narcolepsy. It takes time but does work. The sleep hygiene has allowed me to get off of sleeping medication and the doctors had me on every med available at one time or another.

[angelamallory]

This has been happening to me for a couple of weeks. I’m jolted awake and my heart is pounding. I really need to figure out how to fix this.

[loganschurman]

Had them nightly as a kid, sometimes combined with sleep paralysis. was lovely. Was definitely due to trauma. Deep sympathy for kids that suffer from these and the parents that have to console them

[araven]

My night terrors scare the shit out of my boyfriend. He jokes that one day I'll give him a heart attack! I'll try some of these methods to correct my sleep habits.

[David-jbdv]

I had these when younger and they were pure terror,