Posted by Dr Sophie Bostock - Sleep Expert on 23rd Mar 2022
How to Help Your Child Cope With Nightmares
Nightmares are frightening dreams which wake you up with vivid memories of what has just happened. At least 60% of young children experience the occasional nightmare, and at least half of children have woken their parents after a bad dream.
If your child wakes up frequently with bad dreams they are not alone. One study found that 24% of children aged 2 to 5 and 41% of children aged 6 to 10 experienced frequent nightmares for at least 3 months. Research suggests that 5% of children have recurrent nightmares more than once a week.
Why do nightmares happen?
Nightmares occur during REM, or Rapid Eye Movement sleep, usually in the second part of the night. This stage of sleep is associated with processing emotional memories.
Occasional nightmares are a normal part of growing up, as a child’s imagination and creativity develop. However, nightmares are more likely after a difficult or stressful experience. It might be triggered by changes to routine, a new school, the re-living of a traumatic event or simply watching a horror film. Children who are more anxious generally are more likely to experience intense nightmares.
Sleep deprivation can also provoke nightmares, as the brain can respond to sleep loss by increasing the proportion of REM sleep. Some medications, including antidepressants, antihistamines and caffeine will reduce REM sleep, but this can lead to an increase (“REM rebound”) when you stop taking them.
When your child wakes after a nightmare
After a nightmare most children are afraid to go back to sleep and don’t want to be left alone. I can still remember the intense fear of finding my way to my parents’ room in the dark after a bad dream.
The first priority is to comfort and reassure your child to make them feel safe. This will ideally be back in their own bed, so that this is where they fall back to sleep, but they may need comforting in your bed first. Empathise with their fear, but remind them that it was just a dream and nothing will hurt them. A favourite toy in the bed, or even a family pet sleeping in the same room, can help with a sense of security. Keeping the door open and a dim night light on may also help them to feel relaxed.
How to make nightmares less likely
- Scary movies or stories before bed can make a vulnerable child anxious. Focus on a familiar and comforting bedtime routine. Choose bedtime stories with plenty of humour, and/or where the child overcomes their fears.
- There isn’t always an explanation for nightmares, but if they are becoming more frequent, look for new sources of stress in your child’s life. It’s best to try and discuss these worries during the day, well before the bedtime routine. It might be helpful to ask the teachers at school or nursery for clues.
- Sleep loss or a haphazard routine can make nightmares more likely. Try to start a bedtime routine early enough so that they get the sleep they need.
Evidence-based strategies for recurrent nightmares
Recent research has shown that strategies to help give children a sense of mastery and control can reduce the frequency and intensity of nightmares. For example:
- “Huggy Puppy”: Children aged 4-6 years old were given puppy doll named the “Huggy Puppy.” They were either instructed to protect the doll during the night, or to use it as a protector. Interestingly, both ways of using the doll resulted in fewer nightime fears and better sleep quality (Kushnir 2012)
- Dream Changer: In an Australian study, parents helped their children by using a Dream Changer - a device that looked like a TV remote. Parents were told to tell their kids that dreams are like videos we watch in our sleep. “When you get into bed, think about a good dream you’d like to watch. If a bad dream comes onto the screen, and it wakes you up, just find the Dream Changer and press the button to change the channel. “ Compared to a waitlist group, the children who took a Dream Changer to bed for two weeks had 2 fewer nightmares a week - and the benefits lasted 3 months (Bourboulis 2022).
- Image Rehearsal Therapy: ask your child to focus on what was happening at the point that they woke up from the dream. Then come up with an alternative, more positive and compelling ending.. For example, they could develop their favourite superhero’s superpower, the baddie could suddenly sport roller blades, or lose all their clothes. The new ending doesn’t have to be realistic - it just needs to be exciting enough for your child to want to rehearse it in their minds before they fall asleep. Reducing the anxiety about the bad dream often leads to a more restful sleep (Krakow 2010).
If your child is experiencing recurrent nightmares and you are worried that this is interfering with how they feel during the day, it may be helpful to ask their doctor or a child psychologist for advice. Frequent nightmares can be associated with emotional and psychiatric disorders, so it may be helpful to get a medical perspective.
