It can be alarming to hear your child cry out in fear or find them walking around half-asleep in the middle of the night. Parents often wonder if night terrors, nightmares, or sleepwalking are normal, and when it’s time to worry. This is a question that comes up a lot when we talk to parents about sleep. There are sometimes issues that keep a child up at night that they don’t or can’t express verbally, and night terrors or nightmares are one of those! Then, we may have the child that gets up out of their bed at night, which requires safety planning.
The good news: these nighttime disturbances are very common in children, especially between ages 3 and 10, and in most cases, they’re harmless. Still, they can be distressing for both kids and caregivers. Understanding what’s happening and taking a whole child approach can help your child feel safe, supported, and well-rested.
Let’s go over some of the questions that you may have about night terrors or sleepwalking, and how we can address this from a whole child perspective.
What’s the Difference Between Nightmares, Night Terrors, and Sleepwalking?
- Nightmares happen during dream sleep (REM), which is the part of the night when the brain processes emotions and memories. Kids usually remember them and can often describe the dream afterward.
- Night terrors happen earlier in the night during deep sleep (non-REM). The child may scream, thrash, or appear frightened but isn’t truly awake. They usually don’t remember it the next morning.
- Sleepwalking also occurs during non-REM sleep, when part of the brain is awake enough for movement but not fully conscious.
All three are part of normal childhood development and often resolve as the nervous system matures.
Why Nightmares Happen… A Whole Child Perspective
Nighttime disturbances usually have underlying triggers related to a child’s sleep patterns, sensory regulation, or emotional stress. There are many other contributing factors, though.
Common contributing factors include:
- Overtiredness or irregular sleep schedules. Sleep routines are important in more ways than one.
- Stress or anxiety (new routines, school changes, transitions)
- Fever or illness
- Sensory sensitivities (noise, light, texture, or temperature). Understanding sleep and sensory from a whole child perspective is key.
- Certain medications or caffeine
- Genetic predisposition (family history of sleepwalking or night terrors)
A whole child approach means looking beyond the event itself to see what’s happening in the body and environment that could be disrupting restful sleep.
Learn more about how sleep connects to sensory regulation in My Child Has Sensory Issues — What Can We Do to Help Them Fall Asleep and Stay Asleep?.
How to Keep Your Child Safe During a Night Terror or Sleepwalking Episode
Safety comes first. Most of the time, the episode will pass on its own in a few minutes. In some situations, safety bed modifications might be necessary.
Other ways to help a child in a nightmare or night terror situation are to keep safety in mind. Here’s what to do:
- Stay calm. Your child may appear terrified but isn’t aware of what’s happening. Don’t try to wake them fully. You want to just ensure they’re safe.
- Guide gently. If they’re sleepwalking, use a calm voice and gently steer them back toward bed.
- Clear the environment. Lock doors and windows, block stairs, and remove sharp objects or tripping hazards.
- Avoid shaking or shouting. It can prolong confusion and distress.
- Reassure afterward. If they do wake up, stay nearby until they feel safe again.
How to Reduce Night Terrors, Nightmares, and Sleepwalking
Improving sleep quality and regulation is the best prevention. Here are some strategies backed by occupational therapy and parent coaching principles:
1. Maintain a Consistent Sleep Schedule
Irregular sleep or staying up too late increases the likelihood of deep-sleep disruptions. Keep bedtime and wake-up times within 30 minutes, even on weekends.
Read more about the importance of consistency in How Much Sleep Do School-Age Children and Teenagers Really Need?.
2. Build a Calming Bedtime Routine
Create predictable steps that soothe the sensory system: warm bath, deep-pressure massage, soft lighting, gentle music.
Check out Should I Let My Baby Cry It Out? A Whole Child Approach to Baby Sleep for ideas on building calming, responsive routines that adapt for older children too.
3. Address Sensory and Emotional Triggers
Overstimulation, stress, or anxiety can keep the nervous system alert even during sleep. Occupational therapists can help identify and reduce triggers using sensory-based calming strategies like weighted blankets or white noise.
Learn more in My Child Has Sensory Issues — What Can We Do to Help Them Fall Asleep and Stay Asleep?.
4. Encourage Movement and Regulation During the Day
Physical activity promotes deeper, more organized sleep cycles. Physical therapists (PTs) can help design movement-based routines that balance activity and calm. (Read about PT support for movement and regulation).
5. Build Emotional Vocabulary and Coping Skills
Some kids experience nightmares when they can’t yet verbalize big emotions. Speech therapists and counselors can help children put words to feelings, which reduces nighttime fears. (Explore speech therapy’s role in emotional development).
6. Look at Feeding and Evening Routines
Hunger or reflux can disturb sleep and trigger nighttime wakings. A feeding therapist or SLP can help build balanced routines that support comfort and rest. (Learn more about feeding and sleep).
When to Consult a Doctor
While most night terrors, nightmares, and sleepwalking episodes are harmless, talk with your pediatrician if you notice:
- Episodes several times per week or lasting more than 30 minutes
- Injury or risk of harm during episodes
- Persistent sleep disruption or daytime fatigue
- Snoring, breathing pauses, or other signs of sleep apnea
- Behavioral changes or regression connected to poor sleep
In some cases, your pediatrician may refer you to a sleep specialist for further assessment. Collaborative care between your medical provider and your child’s therapists can help uncover patterns and find gentle, effective solutions.
Supporting the Whole Child (and the Whole Family)
Sleep disruptions are stressful, but they’re also an opportunity to understand your child’s body and brain more deeply. With a calm environment, consistent routines, and support from the right professionals, most children outgrow these episodes.
If you’d like help creating a gentle, sensory-informed bedtime routine, visit the Whole Child Guide Directory to connect with occupational therapists, physical therapists, speech therapists, parent coaches, and sleep specialists who can help your child (and you) rest easier.
Related Posts from Whole Child Guide
- Should I Let My Baby Cry It Out? A Whole Child Approach to Baby Sleep
- Why Does My Toddler Keep Waking Up During the Night?
- When Should my Baby Move to a Toddler Bed
- What Should I Know About Co-Sleeping
- Sleep and Autism
