Nightmares are emotionally disturbing dreams that occur during rapid eye movement (REM) sleep and provoke feelings of fear, terror, distress or extreme anxiety.

Night terrors, or sleep terrors, are frightening dreams that occur during deep sleep and are sometimes accompanied by screaming, crying or yelling. Patients may also run around and throw items.

Nightmares usually involve a complex plot that the patient remembers after awakening. Night terrors are more primitive, involving simple plots such as fire or a monster.

Both nightmares and night terrors are most common in children, beginning around the age of 4 years. They can be extremely frightening for a child, but are not usually a serious problem.

Most people experience nightmares at some point in their lives, usually after a period of emotional or physical stress. Symptoms of nightmares include abrupt awakening from sleep with a lingering sense of fear or anxiety and immediate recall of the frightening dream. Nightmares are common in children, but decrease in frequency as children age. Among adults, nightmares can be caused by a variety of psychiatric disorders (e.g., post-traumatic stress disorder [PTSD]), sleep disorders (e.g., arousal disorders) and medications (e.g., antidepressants).

According to the American Academy of Family Physicians, night terrors are most common in children between the ages of 4 and 12 and affect 1 to 4 percent of all children. Symptoms of night terrors include confusion or disorientation upon waking and profuse sweating with little memory of any frightening dream. The cause of night terrors is unknown, but they are commonly associated with periods of emotional tension, stress and/or conflict.

Night terrors decline in frequency as children age. They are rare in adults and most commonly occur in people with other sleep disorders or substance abuse problems.

Many patients, especially children, respond well to reassurance and support and do not require special treatment for nightmares and night terrors. In persistent cases, patients may be referred to a physician or mental health professional for further evaluation. Some patients may be referred to a sleep center where a sleep study (test that measures physiological aspects of sleep) will be conducted to help identify the presence of a sleep disorder.

Many patients, both children and adults, are treated effectively with reassurance and support. To reassure children, parents may minimize children’s exposure to frightening images and ensure that bedtime is safe and comfortable for youngsters.

Patients whose nightmares or night terrors are caused by underlying conditions (e.g., PTSD) may require therapy, such as cognitive behavioral therapy, or medication, such as antidepressants.