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Nightmares, night terrors and sleepwalking are all parasomnias that are often misunderstood or confused with each other. Parasomnias refer to a specific type of sleep disorders. All the 3 are characterised by abnormal behaviours and experiences that happen during sleep, or while on the border between sleeping and waking.
Let’s break them down!
Nightmares
Nightmares are scary dreams that occur during the REM ( rapid eye movement) phase of sleep, and they affect people of all ages. We often remember our nightmares, sometimes for several days after experiencing them. During the active dream phase, our muscles are temporarily paralysed to prevent us from acting out our dreams. Contrary to how it is portrayed in movies, nightmares don’t cause us to trash about in bed. It is possible to make some sounds, but due to the temporary paralysis that also affects our facial muscles, it is highly unlikely that we can make intelligible sounds (such as actual words).
Night terrors
People often assume that night terror is just another word for a nightmare. The two terms might sound similar but they refer to different things. A night terror is an episode of intense fear that occurs during NREM ( non-rapid eye movement) sleep. There is no active dreaming involved, just a sensation of being frightened. The person having a night terror might appear awake, their eyes might be open, and they might sit up in bed, but they are asleep. Night terrors can look frightening, parents sometimes refer to night terror episodes as the child looking possessed. They often scream, shout, cry and trash around in the bed. Unlike with nightmares, there is no memory of any dream upon waking.
Sleepwalking
Similarly to night terrors, sleepwalking also occurs during NREM sleep, mostly in the first half of the night. It is more common in children than in adults, and there seems to be a genetic link. During a sleepwalking episode a person’s eyes are open but they might not see their environment in the way they would while awake. Contrary to popular belief a sleepwalker is not acting out a dream. The parts of the brain responsible for motor movement and vision are active, however, the prefrontal cortex ( the area of the brain responsible for rational thinking and self-awareness) is not. We mostly perform routine movements during a sleepwalking episode, such as putting on clothes or opening doors, and we rarely remember any of it afterwards.
Stress, unsettling life events, illness, certain medications, poor sleep hygiene and overtiredness can all worsen nightmares, sleepwalking and night terrors. While there is no certain, final fix for either of these 3 parasominas, optimising sleep hygiene, naps and bedtime can go a long way. As an infant and child sleep consultant, I can offer gentle guidance in all of those areas. Please contact me, or check out my website for more details.
