Night terrors, also known as sleep terrors, are episodes of intense fear, screaming, and flailing that occur while a child is asleep. They are a common type of sleep disturbance (a parasomnia) in young children, including two-year-olds. While alarming for parents to witness, night terrors are not typically a sign of underlying psychological distress or a serious problem in a toddler.
How Night Terrors Differ from Nightmares
Night terrors and nightmares are distinct sleep phenomena occurring during different stages of the sleep cycle. A night terror happens during non-rapid eye movement (NREM) sleep, specifically in the deep slow-wave stage, which usually occurs in the first third of the night. Because the child is not truly awake, they cannot be easily consoled and will not remember the episode the next morning.
Nightmares, by contrast, occur during rapid eye movement (REM) sleep, the lighter stage where dreaming happens, typically in the second half of the night. A child who has had a nightmare will usually wake up fully, cry out, be responsive to reassurance, and may even describe the bad dream. The clearest distinction is the state of consciousness: partially asleep during a terror versus fully awake after a nightmare.
Underlying Causes and Common Triggers
Night terrors are essentially a failure of the central nervous system to transition smoothly between deep sleep and lighter sleep, resulting in a partial arousal. The child is momentarily caught between being asleep and awake, leading to the dramatic physical and emotional display. The condition often has a genetic component, meaning a child is more likely to experience them if a family member also had night terrors or sleepwalked.
The most frequent and significant trigger for a night terror in two-year-olds is sleep deprivation or chronic overtiredness. Not getting enough total sleep or having an inconsistent sleep schedule can increase the likelihood of a partial arousal from deep sleep. Other physiological factors that can disrupt the sleep cycle include fever, illness, and certain medication changes.
Environmental and routine disruptions can also increase the frequency of episodes by contributing to stress or fatigue. Minor changes, such as travel, sleeping in an unfamiliar place, or a sudden change in daily routine, can be enough to trigger an event. Ensuring that a toddler gets adequate, uninterrupted sleep is the most direct way to reduce the underlying susceptibility to these partial awakenings.
What to Do During a Night Terror
When a night terror begins, the primary focus for the parent should be ensuring the child’s physical safety. A child may thrash, sit up, or even get out of bed and run around, all while still being asleep. Parents should quietly stay nearby to prevent the child from falling or hitting anything, gently redirecting them back to bed if they move.
It is generally recommended not to attempt to wake the child, as this is difficult to do and often results in the child becoming more confused, distressed, and agitated, potentially prolonging the episode. The child is not truly aware of their surroundings or the parent’s presence, despite their eyes being open. Speaking calmly and softly, using repetitive, soothing words, may help the child transition back to a deep sleep.
Attempts at physical comfort, such as hugging or holding, may be met with resistance or pushing away because the child is in a state of confusion. The episode will typically end on its own within a few minutes. The child will then usually fall back into a sound sleep with no memory of the event, requiring parents simply to monitor the situation until the child is calm and settled.
Reducing the Likelihood of Future Episodes
The most effective long-term strategy for reducing night terrors centers on optimizing the child’s sleep hygiene to combat overtiredness. This includes establishing a consistent bedtime and wake-up time every day to regulate the body’s internal clock. Ensuring the two-year-old receives the appropriate amount of total sleep, often by maintaining a consistent afternoon nap, is particularly important.
The bedtime routine should be calm and relaxing, incorporating activities like a bath or reading a story to help the child wind down. Avoiding screen time for at least an hour before bed is also helpful, as the blue light can interfere with sleep onset. For children whose night terrors occur at a predictable time each night, a technique called scheduled awakening may be beneficial.
This technique involves gently rousing the child—not fully waking them—about 15 minutes before the terror is expected to begin. This slight disruption alters the sleep cycle just enough to prevent the partial arousal that causes the terror. Implementing this for several nights in a row can break the pattern and significantly reduce the frequency of future night terrors.