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Clinical Reference Systems: Pediatric Advisor 10.0
Spanish version
Nightmares
DESCRIPTION
Nightmares are scary dreams that awaken a child. Occasional
bad dreams are normal at all ages after about 6 months of
age. When infants have a nightmare, they cry and scream
until someone comes to them. When preschoolers have a
nightmare, they usually cry and run into their parents'
bedroom. Older children begin to understand what a nightmare
is and put themselves back to sleep without waking their
parents.
CAUSE
Everyone dreams four or five times each night. Some dreams
are good, some are bad. Dreams help the mind process
complicated events or information. The content of
nightmares usually relates to developmental challenges:
toddlers have nightmares about separation from their
parents; preschoolers, about monsters or the dark; and
school-age children, about death or real dangers. Frequent
nightmares may be caused by violent TV shows or movies.
DEALING WITH NIGHTMARES
- Reassure and cuddle your child.
Explain to your child that she was having a bad dream.
Sit on the bed until your child is calm. Offer to leave
the bedroom door open (never close the door on a fearful
child). Provide a night-light, especially if your child
has fears of the dark. Most children return to sleep
fairly quickly.
- Help your child talk about the bad dreams during the
day.
Your child may not remember what the dream was about
unless you can remind him of something he said about it
when he woke up. If your child was dreaming about
falling or being chased, reassure him that lots of
children dream about that. If your child has the same
bad dream over and over again, help him imagine a good
ending to the bad dream. Encourage your child to use a
strong person or a magic weapon to help him overcome the
bad person or event in the dream. You may want to help
your child draw pictures or write stories about the new
happier ending for the dream. Working through a bad
fear often takes several conversations about it.
- Protect your child against frightening movies and TV
shows.
For many children, violent or horror movies cause
bedtime fears and nightmares. These fears can persist
for months or years. Absolutely forbid these movies
before 13 years of age. Between 13 and 17 years, the
maturity and sensitivity of your child must be
considered carefully in deciding when he is ready to
deal with the uncut versions of R-rated movies. Be
vigilant about slumber parties or Halloween parties.
Tell your child to call you if the family he is visiting
is showing scary movies.
CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:
- The nightmares become worse.
- The nightmares are not minimal after using this approach
for 2 weeks.
- The fear interferes with daytime activities.
- Your child has several fears.
- You have other concerns or questions.
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