Night Terrors vs Nightmares - How To Tell The Difference

Night terrors (also called sleep terrors) are parasomnias. Parasomnias can occur during rapid eye movement (REM sleep), or they can occur during the non-REM sleep.
Most of your sleep is non-REM and only a portion of your sleep is REM and that's when you do most of your dreaming.
Night terrors are different from nightmares. Night terrors occur during non-REM sleep, usually in the deep sleep phase. When you’re in deep sleep, you have slower brain waves. We get the bulk of our slow wave sleep during the first ½ or 1/3 of the night. So most times night terrors occur in the first 2 -3 hours after going to sleep.
Normally your body prepares you to wake up by having fewer and shorter phases of deep sleep until you finally wake up from the lighter stages of sleep. But with night terrors, you abruptly wake up from deep sleep. It’s like going from a near coma to being shaken awake. You wake up with a lot of confusion and disorientation. You can wake up screaming, sweating with your heart racing, almost like you’re having a panic attack.
This is a central nervous system arousal that is involuntary. It’s not a reaction to a bad dream. Remember, before you woke up, you were in deep sleep which is a stage of sleep where not much dreaming happens. I say this because I’ve heard people say, I have PTSD and it gives me night terrors. You can have both conditions, but the night terrors are not triggered by having an upsetting dream.
Night terrors can be dangerous because you can do things like thrash in the bed, walk around and do things without being fully aware of what you’re doing.
Nightmares versus Night terrors
1. Nightmares occur during REM sleep. This is a lighter stage of sleep where you do most of your dreaming. Your brain waves are faster and if you wake up from this stage, you’re not as confused and you can remember that you were dreaming. You may only remember parts of the dream or you may remember most of it.
2. Nightmares tend to happen in the latter half of your sleep cycle because that’s when you have more REM sleep. The first half of your sleep is front loaded to get in your deep sleep and the second half is lighter with more dream sleep. But you can still have a night terror later in the night.
What causes night terrors?
They’re common in children and can be due to brain immaturity and not necessarily a sign of a medical problem. But if they persist, you should see a medical professional for an evaluation.
In adults, night terrors can be caused by stress, depression, anxiety, sleep apnea, pain and alcohol. Also sleep deprivation can cause this as well.

What can you do about this?
The first thing to do is make sure you have good sleep hygiene like going to bed at a regular time each night and limiting food and drink before bed. If you tend to wake up to go to the bathroom during the night, you can help this by not having anything to drink one hour before bed, then emptying your bladder just before you go to sleep. It’s okay to go to bed thirsty. It may not feel good, but even if you drink a swallow of water just before bed to wet your whistle, your bladder could wake you up several hours later. That breaks up your sleep, leading to a disrupted sleep pattern. This may not make a huge difference for most people, but if you have sleep problem, you want to make all the tweaks you can.

Another thing you can do is if you have frequent night terrors and they occur around the same time each night, you can have someone wake you up or set your alarm to wake up 30 minutes before to break the pattern. This is a sleep intervention called scheduled awakenings. It’s used for children who are not sleeping through the night and keep waking up around the same time each night. You interrupt the pattern by waking them before they wake up. This helps them sleep through that wake up time.

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