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Parent’s Guide to Helping Teens Through Night Terrors & Nightmares 

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT Meet The Team >

As a parent, witnessing your teen struggle with night terrors and nightmares can be deeply unsettling. At Evolve, we specialize in adolescent care and are committed to helping teens improve their mental health. We’ve created this guide to help you understand teen nightmares and night terrors and provide effective support for your teen.

Helping Teens Through Night Terrors

The Differences Between Night Terrors vs Nightmares 

Night terrors and nightmares are often confused, but they’re distinct experiences. Understanding their differences is crucial in addressing them effectively.

Night Terrors

Night terrors in teens are intense episodes where they may scream, thrash, or appear terrified while still asleep. Unlike nightmares, they usually don’t remember these episodes. These episodes are more than bad dreams and can be linked to genetics, stress, or sleep disruptions.


Nightmares are vividly realistic, disturbing dreams that rattle your teen and often wake them from sleep. Unlike night terrors, they usually remember these dreams. They can stem from anxiety, traumatic experiences, or stress affecting the adolescent brain, and when they’re consistent, often signal underlying emotional issues.

What Causes Sleep Terrors in Teens?

Several factors can contribute to sleep terrors in teens:

  1. Genetics: If a family member, particularly a close relative, has a history of sleep terrors or related sleep disturbances like sleepwalking, the likelihood of a teen experiencing similar issues increases. This genetic predisposition suggests that some individuals are more naturally prone to experiencing these types of sleep disturbances due to inherited traits affecting their sleep patterns or neurological responses during sleep.
  2. Stress and Anxiety: High levels of stress and anxiety are significant triggers for sleep disturbances, including sleep terrors. Stressful life events, daily pressures, or underlying anxiety disorders can disrupt normal sleep architecture, leading to an increase in the frequency and intensity of sleep terrors. Anxiety can also heighten the body’s arousal during sleep, making it more susceptible to sleep disruptions.
  3. Lack of Sleep and Sleep Disruptions: Inconsistent sleep schedules and inadequate sleep can significantly contribute to sleep terrors. Teenagers often experience changes in their sleep patterns due to various factors like academic pressures, social activities, and changes in their biological clocks. This irregularity can disrupt the natural sleep cycle, increasing the likelihood of sleep terrors. A consistent sleep schedule and ensuring adequate sleep are essential for reducing the occurrence of these episodes.
  4. Medications and Substance Abuse: Certain medications, especially those that affect the central nervous system, can increase the risk of sleep terrors. This includes some types of antidepressants, sedatives, and stimulants. Additionally, substance abuse, particularly of alcohol and recreational drugs, can significantly disrupt sleep patterns and quality, leading to an increased risk of sleep terrors.
  5. Fever or Illness: Physical health issues, such as a fever or illness, can impact the quality of sleep and increase the likelihood of sleep terrors. When the body is fighting an infection, it undergoes various physiological changes that can disrupt normal sleep patterns. The increased body temperature and immune response during a fever can also alter brain activity during sleep, potentially triggering sleep terrors.
  6. Psychological Factors: Mental health conditions, notably PTSD (Post-Traumatic Stress Disorder), can play a significant role in the occurrence of sleep terrors. PTSD, often characterized by reliving traumatic events through flashbacks and nightmares, can lead to intense sleep disturbances, including sleep terrors. The heightened state of alertness and anxiety associated with complex PTSD can disrupt the sleep cycle, making it more difficult for the brain to transition smoothly through the different stages of sleep.
  7. Sleep Deprivation: Not getting enough sleep on a regular basis can trigger sleep terrors. Sleep deprivation can cause significant stress on the body and the brain, disrupting the normal sleep cycle and leading to an increase in the frequency of sleep terrors. Ensuring that teens get adequate, restful sleep is a critical step in preventing sleep disturbances like sleep terrors.

Each of these factors can, independently or in combination, contribute to the occurrence of sleep terrors in teens. Addressing these underlying causes can be an effective way of managing or even preventing sleep terrors. This might involve lifestyle changes, counseling, stress management techniques, adjusting medication, or treating underlying medical conditions.

Preventive Techniques for Sleep Terrors 

Sleep terrors may seem overwhelming, but there are techniques that can help mitigate them:

  1. Managing Stress: Stress is a significant trigger for sleep terrors. Teaching teens stress-relief techniques can be immensely helpful. This includes practices such as mindfulness meditation, deep breathing exercises, yoga, or engaging in hobbies and activities that they find relaxing. The goal is to equip them with tools to manage their stress levels effectively, thereby reducing the likelihood of sleep terrors.
  2. Limiting Caffeine: Caffeine is a stimulant that can disrupt sleep patterns and quality, especially when consumed in the late afternoon or evening. Limiting caffeine intake can help improve sleep quality. This includes reducing the consumption of caffeinated beverages like soda, coffee, and energy drinks, particularly in the hours leading up to bedtime.
  3. Maintaining a Consistent Sleep Schedule: A consistent sleep schedule helps regulate the body’s internal clock, leading to improved sleep quality. This means going to bed and waking up at the same time every day, even on weekends. A regular routine signals the brain and body when it’s time to wind down and prepare for sleep, reducing the chances of sleep disruptions like terrors.
  4. Managing Anxiety: If anxiety is a contributing factor to sleep terrors, addressing this underlying issue is vital. This can be through therapy, such as cognitive-behavioral therapy (CBT), which is effective in managing anxiety disorders. Additionally, techniques like journaling, speaking with a trusted individual, or participating in support groups can also help manage anxiety levels.
  5. Addressing Underlying Medical Conditions: Sometimes, sleep terrors are symptomatic of underlying medical issues. Conditions like sleep apnea, restless leg syndrome, or certain neurological disorders can disrupt sleep. It’s important to consult healthcare providers to diagnose and treat any such underlying conditions.
  6. Considering Professional Help: If sleep terrors persist or are severe, seeking guidance from mental health professionals or a sleep specialist is advisable. Professional help can provide a more tailored approach to managing sleep terrors, including potential therapies like talk therapy, medication (if necessary), and other interventions designed to target the root cause of sleep disturbances.
mom talking to teen daughter

How to Help Your Teen Deal with Recurring Nightmares Every Night 

If your teen has recurring nightmares, it’s crucial to create a supportive environment. Discuss their fears and reassure them. Encourage them to write about or draw their nightmares as a way to process these experiences. If the nightmares persist, consider sending them to a therapist to get to the root of the fears they’re experiencing. 

When Teens Dream About Losing Teeth: Causes and Coping

Dreams about losing teeth are often linked to deep-seated anxieties and fears. These dreams might reflect a teen’s worries about their appearance, fear of not being accepted, or anxiety about major life changes (like transitioning to adulthood). They can also symbolize a feeling of powerlessness or loss of control in certain areas of their life.

Encourage your teen to talk about these dreams, which can help in understanding and addressing the underlying anxieties. Techniques such as guided imagery, progressive muscle relaxation, or meditation before bed can also help reduce anxiety and promote more peaceful sleep. If these dreams are frequent or very distressing, it may be beneficial to consult a mental health professional. They can help identify and treat underlying anxiety or other emotional issues.

PTSD Nightmares in Teens

Nightmares are a common symptom of PTSD in teens. They often involve reliving the traumatic event and can be extremely vivid and distressing. For effective treatment of these PTSD nightmares, it’s important to treat the underlying PTSD. This might involve trauma therapy treatment like cognitive-behavioral therapy (CBT) or eye movement desensitization and reprocessing (EMDR), both of which we offer at Evolve. Treatment also includes helping teens develop coping strategies to manage the immediate distress caused by nightmares, such as grounding techniques or creating a safe mental space.

The Impact of Nightmares and Dreams on Teen Mental Health

It may seem unfair, but the nightmares themselves may have a negative impact on teen sleep and mental health, which is why it’s crucial to break the cycle. Recurrent nightmares can lead to fear of going to sleep, resulting in anxiety and sleep avoidance. Over time, this can contribute to the development of mood disorders like depression. Frequent nightmares can disrupt sleep patterns, leading to insomnia. This lack of sleep can exacerbate other mental health issues and negatively impact daily functioning. Unfortunately, there is a correlation between insomnia and teen suicide, so getting professional help is very important.

Creating a Calm Bedtime Routine for Night Terrors

Ready to help your teen get a good night’s sleep? It may be tempting to reach for the melatonin, but that could cause your teen to begin a pattern of using substances to sleep. Here are some natural ways to calm the body down at bedtime:

Limit Screen Time: Encourage teens to turn off electronic devices at least an hour before bed. The blue light from screens can interfere with the body’s natural sleep-wake cycle.

Relaxation Techniques: Practices like deep breathing exercises, mindfulness, or gentle stretching can help the body and mind relax and prepare for sleep.

Comfortable Environment: Ensure the sleeping environment is conducive to rest. This means a comfortable mattress and pillows, a dark room, and a quiet atmosphere.

Calming Activities: Activities like reading a book, listening to soft music, or engaging in a relaxing hobby can help signal to the body that it’s time to wind down.

Consistent Bedtime: Going to bed at the same time every night helps regulate the body’s internal clock, making it easier to fall asleep and reducing the likelihood of sleep terrors.

When To Get Help For Nightmares or Night Terrors 

Seek professional help if your teen’s sleep disturbances persist, particularly if they lead to daytime drowsiness, affect school performance, or cause behavioral issues. At Evolve, we offer treatment for teens with anxiety, and we can help your teen get to the root of what’s bothering them. Reach out to our admissions team to learn how we can support them. 

Frequently Asked Questions (FAQs) About Nightmares and Night Terrors 

Are nightmares and night terrors more common in teens or adults?

Nightmares are common in both, but night terrors are more prevalent in children and can continue into adolescence.

Can anyone experience night terrors, or are they specific to certain age groups?

While more common in children, night terrors can occur at any age.

Are there common themes or triggers for nightmares and night terrors?

Yes, stress, trauma, and sleep disruptions are common triggers.

Are there medications or therapies available to treat or reduce the frequency of night terrors?

Yes. While medication is not typically the first line of treatment, options like benzodiazepines or certain antidepressants may be prescribed in severe cases. More commonly, therapies such as Cognitive Behavioral Therapy (CBT), relaxation techniques, and counseling are employed to address underlying stress or anxiety contributing to night terrors. In some cases, especially for children, a technique known as scheduled awakening—waking the person shortly before they typically experience a night terror—has been effective. It’s important to consult with a healthcare professional to determine the most appropriate treatment approach based on the individual’s specific needs and circumstances.

Can changes in diet or lifestyle help mitigate the occurrence of nightmares or night terrors?

Yes. These changes can include relaxation techniques like deep breathing exercises, mindfulness meditation, or gentle yoga, which help in reducing stress and anxiety. Creating a sleep-conducive environment is also important: ensure the bedroom is quiet, dark, and comfortable, and limit exposure to screens and stimulating activities before bedtime. Additionally, dietary habits play a role; avoid heavy meals, caffeine, and sugary snacks close to bedtime, opting instead for light, sleep-friendly snacks if necessary. These self-help strategies, focused on relaxation and establishing a consistent sleep routine, can significantly reduce the likelihood of experiencing nightmares and night terrors.

Are night terrors related to sleep disorders like sleepwalking or sleep talking?

Yes, they can be associated with other sleep disorders.

How long do nightmares and night terrors typically last during the night?

Nightmares and night terrors usually last a few minutes, but their duration can vary.

Can you remember a nightmare or night terror upon waking up?

Nightmares, yes. Night terrors are often forgotten upon waking.

Should I wake someone up during a night terror, or is it better to let it pass?

It’s usually better to let it pass unless they are in danger.

Are night terrors in teens different from those in adults?

The manifestation can be similar, but the causes might differ.

At what age do most children outgrow night terrors?

Most outgrow them by adolescence.

Should I be concerned if my teen has frequent night terrors?

It’s worth investigating. Consult a healthcare provider if your child’s night terrors are frequent and disruptive.

Are there any medical conditions or medications that may trigger night terrors?

Yes. Certain conditions like Restless Leg Syndrome, central nervous system disorders, and fevers can lead to night terrors. They can also be triggered by certain psychiatric medications, sedatives, stimulants, and substance withdrawal. 

Can sleep apnea or other sleep disorders contribute to night terrors?

Yes. Conditions like sleep apnea, where breathing repeatedly stops and starts during sleep, can cause frequent awakenings and disturb the sleep cycle, potentially leading to night terrors.

How are night terrors diagnosed by medical professionals?

Through a combination of medical history, sleep diaries, and sometimes sleep studies, medical professionals can diagnose night terrors and other sleep disturbances.

What kind of healthcare provider should be consulted for night terrors?

Start with a primary care physician, who may refer to a sleep specialist or psychologist. You can also reach out to us at Evolve if you believe treatment is necessary.

Are there tests or assessments that can help identify the underlying causes of night terrors?

Sleep studies and psychological evaluations can be helpful. At Evolve, we work through these underlying causes in therapy to help your teen get to the root of what’s bothering them. 

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