On awakening from a nightmare, a child is alert and aware of the present surroundings, but the sleep disturbance causes distress and impairment in everyday functioning. Nightmares often are confused with the parasomnia known as night terrors, which are episodes of extreme panic and confusion associated with vocalization, movement, and autonomic discharge. Children with night terrors are difficult to arouse and console and do not remember a dream or nightmare. Most dreaming occurs during REM sleep. REM sleep is characterized by EEG activity similar to a wakeful pattern.
Nightmares occur in all races and cultures.
Sporadic nightmares are common in children and usually occur in the middle of the night or early morning when REM sleep is more common. The dream typically involves some danger or threat to the child. Nightmares may involve a monster, ghost, fierce animal, or bad individual. Loss of control and fear of injury are common themes. Vocalizations, movement, and autonomic symptoms are minimal.