Nightmares and Sleep Terrors, what's the difference?

Everyone has good and bad dreams. It's like a live horror movie playing in your mind, probably waking you up right before something terrible happens.

For example, falling off a cliff or about being murder - relieved when you realize it's just a bad dream, it wasn't real.

But did you know there are actually two types of sleep conditions that fall under the "bad dream" umbrella? Nightmares and sleep terrors (also called night terrors).

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(2.3k points) · opinion .

Nightmares are unpleasant dreams that you usually remember upon waking, while sleep terrors involve feelings of intense fear, screaming, and thrashing around while you're still asleep.

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(2.3k points) · opinion .
Difference between Nightmares and Sleep terrors: you typically remember your nightmares - maybe not every detail, but you can remember that you’ve at least had one.

But with night terrors, you could wake up and have no idea it occurred. The episode is typically remembered by your bed partner (hard for them to sleep through the screaming!), but not by you. So, if you sleep alone, you could have sleep terrors and not even know it.
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(2.3k points) · opinion .
A nightmare tends to get scarier gradually, not right away. Think of it like a scary movie - there tends to be a build up.

Sleep terrors are different, you can be sleeping calmly, and all of a sudden you’re scared and screaming.
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(2.3k points) · opinion .

This is partly due to the stage of sleep the event happens in. Nightmares occur during rapid eye movement (REM) sleep. This is the stage of sleep when vivid dreaming is most likely to happen, according to the American Sleep Association (ASA), and the brain is more active than it is during other stages of sleep.

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(2.3k points) · opinion .

Sleep terrors typically happen during non-REM sleep, specifically stage three sleep. This stage is also called deep sleep, where according to the ASA, extremely slow brain waves start to appear, interspersed with faster waves.

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(2.3k points) · opinion .
Because nightmares and sleep terrors happen during different stages of sleep, they also happen at different times of night as a result. Stages three and four sleep usually happen during the first half of the night, and REM sleep during the second half. So when I’m caring for a patient, I always ask about the timing of the event. If it happened during the first half, I’ll consider sleep terrors, and if it happened in the second half then I’ll lean towards nightmares.
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(2.3k points) · opinion .
I’ll also want to know if my patient was easy to reassure after the event. It’s easier to comfort someone who just woke up from a nightmare than a sleep terror. They’re awake, coherent, and can be reassured. They’ll realize they had a nightmare and it was just a dream. Sleep terrors are different. They can’t be comforted, and they may not even notice someone else is in the room with them. This happens because they’re only partially awake—much of their brain is still asleep.
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(2.2k points) · commented .
So why does our brains play such terrifying tricks on us when we're sleeping?
(855 points) · commented .
Nightmares are very common; 35-45 percent of people have one nightmare per month, and 2-6 percent have them more than once a week. Women have them more often than men, especially during pregnancy.
(855 points) · opinion .

According to the National Sleep Foundation, there are a few things that increase the likelihood of having a nightmare, including eating before bed (your metabolism kicks in, keeping your brain active), medications including certain antidepressants, lack of sleep, sleep disorders like restless leg syndrome, and stress.

Recurring nightmares, or bad dreams where the same theme or events play out, are especially prevalent among trauma survivors and people with PTSD, according to the U.S. Department of Veterans Affairs.

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(855 points) · opinion .

Nightmares are very common—35-45 percent of people have one nightmare per month, and 2-6 percent have them more than once a week. Women have them more often than men, especially during pregnancy.

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(855 points) · opinion .

Not as many people have experienced sleep terrors, but about 10 percent will have one in their lifetime. Sleep terrors tend to affect kids more than adults, according to The Mayo Clinic. Almost 40 percent of children will experience sleep terrors, but most outgrow them by their teen years.

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(855 points) · opinion .

According to the Mayo Clinic, a few things can trigger sleep terrors including sleep deprivation, stress, fevers, and changes in sleep schedule (like travel or jet lag). Sleep apnea, restless leg syndrome, and alcohol use can also increase the likelihood of sleep terrors.

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(855 points) · opinion .

Sleep terrors are more common in people with mood or anxiety disorders, including PTSD. They're also more prevalent in people who sleep walk and/or talk. This is because sleep terrors, sleep walking, and sleep talking are thought to have similar underlying mechanisms in the brain during sleep; they also tend to occur during the same stages of sleep.

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