Nighttime fears in children:
A guide for the science-minded
© 2008 - 2014 Gwen Dewar, Ph.D., all rights reserved
Nighttime fears are very common, and may include fears of intruders,
monsters, unexplained sounds, and darkness. In this article, I review
- The evolutionary basis for children's fears
- Why kids may be biologically unprepared to cope by themselves, and
- How you can help your child overcome her fears and anxieties
If your child suffers from frightening dreams or nighttime screaming episodes, you might also want to check out this article on
nightmares and night terrors.
Nighttime fears in evolutionary and cross-cultural perspective
If you’re reading this because your child suffers from nocturnal
fears, he’s fortunate in at least one respect: You know about it.
In a study of Dutch children, over 73% of kids aged 4-12 years said they experienced fear at night (Muris et al 2001).
Another study of Australian children reported that over 64% of
kids between 8 and 16 admitted to nighttime anxieties or fears (Gordon
et al 2007).
In both cases, many parents were unaware of their children's problems.
Why do so many of these kids report nighttime fears? And why are some parents out of touch?
Perhaps the answer is related to the practice of solitary sleep.
In most places around the world, young children sleep with other
people. But in some Western countries, children are expected to sleep by
Does solitary sleep make children more fearful? It would be
surprising if co-sleeping with parents didn’t reduce a child’s
separation anxiety -- a panic response arising from a primitive part of
brain that also processes information about physical pain (Panskepp
And it makes sense that kids might find nocturnal
separation to be especially distressing. For over 99% of human history,
our ancestors lived as hunter-gatherers. Among these ancestors,
children left alone at night would have been extremely vulnerable to
predation. Leaving a child alone at night meant abandonment and (very
possibly) death. Fear evolved to keep kids close and safe.
Few modern kids have to worry about getting attacked by
predators. But the tendency to be fearful remains, and some young
children have trouble distinguishing fantasy from reality. These kids
may have more nighttime fears as a result (Zisenwine 2012), and sleeping
alone might make things worse.
In a study tracking over 900 Quebecois children from the age of
two, Valérie Simard and her colleagues found that toddlers who slept in
their mothers' beds were less likely to suffer from nightmares in later
years (Simard et al 2008).
The correlation is suggestive, but not conclusive. Maybe kids who
co-sleep have other advantages that reduce the risk of nightmares. But
one thing seems clear. Whether your child sleeps along or with family
members, nighttime fears and anxieties should be taken seriously.
Although the kids in the Australian study were selected from the
general population (as opposed to a psychiatric practice or sleep
clinic), researchers discovered that about 10% of children complaining
of nighttime fears fit the criteria for an anxiety disorder.
And the study by Simard and colleagues reports strong links
between anxiety and bad dreams. Seventeen-month-old kids who were rated
by their mothers as anxious, difficult, or emotionally disturbed were
more likely than other children to have bad dreams at 29 months (Simard
et al 2008).
The researchers speculate that some children—those who are more
inhibited or anxious—at are greater risk for chronic nightmares and
other psychological problems. If parents treat their children’s fears at
an early age, they might help their children avoid emotional problems
later in life.
Addressing your child's nighttime fears may also help her get more sleep. Kids suffering from
nighttime fears may suffer from bedtime problems
and frequent night wakings.
Finally, we should keep in mind that everybody tends to overreact to emotional stimuli at the end of the day.
Experiments suggest that the amygdala -- a brain region that processes
emotional events -- becomes overactive when you are tired (Yoo et al 2007; Maski and Kothar 2013). Negative emotions may come naturally to us at night.
Why kids need help coping with nighttime fears
Adults find it difficult to cope with fear and anxiety. When older
adults go to sleep feeling lonely, threatened, sad, or out-of-control,
they experience elevated levels of cortisol (a stress hormone) the next
day (Adam et al 2006).
If this is the adult experience, what must it be like for a child who lacks the mature coping skills of an adult?
To deal successfully with nighttime fears and separation anxiety, a child needs
- A well-developed sense of time (“when will I see Mommy again?")
- The ability to control emotional impulses
- The ability to distinguish appearances from reality
- The ability to reason consciously and trust rational
conclusions over misleading sensory information (“that shadowy bump on
the floor might look like a monster, but I know it’s really a pile of
Most kids don’t develop these capacities until they are 5-6 years
old—not coincidentally the age when the frontal lobes start to mature
(Eliot 2000). The brain’s frontal lobes permit us to reason,
problem-solve, and plan ahead. They also help us decide what to do with
the raw emotions we feel.
The implications seem clear. When frightened toddlers and
preschoolers are left to fend for themselves, they don’t know how to
calm themselves down. And even after kids develop the ability to reason
about their emotions, they can’t be expected to invent their own
effective fear-management therapies.
Moreover, some kids are intrinsically more timid than others.
These kids may be at a physiological disadvantage when it comes to
confronting their own fears.
Temperamentally-inhibited children tend to have higher resting
heart rates and higher levels of stress hormones. They show greater
brain activity in the right frontal lobe—where fears and anxieties are
processed (Eliot 2000).
And animal studies suggest that the amygdala—the brain structure
that tells us when we should be afraid—is more sensitive, or
“trigger-happy," in timid children (Fox et al 2005; Eliot 2000). These
kids can learn to be less fearful. But to do it, they need the
sensitive, gentle encouragement of their parents.
What's the bottom line?
Kids need help coping with nighttime fears, and they need a
helper who is sensitive to their developmental stage and individual
They need someone to reassure them, to provide them with a sense
of security, and to teach them how to overcome their nighttime fears.
In short, they need responsive, rational parenting.
Helping children cope with nighttime fears: A checklist
• Always question parenting advice that encourages parents to leave
distressed children alone at night. As noted above, kids lack the coping
tools to work things out by themselves. And even advocates of
“cry-it-out" strategies of sleep training warn that such approaches are
inappropriate for young babies and children who are especially fearful
or anxious (France and Blampied 1999; Owens et al 1999).
• Talk to kids about the difference between fantasy and reality,
and prove to them that there is no monster in the closet. As noted
above, children who have trouble distinguishing fantasy and reality may
be at higher risk for nighttime fears (Zisenwine et al 2012).
• Consider sources of daily stress. Kids who suffer from daytime
anxieties—about school, separation from parents, or other concerns—are
more likely to fear the dark and fear sleeping alone (Gregory and Eley
2005). You may be able to reduce your child’s nighttime fears by helping
him cope with daytime stress.
• Review your child’s
and sleep schedule. Sometimes parents overestimate how much sleep their
children need. As a result, they send their kids to bed long before kids
can fall asleep. Kids left to stew in the dark have more time to dwell
on nighttime fears (Ferber 1995).
• Avoid frightening television, stories, and imagery— especially
before bedtime. This includes passive exposure, which occurs when your
child is present while you watch potentially disturbing material on TV. A
recent study reported that 5-6 year olds exposed to adult TV
programs—including the evening news—slept less overall and experienced
more sleep disturbances (Paavonen et al 2006).
• Fight fear with the power of touch. Physical affection switches off separation anxiety (Panskepp 2006).
• Offer your child the comfort of a soft toy animal or doll.
There is experimental evidence that this old standby really helps: In a
study that randomly assigned fearful children to receive a toy "huggy
puppy," kids exhibited fewer nighttime fears and sleep problems than did
children in a control group. The effect was observed whether the toy
was presented as a protector or as a creature needing protection
(Kushnir and Sadeh 2012).
• Try to be patient. If your child’s nighttime fears are
depriving you of sleep, it’s natural to feel resentment. But it’s
important not to direct anger or irritation at your child. If your child
feels rejected, this will only intensify his separation anxiety and
make things worse.
• Respond promptly to nightmares. Assure your child that the
nightmare wasn’t real, and explain that everybody has nightmares
sometimes. The more quickly you break the spell of a frightening dream,
the more quickly your child can get back to sleep.
• Provide your child with a night light. As you and your
works through her nighttime fears, you can switch to progressively
dimmer lights (Glaze 2004). But word to the wise: Find a nightlight that
gives off soft, warm light, not light with a blue cast. The latter
inhibits the production of melatonin in the brain, and thus may prevent
your child from feeling drowsy at bedtime.
• Be a model of calm, confident behavior. When your child comes
to you in a fearful state, be warm, sensitive and responsive. Tell him
you understand that he is scared, and that everybody gets scared
sometimes. But don’t let sympathy turn into overprotectiveness. Many
animals—ranging from birds to monkeys—are sensitive to social cues about
fear (Zentall and Galef 1988). They pick up fears by watching others
model them. Kids are no exception. If your child believes you are
worried or anxious, he may become more fearful.
• Show your child how to relax. For instance, as you soothe a
crying child, you can show her breathing exercises. In a study aimed at
reducing anxiety in young children scheduled for a medical procedure,
researchers taught kids how to take slow, deep breaths by having them
exhale into party blowers (Jay et al 1987). These breathing exercises
appeared to reduce distress in 40% of the kids.
• Counteract frightening thoughts with images of happiness,
safety, and bravery. When he is fearful, help your child think of
situations that make him feel happy and in control. For instance, you
might encourage him to imagine he is playing with his favorite pet. You
might also have your child practice telling himself that he is brave.
This technique was used in the study mentioned above (Jay et al 1987).
• Teach coping skills through role playing. Many kids overcome
their fear of medical check-ups by playing doctor. You can apply this
approach to nighttime fears as well. During the daytime, talk about your
child’s fears and discuss how she can counteract them. Help your child
practice the tactics mentioned above—thinking happy thoughts, telling
oneself that one is brave, rehearsing relaxing techniques, and
transforming frightening imaginary creatures into something silly and
non-threatening. Then try a little role playing (Jay et al 1987). If you
have another adult or older child to help, the two of you can act out
the parts of frightened child and helpful parent. The parent shows the
child how to counter her nighttime fears, and the child tries each
technique out. After this demonstration, have the child play the part of
the comforting adult. You—or a favorite toy—can take the part of the
• During the daytime, create stories with your child in which the
protagonist (your child’s favorite fictional character or hero) learns
to overcome his nighttime fears. This technique—called story
desensitization—is designed to make children less fearful by having them
confront their fears in small steps (King et al 2001). Start by telling
a story that lacks any frightening elements. Then introduce something
that is just a little bit scary. For instance, if your child is afraid
of spiders, you might add a very small, non-threatening spider to the
story (one that keeps its distance from the hero). The hero responds by
successfully practicing the fear management techniques mentioned above.
If this story doesn’t distress your child, you can intensify the
frightening element in the next story—perhaps by making the spider come
closer. In this way, you may gradually desensitize your child’s fears.
• If your child suffers from severe nighttime fears, consult with a doctor or licensed therapist. Recent research suggests that kids with problems at night often suffer from a variety of problems during the day, including anxiety, impulsivity, and abnormal attentional control (Kushnir et al 2014). A specialist can recommend a program of help tailored to the individualized needs of your child.
References: Coping with nighttime fears
Adam EK, Hawkley LC, Kudielka BM, and Cacioppo JT. 2006. Day-to-day
dynamics of experience--cortisol associations in a population-based
sample of older adults. Proc Natl Acad Sci USA. 103(45):17058-63.
Eliot L. 2000. What’s going on in there? How the brain and mind develop during the first five years of life. New York: Bantam.
Ferber R. 1995. Sleeplessness in children. In R Ferber and M
Kruger (eds), Principles and Practices of sleep medicine in children.
Fox NA, Henderson HA, Marshall PJ, Nichols KE, and Ghera MM.
2005. Behavioral inhibition: linking biology and behavior within a
developmental framework. Annu Rev Psychol. 56:235-62
France KG and Blampied NM. 1999. Infant sleep disturbance:
Description of a problem behaviour process. Sleep Medicine Reviews 3(4):
Glaze DG. 2004. Childhood insomnia: why Chris can’t sleep. Pediatrics Clinics of North America 51: 33-50.
Gordon J, King NJ, Gullone E, Muris P, and Ollendick TH. 2007.
Treatment of children's nighttime fears: the need for a modern
randomised controlled trial. Clin Psychol Rev. 27(1):98-113.
Gordon J, King N, Gullone E, Muris P, and Ollendick TH. 2007.
Nighttime fears of children and adolescents: frequency, content,
severity, harm expectations, disclosure, and coping behaviours. Behav
Res Ther. 45(10):2464-72.
Gregory AM and Eley TC. 2005. Sleep problems, anxiety, and
cognitive style in school-aged children. Infant and Child Development
Jay SM, Elliott, CH, Katz, ER, and Siegel, SE (1987).
Cognitive-behavioral and pharmacologic interventions for childrens'
distress during painful medical procedures. J. Consult. Clin. Psychol.
King NJ, Heyne D, Gullone E, and Molloy GN. 2001. Usefulness of
emotive imagery in the treatment of childhood phobias: clinical
guidelines, case examples and issues. Counselling Psychology Quarterly
Kushnir J and Sadeh A. 2012. Assessment of brief interventions
for nighttime fears in preschool children. Eur J Pediatr. 171(1):67-75.
Kushnir J1, Gothelf D2, Sadeh A. 2014. Nighttime fears of
preschool children: A potential disposition marker for anxiety? Compr
Mahat G and Scoloveno M. 2003. Comparison of fears and coping
strategies reported by Nepalese school-age children and their parents. J
Pediatr Nurs. 18(5):305-13.
Maski KP and Kothare SV. 2013. Sleep deprivation and neurobehavioral functioning in children. Int J Psychophysiol. 89(2):259-64.
Muris P, Merckelbach H, Ollendick TH, King NJ, and Bogie N. 2001.
Children's nighttime fears: parent-child ratings of frequency, content,
origins, coping behaviors and severity. Behav Res Ther. 39(1):13-28.
Owens JL, France KG, and Wiggs L. 1999. Behavioural and
cognitive-behavioural interventions for sleep disorders in infants and
children: A review. Sleep Medicine Reviews 3(4): 281-302.
Paavonen EJ, Pennonen M, Roine M, Lahikainen AR (2006): TV
viewing associated with sleep disturbances in 5-6 year old children. J
Sleep Res 15: 154-161.
Panksepp J. 2001. Affective Neuroscience: The Foundations of Human and Animal Emotions. New York: Oxford University Press.
Simard V, Nielsen TA, Tremblay RE, Boivin M, and Montplaisir JY.
2008. Longitudinal study of bad dreams in preschool-aged children:
prevalence, demographic correlates, risk and protective factors. Sleep
Yoo SS, Gujar N, Hu P, Jolesz FA, Walker MP. 2007.
The human emotional brain without sleep--a prefrontal amygdala
disconnect. Curr Biol. 17(20):R877-8.
Zentall TR and Galef BG (eds). 1988. Social learning:
Psychological and biological perspectives. Hillsdale, NJ. Lawrence
Zisenwine T, Kaplan M, Kushnir J, Sadeh A. 2012. Nighttime Fears
and Fantasy-Reality Differentiation in Preschool Children. Child
Psychiatry Hum Dev. 2012 Jul 3. [Epub ahead of print]
Content last modified 1/14