Nightmares are common in childhood and concern regarding underlying psychological or physical causes should only be investigated when nightmares become frequent, are present for a prolonged period of time or are associated with day-time behavioural or performance dysfunction. Sleep terrors may be provoked by a number of factors, such as: fever, sleep deprivation, urinary bladder distension, a noisy environment and central nervous system depressants. This article discusses the differences between nightmares and sleep terrors and provides a management approach for the family practitioner.