Waking up from sleep crying or finding your pillow damp from tears can be distressing. But crying in your sleep is something that happens and can affect people of all ages, including babies, children, adults, and seniors. Here, we explore common causes of crying while sleeping, how it impacts different age groups, and when to talk to your doctor.
What does it mean when you cry in your sleep?
“Crying, even in sleep, can be a normal response to grief, stress, or anxiety,” says Dr. Mia Zaharna, sleep physician at The Permanente Medical Group in San Jose, CA. “It can be a normal part of nightmares or dreams on occasion. However, it can also be related to mental health disorders as well as underlying sleep disorders.”
What causes people to cry in their sleep?
People cry in their sleep for a variety of reasons, including nightmares, night terrors, or other distressing dreams. “If it happens only once in a while, it probably doesn’t have anything to do with trauma and more likely is just due to not getting enough sleep or having your sleep disrupted by other things, such as a disrupted schedule or excessive alcohol,” says Sleep.com advisor Jade Wu, Ph.D. “If it happens frequently, it can reflect significant stress or trauma, just as other parasomnia symptoms like nightmares can reflect stress or trauma.”
Unresolved trauma or grief
One of the main causes of crying in your sleep is past trauma. The reason that unresolved trauma or grief manifests in our sleep is due to our brains performing daily processing functions. “Part of this is cleaning up toxins and storing memories, but another major part is processing what occurred that day or things from the most distant past,” says Dr. Alex Dimitriu, dual board certified in psychiatry and sleep medicine and owner at SiliconPsych.com. “Freud called this ‘day residue,’ or the tendency to keep processing events of the day or more distant past. Crying or other sadness in dreams may be reflective of this background processing and could certainly be unresolved trauma or grief.”
Stress and anxiety
Another main culprit, Dimitriu says, is a carryover of current daytime stressors, which can result in crying in one’s sleep. “Many people are known to experience ‘stress dreams,’ the ones in which you lost your keys, are late to a meeting, a flight, or otherwise unprepared in some way,” Dimitriu says. Stress and anxiety are a normal part of most people’s lives, but if crying in one’s sleep happens too frequently, Zaharna says that “consideration for pathological levels of stress and anxiety in the form of anxiety disorders, depression, or post-traumatic stress disorder might be considered.”
REM Sleep Behavior Disorder
Although it’s rare, REM Sleep Behavior Disorder is another type of sleep disorder in which one might act out their dreams. The dream reenactment includes hand gestures, violent thrashing, punching, and kicking. “This occurs because the muscles which are supposed to be paralyzed in REM sleep are not paralyzed and therefore dreams can be acted out,” Zaharna says. “This may involve vocalizations such as screaming or crying as well. All parasomnias can be worsened by stress, sleep deprivation, and substances such as alcohol.”
How crying in sleep affects different age groups
“Crying during sleep is very common for babies, somewhat less common in children, and becomes less common as a person gets older,” Wu says.
Why babies cry in their sleep
For infants, crying during sleep is very normal. “In the first year, sleep stages are not formed, and even in the second year, they’re slowly being formed. In infants, there are a lot of sleep cycle changes, waking between naps and crying, either because they’re hungry or their diaper needs to be changed,” says Dr. Abhishek Reddy, a physician at Carilion Clinic in Roanoke, VA, who specializes in child and adolescent psychiatry and sleep medicine. “Even when everything is perfect, they still wake up. Research shows it’s about changing in stages — REM to non-REM to REM — that leads to awakenings.”
Why children cry in their sleep
Gradually, children’s sleep stages form and they develop the ability to self-soothe. One of the most common causes of kids crying in their sleep is nightmares. Reddy estimates that on average, 30 to 50% of kids ages 1 to 12 experience nightmares. Because one experiences nightmares while in REM sleep, your body is paralyzed so you can’t act out your dream. “That way, nature has been protective. If it’s really bad, you get up from it, you’re fully alert and have a recall of it,” Reddy says. “Sometimes, if it’s very traumatic, you might cry or be upset about it.”
But other reasons toddlers or young children wake up crying or cry in their sleep can include discomfort, namely stomachaches, gas, acid reflux, or gastroesophageal reflux disease (GERD). Anxiety can be another culprit. “It can also come from separation from parents or being with strangers,” Reddy says. “Anxiety in general can result in crying spells at night.” If a child experienced abuse, either in the present or in the past, this unresolved trauma or grief can also lead to sleep disruptions and possibly crying in one’s sleep.
Night terrors are another reason that children cry in bed, although they’re not as common. He explains that various studies define the age range and percentages differently, but on average, only 6% of children ages 1 to 12 will experience night terrors, as compared to 30 to 50% of children who experience nightmares. Furthermore, Reddy says that night terrors happen more often to children ages 4 to 12.
In the case of night terrors, pediatricians and sleep doctors typically recommend that parents or caregivers provide their child with gentle reassurance and lead them back to bed. Yelling at one’s child or holding them down will only make the situation worse. One important step parents should take is to make sure the bedroom and bed are safe, ensuring that there aren’t any heavy objects on raised shelves and keeping windows closed and locked. By adolescence, night terrors typically spontaneously resolve.
Why adults wake up crying
Unresolved trauma, grief, anxiety, and stress are common reasons adults might wake up crying. Nightmares tend to be less common in adults, although they can happen. People with PTSD are known to have nightmares and sleep disturbances that sometimes lead to awakening. “Some have postulated that the sleep disruption may actually play a role in preventing trauma from being processed in sleep,” Dimitriu says.
Sleep-crying among the elderly
Factors such as emotional trauma, grief, pain, or infection can cause elderly people to cry in their sleep. Parasomnia can affect the elderly, too. “[REM Sleep Behavior Disorder] is a rare disorder, more common in the elderly and those with certain disorders such as Parkinson’s disease or types of dementias known as alpha synucleinopathies,” Zaharna says.
When to seek medical help for sleep crying
Crying in one’s sleep is not always cause for alarm, but if you have concerns or questions, it’s always best to consult your medical care provider. Wu advises seeking medical help “when it’s very frequent and upsetting enough that it affects your mood/functioning during the day or when it significantly disrupts your sleep. It’s unlikely that frequent and severe crying in your sleep occurs in isolation without any other parasomnia symptoms. Those other symptoms will be a red flag for seeking medical help if they occur frequently.”
Trauma, grief, and stress
In the case of trauma, grief, and stress, Dimitriu says that if sleep is not disrupted and your daytime functioning remains intact, the body will heal itself in most cases. However, if crying is associated with sleep disturbance, daytime impairment, or continues for numerous nights in a row, it may be worth speaking with a professional. He adds that the main thrust of treatment for people with episodes of sleep crying is exploring the dreams’ content to identify possible causes, in the immediate or distant past, perhaps brought on by unresolved trauma or grief. In this case, Dimitriu says that speaking with a mental health specialist would be beneficial.
If nightmares are consistently disrupting sleep and interfering with normal daytime functioning, consult your medical professional. “Nightmares are caused by trauma, any kind of trauma,” Reddy says. “The first line of treatment for nightmares is reassurance.” However, for severe cases, where trauma is more, imagery rehearsal therapy (IRT) is an effective treatment. IRT is a cognitive-behavioral treatment for reducing the frequency and intensity of nightmares. Reddy says that IRT is most helpful for school-age children, pre-teens, and teenagers, and that IRT isn’t effective for treating nightmares for children with sexual trauma. In that case, Reddy says that there is solid, though limited, evidence that prazosin is an effective treatment for nightmares for children with trauma, although it is not yet FDA-approved.
Since night terrors commonly affect children, Reddy says that concerns of safety are paramount when considering treatment. “If it’s happening where a kid is getting hurt or hurting others or falling, that [will] probably need immediate attention,” he says. “There’s evidence for small doses of clonazepam, which helps regulate your sleep stages. We don’t prefer using that because benzodiazepines can be addictive long term. But use of a small dose has strong evidence in helping with the treatment of sleep terrors. There’s also evidence for melatonin or antidepressants in the medical treatment of sleep terrors.”
Persistent crying in infants
Although infants have the inability to self-soothe, typically their crying after waking will calm down after they’ve had their diaper changed, are fed, or picked up and held. “Kids who are not [soothed], for whatever reason, maybe they have neuro developmental issues, significant infection, or other medical causes, they would have a hard time going back to sleep or even being able to be soothed.” So if your infant is unusually difficult to soothe, it might be time to speak with their pediatrician.
Is it normal to cry in your sleep?
Crying in your sleep is normal and can be caused by a variety of factors. But if you’re crying in your sleep frequently and it is disrupting your sleep, causing distress, or impacting daily functioning or mood, seek medical help.