A disturbing dream linked with negative feelings (such as fear or anxiety that awakens you) is known as nightmare disorder. Commonly, this health problem appears in children but it may occur at any age. There is nothing to worry about if the nightmares do not happen frequently.
In most cases, this disorder appears in children between 3 and 6 years old and decreases when they reach 10 years old. Furthermore, girls tend to have nightmares more often than boys do. Sometimes, this disorder happens in adulthood or the condition is life-long.
While nightmares are considered common, nightmare disorder happens quite rarely. It is considered that a person has this condition when nightmares provoke distress, sleeping problems, daytime functioning issues, fear of going to sleep, and others.
Symptoms
Those who have nightmares usually see them in the second half of the night. If nightmares provoke you to awaken, it can be challenging to sleep again. Check below some nightmare features:
- Dreams are vivid and real and very upsetting.
- The primary theme of the dreams is linked with threats to safety or survival but can have other disturbing themes too.
- Nightmares can awaken you and make you feel scared, anxious, angry, sad, or disgusted.
- A pounding heartbeat and sweating may appear when nightmares happen.
- You can recall details of the dreams after awakening but it will be challenging to fall asleep again.
Healthcare providers consider nightmares a disorder in the following cases. Examples include:
- Reduced energy, fatigue (extreme tiredness), drowsiness that happen during daytime
- Functioning problems at school, work, or in social situations
- Behavior problems linked with bedtime or fear of the dark
- Concentrating issues
- Memory problems
- Nightmares happen frequently
- Persistent fear and anxiety
When children have nightmare disorder it provokes serious sleep problems for parents or caregivers.
You should seek medical help right away if nightmares happen regularly, and provoke sleeping and behavior problems.
Causes
Healthcare providers call nightmare disorder parasomnia (a sleep disorder type that causes unwanted experiences that happen while a person sleeps or when he/she wakes up). Although the exact cause of nightmares is not known, it usually occurs during the sleep stage called rapid eye movement (REM) sleep. Check below some factors that can trigger nightmares:
- Anxiety or stress – While sometimes nightmares can be caused by a stressful situation (such as problems at home or school), in other cases nightmares can happen due to major changes (such as the death of a loved one).
- Trauma – It is common to have nightmares after accident, injury, physical or sexual abuse, or other traumatic events. However, it is common for people with post-traumatic stress disorder (PTSD) to have nightmares.
- Sleep deprivation – Irregular sleeping and waking times are caused usually by different changes in your schedule. The risk of nightmares also increases due to factors that interrupt the amount of sleep a person gets and insomnia.
- Medicines – There are some medicines considered nightmare triggers. These include beta-blockers, drugs used in the treatment of Parkinson’s disease, blood pressure medicines, antidepressants, smoking cessation medicines, and others. Talk with your doctor for more details.
- Overuse of certain substances including alcohol and recreational drugs.
- Other health conditions – For example depression or other mental health problems, heart disease, cancer, and others.
- Scary movies or books – There are people who read scary books or watch frightening movies, especially during nighttime may experience nightmares.
People with a family history of nightmare disorder or other sleep parasomnias (such as talking during sleep) are more prone to experience nightmares.
What Are The Possible Complications of Nightmare Disorder?
Those who have nightmares may also experience the following complications. For example:
- Excessive sleepiness during the day which interacts with proper functioning at school or work. It also may provoke problems with daily routine (including concentrating and driving).
- Mood swings (including depression or anxiety)
- Suicidal thoughts or attempts
- Fear of going to sleep
Discuss with your healthcare provider about ways to prevent or treat complications.
Diagnosis
There are no specific tests to diagnose this disorder. However, physicians diagnose this condition by performing different tests. They can also ask questions about family history and symptoms you experience. In addition, it is considered you have a nightmare disorder if it provokes distress or you cannot get enough sleep. Check below some methods of how doctors usually diagnose this mental disorder:
- Physical examination – During this procedure, doctors will check for other health problems that may contribute to or even trigger nightmares.
- Symptoms discussion – In most cases, nightmare disorder diagnosis is based on the experiences you have, family history, and sleep problems.
- Polysomnography (nocturnal sleep study) – This test is performed by doctors if you experience severe problems with sleep. It involves several sensors placed on the body that help to record oxygen levels in the blood, brain activity, heart rate, and breathing while you sleeping. It helps to determine if nightmares are linked with another sleep disorder.
Treatment
Mostly, the treatment for nightmare disorder is not required but if you experience distress and sleeping problems, doctors may recommend some procedures and medicines. Physicians usually prescribe the treatment according to the cause and symptoms. Check below some treatment options:
- Medical treatment – In such cases, the patients receive treatment for underlying conditions. Usually after treating the condition, nightmares disappear.
- Anxiety or stress treatment – If you experience nightmares due to stress or anxiety you may need counseling or therapy with a mental health professional, stress-reducing techniques, and others.
- Imagery rehearsal therapy – This procedure is used in people who have nightmares due to PTSD. It can help to decrease how often you have nightmares.
- Medicines – Physicians rarely recommend medicines to treat nightmares. However, you may get a prescription in case you have severe nightmares linked to PTSD.
Frequently Asked Questions
Is it possible to have nightmares due to neurological diseases?
Neurological disorders do not cause nightmares but increase the risk. These include:
- Post-traumatic stress disorder (PTSD)
- Obstructive sleep apnea
- Lewy body dementia
- Migraine
- Parkinson’s disease
- Narcolepsy
What are nightmare types?
Commonly, nightmares occur when a person is very stressed. Check below types of nightmares:
- Idiopathic
- Recurrent
- Post-traumatic
Consult with your doctor for more details.
Are there methods to prevent nightmares?
The following tips can help you prevent or even avoid nightmares. For example:
- Do not engage in stimulating activities before bedtime
- Manage stress
- It is advised to make a sleep-friendly environment
- Establish a bedtime routine
- Regular exercise (aim for at least 30 minutes of physical exercise per day)
- Do not consume heavy meals before bed
- Try to relax before you go to sleep
Ask your healthcare professional if you have any other questions.
