Nightmares are very common. They are disturbing, visual dream sequences that occur in your mind, wake you up and seem very real. They become more disturbing as they unfold. They tend to involve the emotions of anxiety, fear, or terror. Other emotions that nightmares provoke include the following: anger, rage, embarrassment, disgust or other negative feelings. A disturbing dream that does not wake you up is not considered a nightmare. It is simply a “bad” dream. The content of these dreams can often have the same theme.
The dream content often involves danger or other distressing themes. You can normally recall very clearly the details of the nightmare when you wake up. You may have more than one nightmare in a night. Nightmares that arise due to a trauma can also occur and may depict some of the events from the trauma. They may even replay the event in the dreamer’s mind.
Children. They can begin at any age for boys or girls. They usually begin before a child reaches six years of age. Up to half of children from three to five years of age have severe nightmares that disturb their parents. Nightmares in children tend to reach a peak by 10 years of age. After that they decrease. Some children may continue to have nightmares as teens and adults. For them it may be a lifelong problem.
Most adults report having a nightmare at least every now and then. They tend to become less frequent and intense as you age. Teen and adult women report nightmares more often than teen and adult men. Women are also more open to talking about them.
Nightmare disorder is when you frequently have nightmares. This can cause you to fear going to sleep, worry that you will have another nightmare and cause you to feel anxious and make it hard to go back to sleep. This loss of sleep can cause you to have even more intense nightmares. Nightmare disorder can make you very sleepy during the day.
Nightmare disorder can be confused with sleep terrors or sleep behavior disorder. A person having a sleep terror often screams, kicks, thrashes and even bolts out of bed, can be very hard to wake up, often is very confused, only recalls fragments of a dream. Sleep behavior disorder involves a person acting out his dream. It can even result in physical injury. It is most common in middle-aged men. The use of some medications may be a cause of nightmare disorder. It is more common if a relative also has it.
Self Evaluation. If you answer yes to these questions, then you might have nightmare disorder.
- Do you often wake up from sleep due to a disturbing dream?
- Do these dreams evoke emotions of fear, anger, sadness or disgust?
- Are you alert and able to think clearly as soon as you are awake?
- Do you clearly recall details of the dream?
- Do these dreams often occur during the late portion of your sleep period (near morning)?
- Do you have trouble going back to sleep after these dreams?
- Also, your sleep problems may be a result of one of the following: another sleep disorder, a medical condition, medication use, a mental health disorder or substance abuse.
Seeing a Sleep Specialist. You should see a sleep specialist if nightmares cause you great anxiety or often disrupt your sleep. The sleep specialist will help make an accurate diagnosis of your problem. They will also rule out possible underlying causes of the problem. Sleep physicians do not typically treat nightmares. Most often they refer you to an experienced counselor or psychologist.
Sleep Diary. You will also want to keep a sleep diary for two weeks. The sleep diary will help the doctor see your sleeping patterns. This information gives the doctor clues about what is causing your problem and how to correct it.
Testing. Tests are not normally needed for someone who suffers from nightmares. Your doctor may have you do a study if your problem is severely disturbing your sleep: a polysomnogram which charts your brain waves, heart rate, how your arms and legs move and breathing as you sleep. This study will help reveal if your nightmares are related to any other type of sleep disorder.
Treatments. Nightmare disorder is often treated with counseling or psychotherapy. These methods help resolve conflicts that produce nightmares. Intensive therapy may be needed for a person whose nightmares stem from a traumatic event in his or her life. Managing stress in your life is an important way to help manage nightmares. Relaxation training may also help.
Medications.Medications are not commonly used for this problem. They may be considered in extreme cases.
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