Nightmares

Nightmares are vividly realistic, disturbing dreams that can disturb sleep that can create fear, palpitations, and rapid breathing. Just like most dreams, nightmares also tend to occur most often during rapid eye movement sleep or REM sleep. Because periods of REM sleep become progressively longer as the night progresses, nightmares are more common in the early morning hours. Since all dreams including nightmares are a result of the brain’s electrical activity during sleep, they do not signify or mean anything specific.

The subjects of nightmares can vary from person to person. However, there are some common nightmares that many people experience. For example, not being able to run fast enough to escape danger, falling off a cliff, teeth falling out, etc. Recurrent nightmares may occur following a traumatic event, such as an attack or accident.

Although both nightmares and night terrors cause disturbed sleep as well as wake up people in fear, they are different. Night terrors usually occur in the first few hours after falling asleep. They are experienced as feelings and not dreams. Generally, people do not recall their night terror and why they are terrified upon awakening.

Nightmares and night terrors can occur in adults and children. Nightmares are more common in children. One out of every two adults has nightmares on occasion. If nightmares are recurrent, causing significant distress and disturbed sleep, it is important to seek help. Chronic, recurrent nightmares can result in poor quality sleep, and affect mental health and overall health. Treating and preventing nightmares involves identifying and addressing the underlying cause, modifying lifestyle, and practicing good sleep hygiene.

Nightmares in adults are often spontaneous.

There are also several factors and underlying disorders that can cause nightmares:

• Having late-night meals and snacks increases metabolism and brain activity.
• Medications that act on chemicals in the brain, such as painkillers, antidepressants, and blood pressure medications.
• Withdrawal from certain medications and substances, such as alcohol.
• Lack of sleep.
• Psychological conditions, such as depression, anxiety, and post-traumatic stress disorder (PTSD).
• Sleep disorders, such as sleep apnea and restless leg syndrome.

Nightmares caused by other medical conditions or medications usually stop when the condition is treated, or the medications are discontinued. Psychological conditions may require treatment with medication and psychotherapy. Behavioral changes are effective in most cases, including those who have depression, anxiety, or PTSD.

Lifestyle changes, such as keeping a regular wake-sleep schedule, regular exercise, and practicing yoga, meditation, and stress management can help reduce and prevent nightmares. 

Nightmares in children can be extremely frightening to them and feel very real. They may often wake up with fear. They can be afraid or anxious, and experience other emotions (such as anger, sadness, embarrassment, or disgust). The exact cause of nightmares in children is not known.

Certain factors that may increase the risk of nightmares in children include:

• Overtired children
• Stress
• Traumatic events
• Certain medications
• Having a fear of something

The following may help reduce the frequency or stop nightmares in children:

• Making sure the child gets enough sleep.
• Keeping the bedtime routine light and happy.
• Talking about the nightmare during the day.
• Comforting and reassuring the child.
• Encouraging the child to go back to sleep in their bed.
• Avoiding bright lights in the bedroom, and using a night light, which could be used to give the child comfort.
• Leaving the bedroom door open, so they feel safe and close to their parents.

Seeking the help of a doctor or child counselor to help address the underlying cause and the child overcome nightmares and the associated distress.