Symptom: Nightmares

    What Are Nightmares?

    Nightmares are dreams that are scary or disturbing. They cause anxiety and fear, even after you wake up. People of all ages have nightmares, but they are more common in children. Nightmares usually begin before age 10, and girls are more likely to be troubled by them.

    Except in the case of post-traumatic stress disorder, nightmares are not indicative of any underlying medical or psychological condition.

    Nightmares can become a problem if they persist and interrupt your sleep pattern. This can lead to insomnia and difficulty functioning during the day. Consult with your physician if you are having trouble coping with nightmares.

    The medical term for nightmares is parasomnias.

    What Causes Nightmares?

    Nightmares can be triggered by a variety of factors, including:

  • scary movies, books, or videogames
  • snacking just before going to sleep
  • illness or fever
  • medications such as antidepressants, narcotics, and barbiturates
  • over-the-counter sleep aids
  • alcohol or drug abuse
  • withdrawal from sleeping pills or narcotic pain medications
  • stress, anxiety, or depression
  • sleep apnea (when you stop breathing for short periods during sleep)
  • narcolepsy (a sleep disorder characterized by extreme drowsiness during the day following by quick naps or sleep attacks)
  • post-traumatic stress disorder (PTSD)
  • It is important to note that nightmares are not the same as sleepwalking (somnambulism), which causes a person to walk around while still asleep. They also differ from night terrors, also known as sleep terrors. Children who have night terrors sleep through the episodes and generally do not recall the incidents in the morning. Sometimes adults who have night terrors also have limited dream recall.

    What to Do About Nightmares

    Lifestyle changes may help to decrease the frequency of your nightmares. For example:

  • Get regular exercise.
  • Limit the amount of alcohol and caffeine you drink.
  • Avoid tranquilizers.
  • Engage in relaxation techniques such as yoga, tai chi, or meditation before bed.
  • Go to bed at the same time every night and get up at the same time every morning.
  • If your child is having many nightmares, encourage him or her to talk about them. Explain that nightmares can’t hurt him or her. Other techniques include:

  • creating a bedtime routine (keeping the same bedtime each night)
  • helping your child relax with deep breathing exercises
  • having the child rewrite the nightmare’s ending and talk to the characters from the nightmare
  • having your child keep a dream journal
  • allowing your child to use stuffed animals, blankets, or other items for comfort at night
  • using a nightlight and leaving the bedroom door open at night
  • Diagnosing Nightmares

    Most children and adults have nightmares from time to time. You should consult with your doctor if nightmares persist over an extended period of time, disrupt your sleep patterns, and interfere with your ability to function during the day.

    If a new medication prompted your nightmares, ask your doctor if there is an alternative that you might try. Your doctor will ask questions about your use of stimulants like caffeine and alcohol and drug use. Tell you doctor about any prescription or over-the-counter medications or supplements you take.

    There are no specific tests for diagnosing nightmares. However, your physician may advise you to undergo a sleep study. During a sleep study, you spend the night in a laboratory. Sensors monitor your heartbeat, brain waves, breathing, blood oxygen levels, eye movements, leg movements, and muscle tension.

    Treating Nightmares

    Treatment is generally not required for nightmares. However, any underlying medical problems should be addressed. If anxiety, depression, or stress is the cause, your doctor may recommend counseling or stress-reduction techniques. In rare cases, medication for sleep disturbances may be advised.

    In early 2012, the Mayo Clinic announced the use of prazosin, a blood pressure drug, to treat nightmares related to post-traumatic stress disorder (Mayo).


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