A nightmare is a disturbing dream associated with negative feelings, such as anxiety or fear that wake you up. Nightmares are common in children, but they can occur at any age. Occasional nightmares are usually not a cause for concern.
Nightmares can begin in children when they reach 3 and 6 years of age, and usually lessen after age 10. During the teenage and young years, girls seem to have more nightmares than boys, and some people may have them only as adults or throughout their lives.
Although nightmares are common, nightmare disorder is relatively rare. Nightmare disorder occurs when nightmares recur; this causes distress and difficulty sleeping, problems performing daytime functions, or creating a fear of sleeping.
You are likely to have a nightmare in the second half of your night. Nightmares may occur rarely or frequently, or even several times in a single night. The nightmare is often brief but causes you to wake up from sleep, and you may have trouble getting back to sleep.
A nightmare has the following characteristics:
It’s plain and real, and it’s very disturbing, and it only gets more annoying with flashbacks.
The story is usually related to threats to safety, or survival, but can revolve around other disturbing topics.
It wakes you up from sleep.
You feel terrified, anxious, angry, sad, or disgusted by it.
You sweat or your heart races when you’re lying in bed.
You can think clearly when you wake up, and you can recall its details.
It causes you distress that prevents you from going back to sleep easily.
Nightmares are not considered a disorder unless you experience any of the following:
Extreme distress or lack of performance during the day, such as persistent anxiety or fear, or worrying before bed about having another nightmare
Problems with concentration or memory, or you can’t stop thinking about footage from a nightmare
Daytime sleepiness, fatigue, or low energy
Having difficulty at work, school, or social situations
Behavioral problems related to bedtime or fear of the dark
A child with nightmare disorder may cause significant disruption to the sleep of parents or caregivers, in addition to feelings of distress.
When should you visit a doctor?
Occasional nightmares are usually not a cause for concern. And if your child has nightmares, you can simply bring them up to the doctor during a routine child health check-up. However, please consult a doctor, if the following apply to nightmares:
Repeat and persist over time
Routine disruption of sleep
Caused by the fear of going to sleep
Caused by behavioural problems during the day, or difficulty doing chores
Doctors refer to nightmare disorder as a parasomnia — a sleep disorder that involves unwanted experiences that occur while you are asleep or asleep, or upon awakening. Nightmares often occur during the phase of sleep known as rapid eye movement sleep. The true cause of the nightmares is still unknown.
However, nightmares may be caused by several factors, including the following:
Stress or anxiety. The stresses of normal daily life, such as having a problem at home or school, sometimes lead to nightmares. A person may experience the same effect as a result of a major change in his life, such as the move of a loved one to another place or his death. Anxiety is associated with an increased risk of nightmares.
Injuries. Nightmares are common after an accident, injury, physical abuse, sexual assault, or other traumatic events. Nightmares are common in people with post-traumatic stress disorder.
Sleep deprivation your risk of nightmares can be increased by shifting scheduling in a way that causes you to have irregular bedtimes and wake up times more often, or get little or no sleep. Insomnia is also associated with an increased risk of nightmares.
Pharmaceutical. Some medications — such as certain types of antidepressants, blood pressure medications, beta-blockers, and drugs used to treat Parkinson’s disease or to help stop smoking — can cause nightmares.
Substance addiction. Alcohol and drug addiction or abstinence can cause nightmares.
Other disturbances. Depression and other mental health disorders may be associated with nightmares. Nightmares may occur in the case of some conditions such as heart disease or cancer. Nightmares are also associated with other sleep disorders that prevent you from getting enough sleep.
Scary books and movies. Reading scary books or watching horror movies, especially before bed, can cause some people to have nightmares.
Nightmares become more common when family members have a history of nightmares or other parasomnias, such as talking during sleep.
Nightmare disorder may cause:
Excessive daytime sleepiness may lead to problems at school or work or problems with daily tasks, such as driving and concentrating.
Mood problems, such as depression or anxiety about dreams that continue to bother the patient
Resisting sleeping or going to bed due to fear of encountering another disturbing dream
Suicidal thoughts or suicide attempts
How to cure dreadful dreams and nightmares
Here we explain how to overcome nightmares:
The treatment of terrifying dreams and nightmares lies in finding the cause, and then working to treat it, as follows:
If the cause is certain medications, we stop them or change the medication.
If it is caused by organic disease or a psychological disorder, such as anxiety and stress disorders, we treat this disease, and the person’s sleep improves, and nightmares decrease.
As for nightmares of unknown cause, the basic treatment is to modify some personal habits and modify the sleep environment, as follows:
Organizing a specific time to sleep and wake up.
Avoid caffeine and fatty, spicy, and sugary foods 4-6 hours before bed.
Avoid drinking a lot of fluids before bed.
Drink hot milk or yogurt before bed. Warm milk and foods containing the amino acid tryptophan may help improve sleep quality.
Practicing relaxation techniques before bed, such as deep breathing, may help relieve anxiety and reduce stress.
Sleep on a comfortable mattress and pillow and in a room that is as dark and quiet as possible.
Maintain a comfortable temperature in the bedroom, and make sure the room is well ventilated.
It is worth noting that dreams are a release for internal repressions that were not properly emptied in waking life, and therefore one of the solutions is for a person to always reveal himself by talking with a close friend, or by writing on paper so that feelings do not explode in the form of a nightmare.
There are also several cognitive-behavioral therapies for nightmares, one of which is Image Rehearsal Therapy, to give your nightmares a happy ending.
In this therapy, the person remembers the nightmare and writes it down, then changes the general pattern of the nightmare, the story, the ending, or any other part of the dream to make it more positive and more beautiful.
Then he rehearses this new scenario and makes several rehearsals until he can replace the unwanted and disturbing aspects of the dream with more positive and joyful parts.
The person performs this training daily for 10 to 20 minutes, and with these modifications, nightmares are reduced and nightmares disappear, and the quality of sleep improves to be a comfortable and peaceful sleep.
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