Common causes include stress, negative life events, the experience of trauma as in posttraumatic stress disorder (PTSD), depression, other psychiatric disorders, and medication side effects. This topic reviews the causes, differential diagnosis, evaluation, and management of nightmares in adults.
Nightmares can be triggered by many factors, including: Stress or anxiety. Sometimes the ordinary stresses of daily life, such as a problem at home or school, trigger nightmares. A major change, such as a move or the death of a loved one, can have the same effect.
Nightmares can arise for a number of reasons—stress, anxiety, irregular sleep, medications, mental health disorders—but perhaps the most studied cause is post-traumatic stress disorder (PTSD).
Nightmares are associated with disturbed sleep, low well-being and affect daytime mood and behavior. Nightmare disorder is a very common comorbidity in nearly all psychiatric conditions. In borderline personality disorder (BPD), for example, up to 50% are troubled by frequent nightmares [5-7].
It's normal for both children and adults to have bad dreams and nightmares every now and again.
And, generally speaking, people with nightmare disorders have the problem once a week or more and, in fact, most people who seek treatment have nightmares around three or four times a week, as much as seven times a week.
Nightmare disorder can only be diagnosed when disturbing dreams are chronic and persistent. You may have nightmare disorder if you experience: daytime fatigue. decreased emotional and physical well-being.
Some younger children may also have nightmares, beginning as young as 6 months, and nightmares can persist until a child is 10 or older.
No, we should never ignore bad dreams. We give priority in our dreams to things that seem to be a threat to our wellbeing, or even potentially our lives. For instance, children who grow up in violent homes are likely to have quite severe nightmares.
Pharmacologic Treatment Options
The following may be used for the treatment of nightmare disorder: nitrazepam, prazosin, and triazolam. The following are not recommended for the treatment of nightmare disorder: clonazepam and venlafaxine.
Night terrors and nightmares are different and happen at different stages of sleep. During a night terror you may talk and move about but are asleep. It's rare to remember having a night terror. Nightmares are bad dreams you wake up from and can remember.
The nightmare can cause the sufferer to awaken in a heightened state of distress, resulting in perspiration and an elevated heart rate. Often it takes time to recover from the negative emotions invoked by the nightmare and the person may have difficulty returning to sleep.
Nightmares, dreams and other sleep disturbances are a common symptom of complex trauma with nightmares recognised as a principal feature of post-traumatic stress disorder (PTSD). The treatment of nightmares not only alleviates those symptoms but is shown to help reduce PTSD symptoms in general.
Nightmares about falling were followed closely by dreams about being chased (more than 63 percent). Other distressing nightmares included death (roughly 55 percent), feeling lost (almost 54 percent), feeling trapped (52 percent), and being attacked (nearly 50 percent).
"For many people, the adrenaline and excitement experienced upon realizing that they are dreaming is enough to wake them," Backe said. "However, if this is not the case and you are 'stuck' in a bad dream, doing something particularly jarring — for example, jumping off of a cliff in your dream should do the trick."
According to current diagnostic classifications, nightmares are defined as frightening or disturbing dreams that awaken the sleeper while bad dreams are defined as frightening or disturbing dreams that do not awaken the sleeper (Hasler & Germain, 2009; Nadorff et al., 2014).
Because nightmares may have a significant impact on your quality of life, it's important to consult a medical professional if you experience them regularly. Sleep deprivation, which can be caused by nightmares, can cause a host of medical conditions, including heart disease, depression, and obesity.
It can mean, for example, that the person acts out dreams of being attacked, engaging in combat, or fleeing from a bushfire. Typically, arms and legs thrash about, the person may yell and scream, and in some cases, unintentionally assault their sleeping partner.