Nightmares and the Brain Harvard Medical School

You can have nightmares for all kinds of reasons, including anxiety, sleep deprivation, drug and alcohol use, and medical conditions like obstructive sleep apnea and post-traumatic stress disorder (PTSD). Nightmares are vividly realistic, disturbing dreams that rattle you awake from a deep sleep. Nightmares tend to occur most often during rapid eye movement (REM) sleep, when most dreaming takes place. Because periods of REM sleep become progressively longer as the night progresses, you may find you experience nightmares most often in the early morning hours.

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Nightmares are defined as extremely disturbing, well-recalled dreams that usually involve threats to survival, your physical body, or your security. People who are deeply affected by nightmares can be treated in a variety of ways. If a stressor is identified, effective ways to manage it should be found. For medication-induced nightmares, dosages might need to be altered or different drugs administered.

• Nightmares are common among those with post-traumatic stress disorder (PTSD).
• Image rehearsal therapy aims to reformulate the plot of a recurring dream to make it less disturbing.
• You might be dealing with intense emotions or responsibilities that you can’t manage.
• And between 2% and 8% of the adult population is plagued by nightmares.
• Despite these physical reactions, people who experience night terrors usually sleep through them.

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Stress is one of the emotions that many people have trouble channeling in a productive manner. Because of this, dreams may be one of the only opportunities for the body to work through those feelings. Treatment for nightmares in adults depends on what may be causing them. Night terrors and nightmares are different and happen at different stages of sleep.

What Are Recurring Nightmares? Plus Coping Tips

When you dream of falling, it might feel like you’re plummeting from a great height. This common nightmare can be a signal that you’re feeling out of control in your waking life. It could mean you’re worried about a situation or decision where you feel uncertain or insecure. Falling dreams often reflect anxiety as such, they might be a way for your subconscious to tell you to address those concerns.

Nightmare Disorder

“We know that sleep deprivation and other sleep problems, like having an irregular sleep schedule, can be linked to a higher likelihood of having nightmares,” Dr. Tiani says. If your nightmares continue for weeks or even months, it’s time to bring it up with a healthcare provider. Whatever the plot of your personal horror film, there’s no feeling quite as scary as waking up sweaty, shaking and filled with a sense of dread … and then realizing that it was all a dream. You’re more likely to have a nightmare in the second half of your night. Nightmares may occur rarely or more frequently, even several times a night.

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This is because they typically happen during the rapid eye movement (REM) stage of sleep, during which brain activity resembles wakefulness. This “dream enacting behavior” typically reflects the content of nightmares—often action-filled or violent dreams in which the person is being attacked or is trying to escape danger. These involuntary recollections are often experienced as nightmares and they can be highly distressing.

• When we sleep we go through different sleep stages, from light, to deep and then to REM.
• Your doctor may prescribe medications depending on whether you also have a PTSD diagnosis, have nightmare disorder in isolation, or nightmares are the result of another cause.
• Fortunately, there are steps you and your doctor can take to lessen the frequency of your nightmares and the effect they are having on your life.
• Focus on the visuals, sounds you’d hear and even scents you’d smell if you were really there.
• A gentle start-up in communication refers to initiating a conversation with care, empathy, and respect.
• A gentle start-up not only reflects respect but also serves to preserve the equilibrium within the relationship.
• If you cannot move or speak as you wake up or fall asleep, you may have sleep paralysis.

Nightmares vs. night terrors

They may ask questions about the frequency, duration, timing, and content of the nightmares, as well as how they affect the person’s sleep and life. A doctor may also gather information using a five-question diagnostic test called the nightmare disorder index. If they happen frequently, they can interfere with daytime functioning. Psychological therapy for nightmares is called image rehearsal therapy, or IRT.

Frequently Asked Questions (FAQs)

• Research confirms that parental soothing and reassurance can go a long way toward easing the lingering effects of a child’s disruptive dreams.
• It is a stage of sleep that is characterized by rapid eye movement, irregular heartbeat, and increased rates of respiration.
• A primary care physician or a sleep specialist can provide an initial diagnosis of nightmare disorder.
• These changes can cause uncertainty and stress, which might show up in your dreams.
• Adhere to a routine and schedule every night and morning; going to sleep at the same time each night can help, as can avoiding sleeping in.
• It might also reflect concerns about communication or how others perceive you.

People with post-traumatic or chronic nightmares can be treated with psychological therapy or with medication. It is a stage of sleep that is characterized by rapid eye movement, irregular heartbeat, and increased rates of respiration. REM sleep is discontinuous, chunked into four or five periods that together make up about 20 percent of our slumber.

Schedule “worry time.”

Just like death and taxes, nightmares are, to some extent, a fact of life. But if you’re able to identify a known cause (or two or three) of your nightmares, you can take steps to try to prevent them. Nightmares are more common when family members have a history of nightmares or other sleep parasomnias, such as talking during sleep.

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A doctor may be able to identify factors that are contributing to nightmares, such as medications or an untreated mental health condition. Nightmare disorder is referred to by doctors as a parasomnia — a type of sleep disorder that involves undesirable experiences that occur while you’re falling asleep, during sleep or when you’re waking up. Nightmares usually occur during the stage of sleep known as rapid eye movement (REM) sleep. If you find that your disturbing dreams start to become chronic, you may have a mental health condition known as nightmare disorder.

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Because nightmare disorder compromises sleep and creates stress, it tends to negatively affect other aspects of a person’s life, such as their ability to work. Nightmares are often triggered by stress, a difficult life event, or trauma. Having nightmares may be a way for the brain to process anxiety and fear. Some common themes of nightmares include confrontations, chases, near-death experiences, and failure. Frequent childhood nightmares (e.g., several per week) may cause significant distress to parents and children. Research confirms that parental soothing and reassurance can go a long way toward easing the lingering effects of a child’s disruptive dreams.

A sleep study is not usually needed for nightmares, but a doctor may suggest a sleep study if a person also has signs of a sleep disorder. For example, if nightmares are related to breathing problems during sleep, a sleep study can diagnose or rule out a sleep-related breathing disorder. Children often respond well to having a quiet and dark bedroom, a consistent bedtime, and a screen-free evening routine.

A doctor may recommend one or a combination of these techniques in addition to medication. Your daily habits and environment can significantly impact the quality of your sleep. Some drugs work by dampening the fight-or-flight response, and research on other types of medication is ongoing.

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Nightmares can be about things like being chased, falling, or losing something important. They can be caused by stress, fears, or things that happened during the day. While they are disturbing, nightmares are a normal part of dreaming and can sometimes help you work through your worries or fears. People with nightmare disorder have recurring nightmares that disrupt sleep, impair daytime functioning, and cause ongoing distress. Nightmare disorder is one of many parasomnias, which are unpleasant experiences that occur when a person is sleeping, falling asleep, or waking.

How Sleep Works

We can’t always remember our bad dreams, even if we emotionally or physically react to them — but if you can recall what you dreamt about, image-rehearsal therapy may help reduce nightmares the next time you sleep. The idea is to recast your nightmare into a happier, more peaceful script, says Dr. Dasgupta. For example, if you were running down a dark path as a threat got closer and closer, perhaps your new scenario features you walking down a quiet wooded path with your loyal dog trotting along behind you.

Health Conditions

• A person with nightmare disorder has recurring nightmares that affect their daily functioning and cause distress.
• These aren’t the only medications that can cause nightmares, and not everyone who takes these medications will have nightmares.
• By Melissa Porrey LPC, NCCPorrey is a licensed professional counselor and writer based in DC.
• Root of Nightmares Raid is a great source for weapons infused with the Strand elemental damage.
• Night terrors tend to happen in a sleep stage known as deep sleep, rather than when in REM, which is when nightmares happen.

You’re giving a big presentation in front of the entire school and when you look down, you realize that you’re standing stark naked in front of everyone you know. You’ll soon start receiving the latest Mayo Clinic health information you requested in your inbox.

What Are Recurring Nightmares? Plus Coping Tips

A therapist can help you safely confront distressing memories and emotions, which can lessen symptoms like nightmares and flashbacks. But when nightmares start to become frequent or so upsetting that they impact your sleep, they can begin to take a toll on your waking hours, too. Having a child with nightmare disorder can cause significant sleep disturbance and distress for parents or caregivers. Sleep deprivation, which can be caused by nightmares, can cause a host of medical conditions, including heart disease, depression, and obesity.

However, the effectiveness of medications for nightmares remains unclear. A type of CBT that specifically focuses on sleep-related concerns is called CBT for insomnia (CBT-I). A CBT-I therapist may guide a person to restructure their sleep schedule and restrict negative stimuli in hopes of improving sleep and reducing nightmares. Another common sleep disorder that’s been linked to nightmares is untreated obstructive sleep apnea.

A study from 2015 reported that 17.8% of students believed that what they ate affected their dreams, but there is very little research showing if this is true. Various treatments can help you manage and prevent http://blogs.evergreen.edu/morisa24/2013/05/19/nightmares/, including talk therapy, medications, and good sleep hygiene. Most people have the occasional bad dream — but when nightmares are frequent they can be very disruptive. Nightmares are also frequently present with mental-health disorders including PTSD, insomnia, schizophrenia, psychosis, and mood, anxiety, adjustment, and personality disorders. Join our Sleep Care Community — a trusted hub of sleep health professionals, product specialists, and people just like you. Whether you need expert sleep advice for your insomnia or you’re searching for the perfect mattress, we’ve got you covered.

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There are a number of other steps you can take on your own that may help reduce your nightmare frequency. So is engaging in regular exercise, which will help alleviate nightmare-causing anxiety and stress. Imagery rehearsal treatment is a promising cognitive behavioral therapy for recurrent nightmares and nightmares caused by PTSD. The technique helps chronic sufferers change their nightmares by rehearsing how they would like them to transpire.

By Melissa Porrey LPC, NCCPorrey is a licensed professional counselor and writer based in DC. The gentle start-up approach aligns with these values and aims to minimize the emotional impact of difficult moments within the family. By choosing a more respectful and considerate tone, family members can navigate challenging conversations with minimal emotional harm, ultimately promoting healthier and more harmonious family dynamics. Maintaining harmony is a fundamental value within Asian households as well.

When we sleep we go through different sleep stages, from light, to deep and then to REM. That being said, researchers at the University of Montreal have found that physical aggression is the theme of about half of all nightmares. According to the study, there are ten more standard storylines for nightmares, including disaster scenarios, insect encounters and interpersonal conflicts.