Description

A nightmare is a disturbing dream associated with negative feelings, such as anxiety or fear that awakens you. Nightmares are common in children but can occur at any age. Occasional nightmares usually are nothing to worry about.

Nightmares may begin in children between 3 and 6 years old and tend to decrease after the age of 10 years. During the teen and young adult years, girls appear to have nightmares more often than boys do. Some people have them as adults or throughout their lives.

Although nightmares are common, the nightmare disorder is relatively rare. Nightmare disorder is when nightmares happen often, cause distress, disrupt sleep, cause problems with the operation during the day, or create fear of going to sleep.

Symptoms

You have more chances of having a nightmare in the second half of the night. Nightmares can occur rarely or more frequently, even several times a night. The episodes are usually brief, but they can cause you to wake up, and go back to sleep can be difficult.

A nightmare can involve these features:

  • Your dream seems vivid and real, and it is very annoying, often increasingly disturbing as the dream unfolds.
  • His dream of the story is usually related to threats to the security or survival, but can have other disturbing themes.
  • His sleep awakens.
  • You feel scared, anxious, angry, sad, or upset as a result of his dream.
  • You feel sweaty or have a pounding heartbeat, while in the bed.
  • You can think clearly when you wake up and can remember the details of your dream.
  • Your dream causes distress that prevents you from falling back to sleep easily.

Nightmares are only considered a disorder if you experience:

  • Frequent appearances
  • Great distress or impairment during the day, such as anxiety or fear, persistent, or bedtime anxiety about having another nightmare
  • Problems with concentration or memory, or you can't stop thinking about the images of your dreams
  • Daytime sleepiness, fatigue or lack of energy
  • Problems functioning at work or in school or in social situations
  • The behavior problems associated with bedtime, or fear of the dark

Having a child with nightmare disorder may cause significant sleep disorders, and the anguish of the parents or caregivers.

When to see a doctor

Occasional nightmares are not a cause of concern. If your child has nightmares, you can simply talk about all of them in a routine well-child visits. However, consult your doctor if nightmares:

  • Frequently occur and persist over time
  • Routinely disrupt sleep
  • Cause fear of going to sleep
  • Cause daytime behavior problems or difficulties of operation

Causes

Nightmare disorder is referred to by doctors as a parasomnia — a type of sleep disorder that consists of the unpleasant experiences that occur while you are 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. The exact cause of nightmares is not known.

Nightmares can be caused by many factors, including:

  • The stress or anxiety. Sometimes, the ordinary stresses of daily life, such as a problem at home or at school, to cause nightmares. A major change such as a move or the death of a loved one, can have the same effect. Experiencing anxiety is associated with an increased risk of nightmares.
  • The Trauma. Nightmares are common after an accident, injury, physical or sexual abuse, or other traumatic event. Nightmares are common in people who have post-traumatic stress disorder (PTSD).
  • Sleep deprivation. Changes in the programming that causes irregular sleep and wake times, or to interrupt or reduce the amount of sleep can increase your risk of having nightmares. Insomnia is associated with an increased risk of nightmares.
  • Drugs. Some drugs — including certain antidepressants, blood pressure medications, beta blockers, and drugs used to treat Parkinson's disease or to help quit smoking — can cause nightmares.
  • The misuse of substances. Alcohol and recreational drug use or withdrawal can cause nightmares.
  • Other disorders. Depression and other mental health disorders may be linked to nightmares. Nightmares can occur along with some medical conditions, such as heart disease or cancer. The fact of having other sleep disorders that interfere with adequate sleep may be associated with the fact of having nightmares.
  • Scary books and movies. For some people, reading scary books or watching scary movies, especially before bedtime, can be associated with the nightmares.

Risk factors

Nightmares are most common when a member of the family has a history of nightmares or other sleep parasomnias, such as talking during sleep.

Complications

Nightmare disorder can cause:

  • The excessive daytime sleepiness, which can lead to difficulties at school or work, or problems with everyday tasks, such as driving and concentration
  • Problems with mood, such as depression or anxiety dreams that continue to bother you
  • The resistance to going to bed or to sleep for fear you're going to have another bad dream
  • Suicidal thoughts or attempts of suicide

Diagnosis

There is No evidence to routinely done to diagnose nightmare disorder. Nightmares are only considered a disorder if disturbing dreams cause distress or keep you from getting enough sleep. To diagnose nightmare disorder, your doctor will review your medical history and your symptoms. Your evaluation may include:

  • Examination. You may have a physical exam to identify any conditions that may be contributing to the nightmares. If your recurring nightmares indicate underlying anxiety, the doctor may refer you to a mental health professional.
  • The symptoms of the discussion. Nightmare disorder is usually diagnosed based on the description of their experiences. Your doctor may ask about your family history of sleep problems. Your doctor may also ask you or your partner about your sleep behaviors and discuss the possibility of other sleep disorders, if indicated.
  • Nocturnal sleep study (polysomnography). If your sleep is severely disturbed, your doctor may recommend a sleep study during the night to help determine if the nightmares are connected to another sleep disorder. The sensors in your body is going to record and monitor your brain waves, the oxygen level in the blood, heart rate and breathing, as well as eye and leg movements during sleep. You can be in a video to document your behaviour during the sleep cycles.

Treatment

The treatment of nightmares is usually not necessary. However, treatment may be needed if the nightmares are causing you distress or disorders of the sleep and interfere with its functioning during the day.

The cause of the nightmare disorder help determine the treatment. Treatment options may include:

  • The medical treatment. If the nightmares are associated with an underlying medical condition, treatment is directed at the underlying problem.
  • Stress or anxiety treatment. If a mental health condition, such as stress or anxiety, seems to be contributing to the nightmares, your doctor may suggest stress-reduction techniques, counseling or therapy with a mental health professional.
  • Images of the trial of the therapy. Often used with people who have nightmares as a result of post-traumatic stress disorder, the images of the trial of the therapy is to change the termination of his well-remembered nightmare while awake, so that is no longer in danger. After testing the new end in your mind. This approach can reduce the frequency of nightmares.
  • The medication. Medication are rarely used for the treatment of nightmares. However, the medication may be recommended for severe nightmares associated with post-traumatic stress disorder.

Lifestyle and home remedies

If nightmares are a problem for you or for your child, try these strategies:

  • Establish a regular, relaxing routine before bedtime. A consistent routine is important. Make a quiet, relaxing activities such as reading books, doing puzzles, or soak in a hot bath before bedtime. Meditation, deep breathing or relaxation exercises can also help. Also, make the bedroom quiet and comfortable for sleeping.
  • Offer guarantees or warranties. If your child is struggling with nightmares, to be patient, calm and serenity. After your child wakes up from a nightmare, to respond quickly and soothe your baby to the bed. This can prevent future nightmares.
  • Talk about the dream. Ask your child to describe the nightmare. What happened? That was in the dream? What did he fear? Then, remind your child that the nightmares are not real and can't hurt you.
  • Rewrite the end. Imagine a happy ending for the nightmare. Encourage your child to draw a picture of the nightmare, to "talk" to the characters of the nightmare or write about the nightmare on a daily basis. Sometimes a little creativity can help.
  • Put stress in its place. If stress or anxiety is a problem, talk it out. The practice of some simple stress-relieving activities, such as deep breathing and relaxation. A mental health professional can help, if necessary.
  • Provide comfort measures. Your child might feel more secure if he or she sleeps with a favorite stuffed animal, blanket, or other object of comfort. Let your child's door open at night so that he or she does not feel alone. Leave the door open, too, in case your child needs comfort during the night.
  • Use a night light. Keep a night light in your child's room. If your child wakes up during the night, the light can be reassuring.

Preparing for your appointment

If you nightmares cause concerns about the sleep disorder or underlying conditions, consider talking to a doctor. The doctor may refer you to a sleep specialist or a mental health professional.

Keeping a sleep diary for two weeks before your appointment can help your doctor to understand more about your sleep schedule, factors that affect sleep and when nightmares occur. In the morning, record everything that you know of bedtime rituals, the quality of sleep, and so on. At the end of the day, registration of behaviors that can affect sleep, such as the hours of sleep interruptions, consumption of alcohol and drugs that are taken.

You can bring a friend or family member, if possible, to provide additional information.

What you can do

Before your appointment, make a list of:

  • Any of the symptoms experienced, including those that may seem unrelated to the reason for the appointment
  • Key personal information, including any major stresses or recent life changes
  • All the drugs, vitamins, herbs, or other supplements that are taken, and the dose
  • Questions for the doctor to help make the most of your time together

Some questions to ask the doctor may include:

  • What is likely the cause of these symptoms?
  • What are other possible causes?
  • What kind of proof do you need?
  • It is the condition likely temporary or chronic?
  • What is the best course of action?
  • What are the alternatives to the primary approach you're suggesting?
  • There are restrictions that must be followed?
  • Do you recommended to consult a specialist?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Do not hesitate to ask questions during your appointment.

What to expect from your doctor

The doctor will ask a series of questions. Be prepared to answer to reserve a time to go through any of the points that you want to devote more time. Your doctor may ask:

  • When did symptoms begin?
  • What is the frequency of the nightmares occur, and what?
  • What is the usual bedtime routine?
  • Is there a history of sleep problems?
  • Does anyone else in your family has trouble sleeping?
Symptoms and treatment of Nightmare disorder