Nightmares
A nightmare is a bad dream that brings out strong feelings of fear, terror, distress, or anxiety .
Anxiety
Stress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...
Causes
Nightmares usually begin before age 10 and are most often considered a normal part of childhood. They tend to be more common in girls than boys. Nightmares may be triggered by seemingly routine events, such as starting at a new school, taking a trip, or a mild illness in a parent.
Nightmares may continue into adulthood. They can be one way our brain deals with the stresses and fears of everyday life. One or more nightmares over a short period of time may be caused by:
- A major life event, such as the loss of a loved one or a traumatic event
- Increased stress at home or work
Nightmares may also be triggered by:
- A new drug prescribed by your health care provider
-
Abrupt
alcohol withdrawal
Alcohol withdrawal
Alcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol on a regular basis suddenly stops drinking ...
- Drinking too much alcohol
- Eating just before going to bed
- Illegal street drugs
- Illness with a fever
- Over-the-counter sleep aids and medicines
- Stopping certain drugs, such as sleeping pills or opioid pain pills
Repeated nightmares may also be a sign of:
Repeated nightmares
Repeated nightmares are bad dreams that recur frequently and involve the same theme. Nightmares usually begin before the age of 10. They are conside...
-
Breathing disorder in sleep (
sleep apnea
)
Sleep apnea
Obstructive sleep apnea (OSA) is a problem in which your breathing pauses during sleep. This occurs because of narrowed or blocked airways.
-
Post-traumatic stress disorder
(PTSD), which can occur after you have seen or experienced a traumatic event that involved the threat of injury or death
Post-traumatic stress disorder
Post-traumatic stress disorder (PTSD) is a type of anxiety disorder. It can occur after you have gone through an extreme emotional trauma that invol...
- More severe anxiety disorders or depression
-
Sleep disorder (for example,
narcolepsy
or
sleep terror disorder
)
Narcolepsy
Narcolepsy is a nervous system problem that causes extreme sleepiness and attacks of daytime sleep.
Sleep terror disorder
Night terrors (sleep terrors) are a sleep disorder in which a person quickly wakes from sleep in a terrified state.
Home Care
Stress is a normal part of life. In small amounts, stress is good. It can motivate you and help you get more done. But too much stress can be harmful.
If you are under stress, ask for support from friends and relatives. Talking about what is on your mind can help.
Other tips include:
- Follow a regular fitness routine, with aerobic exercise, if possible. You will find that you will be able to fall asleep faster, sleep more deeply, and wake up feeling more refreshed.
- Limit caffeine and alcohol.
- Make more time for your personal interests and hobbies.
- Try relaxation techniques, such as guided imagery, listening to music, doing yoga, or meditating. With some practice, these techniques could help you reduce stress.
- Listen to your body when it tells you to slow down or take a break.
Practice good sleep habits. Go to bed at the same time each night and wake up at the same time each morning. Avoid long-term use of tranquilizers, as well as caffeine and other stimulants .
Caffeine
Caffeine is a substance that is found in certain plants. It can also be man-made and added to foods. It is a central nervous system stimulant and a...
Stimulants
Stimulants are drugs that increase your heart rate, breathing rate, and brain function. Some stimulants affect only a specific organ, such as the he...
When to Contact a Medical Professional
Tell your provider if your nightmares started shortly after you began taking a new medicine. They will tell you if you should stop taking that medicine. DO NOT stop taking it before talking to your provider.
For nightmares caused by street drugs or regular alcohol use, ask for advice from your provider on the safest and most effective way to quit.
Also contact your provider if:
- You have nightmares more than once a week.
- Nightmares stop you from getting a good night's rest, or from keeping up with your daily activities for a long period.
What to Expect at Your Office Visit
Your provider will examine you and ask questions about the nightmares you are having. Next steps may include:
- Certain tests
- Changes in your medicines
- New medicines to help with some of your symptoms
- Referral to a mental health provider
References
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders . 5th ed. Arlington, VA: American Psychiatric Publishing; 2013.
Arnulf I, Carr M. Nightmares and dream disturbances. In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 104.
Chokroverty S, Avidan AY. Sleep and its disorders. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 102.
Pigeon WR, Mellman TA. Dreams and nightmares in posttraumatic sleep disorder. In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 55.
Review Date: 2/21/2016
Reviewed By: Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.