Nightmares

Alternative names

Dreams - bad; Bad dreams

Definition

A nightmare is a dream occurring during rapid eye movement (REM) sleep that brings out feelings of strong, inescapable fear, terror, distress, or extreme anxiety. They typically occur in the latter part of the night and usually awaken the sleeper, who is able to recall the content of the dream. See also night terror; sleep disorders.

Considerations

Nightmares tend to be more common among children and decrease in frequency toward adulthood. About 50% of adults experience occasional nightmares, women more often than men.

Eating just prior to going to bed, which raises the body's metabolism and brain activity, may cause nightmares to occur more often. Adults who experience repeated nightmares that become a significant problem should seek help.

Common Causes

• anxiety or stress are the most common cause: a major life event precedes the onset of nightmares in 60% of cases
  
• illness with a fever
  
• death of a loved one (bereavement)
  
• adverse reaction to or side effect of a drug
  
• recent withdrawal from a drug such as sleeping pills
  
• effect of alcohol or excessive alcohol consumption
  
• abrupt alcohol withdrawal
  
• breathing disorder in sleep (sleep apnea)
  
• sleep disorders (narcolepsy, sleep terror disorder)
  

Home Care

If you are under severe stress, you should seek out the support of friends and relatives. Talking about what is on your mind can really help. Also, following a regular energetic fitness routine, using aerobic exercise if possible, will help. You will find that you will be able to fall asleep faster, benefit from deeper sleep, and wake up feeling more refreshed. Learn techniques to reduce muscle tension (relaxation therapy), this will also help reduce your anxiety.

Practice good sleep hygiene. Avoid long-term use of tranquilizers, and avoid caffeine and other stimulants.

If you noticed that your nightmares started shortly after you began taking a new medication, contact your health care provider. He or she will advise you on how to discontinue that medication if necessary and recommend an alternative.

For nightmares resulting from the effects of "street drugs" or persistent alcohol use, seek counsel on the best way to discontinue use. An Alcoholics Anonymous group, for example, might suggest a safe way for you to stop drinking without putting your health at risk. You can also attend their regularly scheduled meetings (see alcoholism - support group).