nightmare
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What is a nightmare?
A nightmare is a disturbing dream that provokes a strong negative emotional reaction, causing the sleeper to awaken due to emotional distress. Nightmares differ from upsetting dreams that don't cause the dreamer to awaken.
Nightmares typically occur during REM sleep, the deepest stage of sleep, and people can often recall them in vivid detail. They are more common in children than in adults. Although the causes of nightmares remain unclear, nightmare occurrence and frequency are associated with various factors, including activity level, age, diet, medication, and physical and mental health. Practicing healthy sleep habits, such as avoiding caffeine and alcohol close to bedtime and engaging in regular exercise, can decrease the likelihood of nightmares.
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How are nightmares different from regular dreams?
Nightmares are disturbing dreams that evoke strong negative emotions, causing the sleeper to awaken, unlike upsetting dreams that don't disrupt sleep. Nightmares are different from night terrors, which involve partial awakening with vocalizations and autonomic symptoms and occur during non-REM sleep, whereas nightmares occur during REM sleep. People can often recall their nightmares in vivid detail.
Nightmare frequency is associated with factors like activity level, age, diet, medication, and physical and mental health. Nightmares are more common in children than adults. The causes of nightmares remain unclear; however, they may be connected to processing stressful events or suppressed emotions.
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When do nightmares usually occur during sleep?
Nightmares typically occur during REM (rapid eye movement) sleep, the deepest stage of sleep, characterized by rapid and irregular eye movement and changes in breathing and heart rate. A single sleep cycle lasts about 90 to 110 minutes, and most adults complete four to six cycles per night. Nightmares usually occur in the later stages of REM sleep, which may explain why they trigger the sleeper to awaken. People can often recall their nightmares in vivid detail.
REM sleep is also the stage of sleep during which dreams prevail. Although dreaming can also occur during non-REM sleep, dreaming reports from people waking from REM sleep are more frequent, and the content of their dreams is florid, vivid, and hallucinatory.
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What are common causes of nightmares?
Nightmares can stem from multiple sources, though the exact causes are not always clear. Some theories suggest nightmares are the brain's way of processing stress or figuring out how to respond to threats. Suppressed emotions, anxiety, and worry have also been linked to nightmare frequency.
Environmental and lifestyle factors such as alcohol and drug use, an irregular sleep schedule, jet lag, bereavement, and a poor diet can contribute to nightmares. Mental health issues like post-traumatic stress disorder (PTSD), borderline personality disorder (BPD), schizophrenia, depression and anxiety are also associated with nightmares. Additionally, certain medications, including amphetamines, antidepressants, and sleep supplements like melatonin, have been linked to nightmares. Practicing healthy sleep habits, like avoiding alcohol and caffeine before bed, may help reduce the likelihood of nightmares.
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How can nightmares affect someone's sleep and feelings during the day?
Nightmares, disturbing dreams that provoke strong negative emotional reactions, can significantly impact an individual's sleep and daytime feelings. They typically occur during REM sleep, often triggering the sleeper to awaken due to emotional distress.
The causes of nightmares are not clear, but they have been linked to conditions such as sleep apnea and narcolepsy, as well as mental health issues like anxiety, depression, and post-traumatic stress disorder (PTSD). The frequency of nightmares is also associated with daytime sleepiness, irritability, insomnia, poor concentration, self-harming tendencies, and suicidal thoughts. Although nightmares generally cannot be prevented, practicing healthy sleep habits can decrease anxiety and, thus, the likelihood of nightmares.
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What are some ways to cope with or prevent frequent nightmares?
Nightmares cannot be fully prevented, but healthy sleep habits can lower anxiety and the chance of them occurring. Avoid caffeine, alcohol, and drugs before bed, and exercise regularly to reduce stress and improve sleep.
For severe cases, imagery rehearsal therapy (IRT), a type of cognitive behavior therapy (CBT), can help lessen how often nightmares occur. With IRT, reimagine nightmares with happier conclusions. IRT and CBT help people see nightmares as unpleasant thought patterns, which helps them face their fears.
Nightmares may be connected to suppressed emotions; studies have found that higher levels of worry and anxiety are linked to nightmare frequency. They are most common in children, but 50 to 85 percent of adults experience them occasionally.
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nightmare, disturbing dream that provokes a strong negative emotional reaction. Nightmares differ from other dreams in that they typically cause the sleeper to awaken because of emotional distress. An upsetting dream that does not cause the dreamer to awaken is usually not considered a nightmare. Although the causes of nightmares remain unclear, nightmare occurrence and frequency are associated with various factors, including activity level, age, diet, medication, and physical and mental health.
Characteristics
Nightmares typically occur during REM sleep, which is the deepest stage of sleep and is characterized by rapid and irregular eye movement as well as changes in breathing and heart rate. REM sleep makes up one phase of the sleep cycle (a single sleep cycle lasts about 90 to 110 minutes; most adults complete four to six cycles per night). Nightmares typically occur in the later stages of REM sleep, which may explain why they trigger the sleeper to awaken.
People can often recall their nightmares in vivid detail. This sets nightmares apart from night terrors (or sleep terrors), which involve partial awakening and are characterized by vocalizations and autonomic symptoms, such as sweating and rapid heart rate. Night terrors usually occur during non-REM sleep, the first phase of the sleep cycle.
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Epidemiology
Nightmares are more common in children than in adults. It is estimated that half of children ages 3 to 6 experience nightmares and that about 20 percent of children ages 6 to 12 experience nightmares. About 50 to 85 percent of adults experience nightmares occasionally, while between 1 and 8 percent of adult sleepers experience nightmares frequently enough for the disturbing dreams to be classified as a disorder. Nightmare disorder is marked by frequent nightmares that interfere with daily life and is considered a form of parasomnia (general sleep disorder). It is more likely to develop when family members are also affected by nightmare disorder or other parasomnias.
Nightmares tend to occur at the same frequency between genders in childhood. In adulthood, however, women are more likely than men to report nightmares. In general, women’s reports about nightmares tend to center on interpersonal struggles, such as sexual harassment or attacks against family and loved ones. Men, by comparison, are more likely to report nightmares about war or terrorism.
Causes
The causes of nightmares remain unclear, though various theories have been set forth. It has been suggested, for example, that the brain uses nightmares to figure out how to respond to certain kinds of threats in waking hours; nightmares may also help the brain process stressful events that have already happened. Alternatively, nightmares may be connected to suppressed emotions; studies have found, for example, that higher levels of worry and anxiety are linked to nightmare frequency.
Environmental and lifestyle factors linked to nightmares include alcohol and drug use, disruptions in sleep schedule, illness, jet lag, periods of bereavement, and poor diet. Nightmares are most common in individuals who sleep less than 5 or more than 10 hours per night. In addition, conditions such as sleep apnea and narcolepsy are associated with nightmares, as are cancer, Parkinson disease, coronary heart disease, and chronic pain.
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Nightmare occurrence is one of the main symptoms used to diagnose persons with post-traumatic stress disorder (PTSD)—an estimated 70 to 90 percent of PTSD patients experience frequent nightmares. It is thought that trauma may be a predominant cause in such instances, because PTSD nightmares are very similar to daytime flashbacks. Nightmares also generally occur at increased frequency in persons with mental health issues. For example, nightmares affect about half of all patients with borderline personality disorder (BPD) and 10 percent of those with schizophrenia. Nightmares are also linked to depression, anxiety, daytime sleepiness, irritability, insomnia, poor concentration, self-harming tendencies, and suicidal ideation.
Associations between nightmares and physical and mental health conditions may be related to increased levels of daytime stress. Nightmare occurrence and frequency may also be linked to the use of certain medications, especially amphetamines, antidepressants, antiparkinson drugs, beta-blockers, and sedative-hypnotic drugs. In particular, the use of sleep supplements, such as melatonin, and prescription sleeping drugs, such as zolpidem, are associated with the occurrence of vivid dreams and nightmares.
Nightmare prevention
Nightmares generally cannot be prevented. However, studies have shown that practicing healthy sleep habits can decrease anxiety and thus decrease the likelihood of nightmares. Avoiding caffeine, alcohol, and drugs close to bedtime and engaging in regular exercise, which decreases stress and promotes sleep quality, can also reduce nightmare risk.
In more-severe cases, imagery rehearsal therapy (IRT), a form of cognitive behavior therapy (CBT), can help reduce nightmare frequency. During IRT, patients are encouraged to reimagine their nightmares with different, happier endings. IRT and other types of CBT are used to help patients recognize their nightmares as unpleasant thought patterns, which can in turn help them to confront their fears.