A nightmare is a common phenomenon. It is defined by disturbing dreams that are associated with negative feelings, such as fear or anxiety that awakens you.

Bad dreams or Nightmares are common in kids but can occur at any age, and occasional nightmares are usually nothing to worry about.

Nightmares may start in children between the ages of 3 and 6, and tend to drop after 10 years of age. During the teenage and young adult years, female children appear to have more nightmares than male kids do.

Some people also have nightmares as adults or sometimes throughout their lives. Although nightmares are quite frequent, the disorder is relatively rare.

Nightmare disorder is diagnosed when nightmares happen frequently, disrupts sleep, causes distress, causes problems with daytime functioning, or trigger fear of going to sleep.

Symptoms of Nightmare

A person is more likely to suffer a nightmare in the second half of their night. Nightmares are unpredictable, and may rarely occur or happen more frequently, even occur several times a night.

Episodes of nightmares are generally brief, but they cause a person to awaken in shock and find it difficult to return to sleep.

A nightmare may involve some or all of these features:

  • Your dream is vivid and seemingly real and is quite upsetting, often becoming scarier and more disturbing as the scenes begin to unfold.
  • The storyline of your dream is usually related to survival, threats or safety, but it can also have some other disturbing themes
  • Your dream scares you till it awakens you
  • You feel angry, scared, anxious, sad or disgusted because of your dream
  • You feel hot, sweaty or deal with a pounding heartbeat while in bed
  • You do not have problems with thinking clearly upon awakening and can remember all the details of your dream
  • Your dream leads to distress that prevents you from quickly falling back to sleep.
  • Nightmares can only be considered a disorder if you experience any of the following:
  • Frequent occurrences
  • Significant distress, discomfort or impairment during the day, such as constant fear as anxiety, or bedtime anxiety about having bad dreams or another nightmare
  • Problems with memory or concentration, or you cannot stop thinking about the images from your bad dreams
  • Daytime fatigue, sleepiness, or low energy
  • Problems functioning at school or work or in other social situations
  • Behavior problems that are related to bedtime or a sudden fear of the dark

Having a child or teenager with nightmare disorder will likely cause significant sleep disturbance, worry, and distress for caregivers or parents.

When you should see a doctor?

Occasional nightmares are not usually a severe cause for concern. If you have a child that deals with nightmares, you can mention them to your doctor at a routine exam.

, do not hesitate to consult your doctor if the nightmares:

  • Routinely disrupt sleep
  • Occur frequently and persist over time
  • Cause fear of going to sleep
  • Request an Appointment at Mayo Clinic
  • Cause daytime behavior problems or difficulty functioning

Causes of Nightmare disorder

Nightmare disorder is called parasomnia by medical practitioners — it is a type of sleep disorder that is characterized by undesirable experiences that happen while a person is falling asleep, during sleep or when they are waking up.

Nightmares usually occur during the stage of sleep called rapid eye movement (REM). Nobody knows the exact cause of nightmares.

Nightmares and bad dreams can be triggered by many factors, including these:

  • Stress or anxiety: Sometimes we may want to overlook the ordinary stresses of daily life, such as a problem at school or at home, but they can trigger nightmares. A significant life change, such as a relocation or the passing of a loved one, can have a similar effect. Experiencing mental stress and anxiety is associated with a higher risk of insomnia and nightmares.
  • Trauma: Nightmares are commonly associated with life after an accident, sexual abuse, injury, physical abuse, or any other traumatic event. It is also common to have nightmares if you have been diagnosed with post-traumatic stress disorder (PTSD).
  • Sleep deprivation: Changes in a person’s work schedule that leads to irregular sleeping and waking patterns or times or that reduce or interrupt the amount of sleep the person gets can up the risk of having nightmares. Insomnia has also been associated with an increased risk of having nightmares.
  • Medications: Some specific medications — including some antidepressants, beta-blockers, blood pressure medications, and drugs that are used for the treatment of Parkinson’s disease or to help a person quit smoking — can cause nightmares.
  • Substance abuse: The use of alcohol and other recreational drugs or withdrawal can cause nightmares.
  • Other disorders: Other mental health disorders like depression, PTSD, and anxiety, amongst others, may be linked to nightmares. Nightmares may happen alongside certain medical conditions, such as cancer or heart disease. Having other sleep disorders that mess up your sleep life or prevents adequate sleep can be connected with having nightmares.
  • Scary books and movies: Scary movies and books can be thrilling, but they are not worth it for some people. Reading scary books or watching scary movies, especially at night before bed, can trigger nightmares.

Risk factors

Nightmares are more common when several family members have a history of sleep parasomnias like sleepwalking, talking in their sleep, or just nightmares.

Complications associated with Nightmare disorder

A nightmare disorder may cause any of these:

  • Excessive sleepiness during daytime, which can lead to challenges at school or work, or challenges with everyday tasks, including driving and concentrating
  • Problems with emotions and mood, such as anxiety, fear, anger, or depression from dreams that won’t stop to bother you
  • Resistance to going to sleep or going to bed for fear you will have to deal with another nightmare
  • Suicidal thoughts or suicide attempts.

There is no known cure for nightmares. However, seeing a psychologist or discussing with other mental health professionals can be of great help to people with Nightmare disorder.

If you are a parent whose child has constant nightmares, having them sleep in your room, and following steps provided by a mental health professional can be of great benefit as well.

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