Nightmare Disorder

What is Nightmare Disorder?

Nightmare Disorder, also called parasomnia, is a condition in which a person experiences frequent vivid nightmares. During the night, we go through the sleep cycle four to six times, with the length of REM sleep becoming longer each time. Nightmares occur most often during the REM stage, so patients are more likely to have them during the last half of the night.

Everyone experiences nightmares from time to time. It is when they become recurrent and create problems for the patient that the situation needs to be addressed. There are numerous triggers that can serve as a catalyst for frequent nightmares, including trauma, stress, medications, sleep deprivation, scary movies and books, and substance abuse.

Additionally, certain medical and mental health conditions such as anxiety have been linked to the disorder.

What are the Symptoms of Nightmare Disorder?

Parasomnia does not necessarily occur every night. When a person does have nightmares, they typically experience:

  • Disturbing, vivid dreams
  • Dreams related to personal safety or survival
  • Dreams that wake the patient
  • Feelings of fear, anxiety, sadness, anger, or disgust in response to the dream
  • Waking in a cold sweat with a racing heartbeat
  • Easily recalling details from the dream
  • Inability to fall back to sleep
  • Distress or difficulty functioning during the day

When nightmare disorder manifests in children, the content of the dreams will vary depending on age and gradually becomes more complex. A younger child may often dream of monsters, while older children have nightmares related to difficulties at home or school.

How is Nightmare Disorder Treated?

Most of the time, nightmares do not require treatment. However, if sleep disruptions are interfering with the patient’s ability to function during the day or creating undue stress, doctors may recommend a variety of therapies. Dreams associated with other health issues will usually improve once the condition is treated. Medications can be used to reduce REM sleep, while counseling and therapy help relieve anxiety and stress. Imagery rehearsal therapy is often used for patients with nightmares related to PTSD and other trauma.

Last Reviewed:
October 07, 2016
Last Updated:
August 10, 2017