Nightmares are disturbing dreams associated with negative feelings, such as anxiety or fear. Nightmares are common. They may begin in childhood and tend to decrease after about age 10. However, some people have them as teens or adults, or throughout their lives.
Until age 13, boys and girls have nightmares in equal numbers. At age 13, nightmares become more prevalent in girls than boys.
Nightmares seem real, often becoming more disturbing as the dream unfolds. But nightmares usually are nothing to worry about. They may become a problem if you have them frequently and they cause you to fear going to sleep or keep you from sleeping well.
Nightmares are referred to by doctors as parasomnias — undesirable experiences that occur during sleep, usually during the stage of sleep known as rapid eye movement (REM). You've had a nightmare if:
Children's nightmare content varies with age, typically becoming more complex. While a young child might dream of monsters, an older child might have nightmares about school or difficulties at home.
When to see a doctor
Talk to your doctor earlier if nightmares:
Nightmares can be associated with another sleep disorder. Many other factors can trigger nightmares, including:
Most nightmares occur during rapid eye movement (REM) sleep. You normally go through four to six sleep cycles a night, cycling through the sleep stages in about 90 minutes. Your REM stage lengthens with each cycle, from several seconds in the first cycle to up to an hour in the last. You're more likely to have a nightmare in the last third of your night.
Occasional nightmares usually aren't a concern, but regularly disrupted sleep can be. It can cause excessive daytime sleepiness, which can lead to difficulties at school or work, or problems with everyday tasks such as driving.
Preparing for your appointment
For children, nightmares tend to decrease by the time they're adolescents. However, if you have concerns about safety or underlying conditions, you may want to see your doctor. Your doctor may refer you to a sleep specialist.
It's a good idea to prepare for your appointment. Here's some information to help you.
What you can do
Preparing a list of questions for your doctor will help you make the most of your time together. For nightmares, some basic questions to ask your doctor include:
Don't hesitate to ask other questions that occur to you.
What to expect from your doctor
Tests and diagnosis
There are no tests routinely done to diagnose nightmares. Occasionally, if your sleep is severely disturbed, your doctor may recommend an overnight sleep study to help determine if the nightmares are connected to another sleep disorder. Nightmares should be distinguished from night terrors, another parasomnia in which you are likely to sit up, scream, talk, thrash and kick, and, for older adults, REM sleep behavior disorder, which involves the acting out of dreams.
Your doctor will review the information to determine whether you have any sleep disorders.
Treatments and drugs
Treatment for nightmares isn't usually necessary. If the nightmares are associated with an underlying medical or mental health condition, treatment is aimed at the underlying problem. If stress or anxiety seems to be contributing to the nightmares, your doctor may suggest stress-reduction techniques, counseling or therapy.
Medication is rarely used to treat nightmares. However, medications that reduce REM sleep or reduce awakenings during sleep may be recommended if you have severe sleep disturbance.
Imagery rehearsal therapy
Lifestyle and home remedies
If you're having nightmares, try some relaxation techniques before bedtime. Take a warm bath, meditate or practice deep breathing. If your child is struggling with nightmares, be patient, calm and reassuring. Sometimes a little creativity helps, too.
Safety counts, too. If your child has frequent nightmares, make sure his or her bedroom is safe. Skip the bunk beds, and consider blocking doorways or stairways with a gate in case your child tries to run after he or she wakes up.
Last Updated: 2011-08-12
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