Nightmare Disorder: Symptoms, Causes, Treatment

Escape the Nightmares, Find Relief.
Nightmare Disorder: Symptoms, Causes, Treatment
Tom Greenspan
December 21, 2022

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Are troubling dreams keeping you awake at night lately? Then chances are that you are suffering from a condition known as nightmare disorder.

It is quite natural to dream while you are asleep. And while most dreams are benign or abstract in nature, some of them tend to be pretty disturbing, and those are known as nightmares. 

On that note, most people experience nightmares every once in a while. However, if you have been experiencing them persistently, then it is definitely a cause for concern. 

But what causes this nightmare disorder, and how can you treat such a problem? Well, these are some of the questions that we have answered in this guide.

So, if you are suffering from this issue, and want to know more about it, then keep reading!

Nightmare Symptoms, Causes, And Treatments

Nightmare Disorder Explained

Also referred to as a type of parasomnia by medical professionals, nightmare disorder is a sleep disorder that is characterized by frequent nightmares (hence the name). Nightmares occur during the REM (rapid eye movement) stage of sleep, just like any other dream. 

But unlike regular dreams, these nightmares often make you feel anxious, frightened, or dysphoric. And while these nightmares are quite brief, they are enough to disrupt your sleep for the rest of the night.

There are a lot of similarities between this problem and other types of parasomnias, such as night terrors, confusional arousal, or sleepwalking. However, there are several differences between them as well, which you need to know. 

For starters, this issue does not involve any motor function, which is unlike the other sleep disorders that we have mentioned here. In other words, you do not sit up, stand or walk around when you experience these nightmares.

Apart from that, you can often remember what the nightmare was about, or at the very least, you can recall some parts of it. In the case of these other parasomnias, though, the patient cannot recall what happened to them once they are awake.

Lastly, issues like confusional arousal or night terrors often leave you feeling disoriented and confused when you wake up. But when you wake up after experiencing a nightmare, there is no such disorientation, meaning that you are fully aware of your surroundings.

What Are The Symptoms Of Nightmare Disorder?

Most of the nightmares that accompany this problem have some distinctive characteristics, as we have mentioned below.

  • The dream feels very vivid and is highly disturbing
  • You feel threatened by the theme and storyline of the dream
  • The dream gets increasingly disturbing as it progresses
  • Your dream wakes you up
  • There are a lot of negative feelings after waking up from the dream
  • You feel sweaty, tense, and shaky after waking up
  • Your heart rate increases drastically
  • You have trouble going back to sleep

Of course, these are some of the symptoms that are experienced while in bed. There are a lot of accompanying physical symptoms that can affect your daily lifestyle too. These have been mentioned below.

  • Lowered concentration
  • Memory problems
  • Excessive daytime sleepiness
  • Reduced energy ad daytime productivity
  • Stress and anxiety
  • Behavioral issues

Here, you need to keep in mind that the severity of the problem often affects the intensity of these symptoms. If you are suffering from mild nightmare disorder, you may get at most one or two nightmares per week. In that situation, the symptoms will be mild as well, and hence they will be easily manageable.

On the other hand, if you have moderate nightmare disorder, you might experience these nightmares more frequently. Likewise, the symptoms will be relatively intense in this scenario, but they can still be managed with some effort.

And if you are suffering from severe nightmare disorder, you will get nightmares almost every night. In extreme cases, you can even experience multiple nightmares in a single night. Subsequently, the symptoms experienced in such situations will be quite extreme. It is advisable to visit the doctor at this point, or else the symptoms might get worse.

What Causes Nightmare Disorder Or Frequent Nightmares?

Nightmare disorder can be caused due to a range of reasons, both physiological and psychological. Although, psychological factors play a more significant role here, for they can affect the sleep cycle directly.

In any case, we have discussed each of these reasons in detail below.

1. Anxiety

This is possibly the biggest reason behind the occurrence of nightmare disorder. Anxiety is a serious mental health disorder that is characterized by feelings of intense dread and uneasiness. People suffering from anxiety issues feel tense and restless almost all the time. So, you can obviously guess how that affects sleep and dreams.

2. Stress

Stress is another factor that can trigger recurrent nightmares while sleeping. This condition is often the result of a difficult lifestyle situation, such as high work pressure, difficulties at school, household problems, and many more. 

A stressed individual tends to become mentally tense and worry a lot about these issues, due to which they suffer from constant mental strain. That ultimately affects their sleep cycle and the type of dreams they get, eventually leading to nightmare disorder.

3. Trauma/ Post-Traumatic Stress Disorder 

Trauma is when an individual experiences a sad or disturbing event in life. Incidents like the death of a loved one, accidents, and physical or sexual abuse all lead to trauma. And in extreme cases, it leads to a condition known as post-traumatic stress disorder (PTSD).

Any type of trauma can trigger nightmares, but these nightmares eventually subside after a while once the person starts to get over the event. However, individuals who have PTSD are more vulnerable to experiencing chronic nightmares. Similarly, the nature of the nightmares they experience is more intense by comparison.

4. Other Mental Health Disorders

Besides the ones mentioned above, nightmare disorders can be caused by other types of mental health problems as well. More specifically, issues like depression, schizophrenia, bipolar disorder, and borderline personality disorder (BPD) can lead to this sleep disorder.

In that context, the above mental disorders may lead to other sleep problems like sleep terrors and insomnia. So, it is advisable to get them diagnosed as soon as possible.

5. Sleep Deprivation

Sleep deprivation is a common problem nowadays, and it is generally a result of poor lifestyle choices. Individuals who are sleep deprived tend to have an erratic sleep schedule. For instance, they may go to sleep late at night and sleep through the day. Or they may fail to get an adequate amount of sleep daily.

The lack of proper sleep eventually leads to REM sleep rebound, which is accompanied by an increase in the frequency and intensity of rapid eye movements. This, in turn, acts as a trigger for vivid and disturbing dreams.

6. Drugs And Medications

If you engage in drug and substance abuse, you will experience nightmares more frequently. Such drugs interfere with the functions of the brain and nervous system, which leads to sleep disturbances and nightmares. Conversely, if you have been abusing drugs and illicit substances for a long time and want to quit, you will experience nightmares as a withdrawal symptom.

Even prescription drugs like antidepressants and beta blockers can trigger nightmares. That’s why you should always consult your doctor before you start taking such medications.

Is Nightmare Disorder A Common Problem?

As we have stated before, nightmares are a fairly common occurrence during sleep. This means that nearly everyone has experienced a nightmare at least once in life. In this regard, children have been observed to get nightmares more frequently than adults. Fortunately, the frequency of these nightmares often reduces as they become older.

This does not mean that adults are immune to experiencing nightmares, though. Sure, they might not get nightmares as often as children, teenagers, or young adults, but they do get them every once in a while. Adults typically experience nightmares after a traumatic event. If you have ever seen or experienced something sad or upsetting, you will probably be able to verify this fact.

One interesting thing to note here is that the nightmare frequency can vary based on the gender of adult individuals. According to a study, women experience nightmares more frequently than men. The same study also revealed that such a gender difference was not observed in the case of children or older adults. In other words, children and elderly individuals of both genders experience nightmares at similar frequencies.

So, to sum it up, occasional nightmares are common, and thus, they are not a matter of concern. In fact, evidence suggests that around 47% of college students experience a nightmare once every two weeks. However, frequent occurrence of nightmares, which is a major symptom of nightmare disorder, is comparatively rare, with only 5-8% of the population suffering from such a problem.

How To Treat Nightmare Disorder?

There was a time when issues like nightmare disorder were considered untreatable. But thanks to advancements in sleep medicine and neuroscience, we have a better understanding of such problems, and that helps with their management.

With that being said, there are two different ways of tackling this sleep disorder, and each has its pros and cons. You can resort to therapies, such as psychotherapy and cognitive behavioral therapy (CBT), which often give better results but can be time-consuming. Or, you can use medications that provide quick results but may produce adverse side effects. 

In any case, here are some possible strategies that you can follow to address this problem.

1. Hypnosis

Hypnosis is one of the most popular and effective methods to treat nightmare disorders. In this process, the therapist puts the patient in a relaxed, trance-like state. The individual can be conditioned to combat stress and negative emotions better in this state, which can eventually help them to get rid of this problem.

2. Image Rehearsal Therapy

In this approach, the patient is instructed to write down their recurring nightmares in the form of a script. Then, they need to rewrite this script to eliminate the upsetting elements and make it more neutral or favorable. They have to rehearse this altered script repeatedly while they are awake, which helps to modify the subject matter of their nightmares positively.

3. Lucid Dreaming Therapy

Lucid dreaming is a specialized sleep technique where the person remains fully aware while dreaming and can even control the different elements of their dream. In other words, lucid dreamers can eliminate any negative aspects and turn their nightmares into pleasant dreams. It is a bit difficult to master this technique, but once you get the hang of it, lucid dreaming can be immensely helpful in mitigating nightmare disorder.

4. Progressive Deep Muscle Relaxation

This method is used to calm your mind and body through deep meditation, breathing, and stress-release exercises. Therapists suggest using this technique before going to sleep so that you are fully relaxed and in a peaceful state of mind. That, in turn, will help to reduce the occurrence of nightmares.

5. Medications

Different sleep medications are available today, which can be highly effective in minimizing or treating nightmare disorders. Prescription sleeping pills and antidepressants are some of the most common options, but there are other types of drugs that can be used too. However, as we’ve said once before, these drugs may produce some adverse side effects, so we would not suggest using them without proper approval from your doctor.

Final Words

We know how difficult it can be to live with nightmare disorder (or any type of sleep disorder, to be honest). That said, you can prevent such problems if you follow healthy sleep hygiene. 

Make sure to go to bed and wake up at fixed times and get the right amount of sleep. Try not to deviate too much from this routine, or else it will affect your sleep quality, and you’ll go back to having frequent nightmares again.

Also, avoid drinking caffeine or alcohol before bedtime, and reduce your screen time before going to sleep. Ensure that the ambiance in your bedroom is pleasant, as that can help you fall asleep faster.

And that brings us to the end of this guide. Sleep tight, folks!