Nightmares

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Introduction

Nightmares or bad dreams are commonly experienced by children as a natural part of growing up.  They may occur in adults from time to time as well.  People experiencing stressful life events or sleep disorders or who use alcohol, illegal drugs, or certain medications are at risk for nightmares.  Frequent distressing nightmares should be brought to the attention of your doctor.  Treatment for nightmares depends on the cause.
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Anatomy

Sleep is vital for life, just like eating and breathing.  Sleep allows your body to rest.  It is believed that during sleep your brain performs important functions, such as storing memory and processing brain chemicals.
 
In a way, your body goes on “auto-pilot” while you sleep.  Your brain regulates automatic functions for you, such as breathing, heart rate, and blood pressure.  Each night you go through several cycles of sleep that consist of light to deep sleeping.  Most people dream for a few hours each night.  Although sleep is a complex process that is not fully understood, it is known that a good night’s sleep is important for optimal health and functioning.
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Causes

There are many reasons why nightmares may occur.  Life changes, stress, grief, post-traumatic stress disorder, and anxiety are frequent causes of nightmares.  They may result from certain medications and using alcohol or illegal drugs.  Sleep disorders can also cause nightmares.
 
Young children commonly experience nightmares and eventually grow out of them.  In children, nightmares are more common in girls than boys.  In adults, nightmares are more common among women than men.  
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Symptoms

Nightmares commonly have themes of extreme fear and anxiety.  Nightmares in childhood most frequently involve the theme of being chased by animals.  In adulthood, nightmares most frequently involve being chased by a person.  You may wake up during a nightmare or awaken and remember your dream. 
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Diagnosis

You should contact your doctor if you or your child experience frequent disturbing nightmares.  Your doctor will review your medical history and review your medications.  You will receive an examination and your blood may be tested.  You should let your doctor know if there have been stressful events in your life lately or if you use alcohol or illegal drugs.  Your doctor may refer you to a specialist, such as a neurologist, psychiatrist, therapist, or sleep medicine doctor as appropriate.

A sleep study may be conducted to learn more about your sleep patterns.  A sleep study is helpful for diagnosing sleep disorders, such as sleep apnea, that can contribute to nightmares.  A sleep study is used to take measurements of basic body functions, such as heart rate, blood pressure, and blood oxygen levels, while you sleep.  A sleep study may be conducted at a sleep clinic or in some cases; it may be conducted at your home.
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Treatment

The treatment that you receive depends on the cause of your nightmares.  Counseling and relaxation techniques can help decrease nightmares.  It can be helpful to not use alcohol or illegal drugs.  If nightmares are a side effect of your medication, your doctor may be able to substitute another medication in its place.  It is very important not to discontinue using a medication without talking to your doctor about it first.  For some types of sleep disorders, prescription medication may help prevent nightmares.

Parents may help their children with nightmares by establishing a regular predictable nighttime routine that makes the child feel safe and comfortable.  Avoid scary movies, television shows, news, or stories, especially right before your child’s bedtime.  You should gently reassure your child and listen to his or her concerns.  It can be helpful to have a night light in the child’s room and have your child sleep with a favorite stuffed animal or doll.  Children with frequent intense nightmares may benefit from talking with a therapist if they have experienced a traumatic event.
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Am I at Risk

Risk factors for nightmares:


_____ Increased dreams or nightmares can be side effects of some medications or occur shortly after discontinuing some types of medications.
_____ Alcohol and illegal drug use or withdrawal can increase the risk of nightmares.
_____ People with post-traumatic stress disorder, anxiety, stress, or grief have an increased risk of having nightmares. 
_____ People that have experienced the death of a loved one, a crime, military combat, abuse, sexual assault, or a major life event, such as divorce, have an increased risk of nightmares.
_____ Sleep disorders, such as sleep apnea or narcolepsy, can increase the risk of experiencing nightmares.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.