Dreams - bad; Bad dreams
A nightmare is a dream that occurs during sleep that brings out strong feelings of fear, terror, distress, or anxiety. Nightmares usually happen in the second part of the night and wake up the sleeper, who is able to remember the content of the dream.
Nightmares tend to be more common among children and become less frequent toward adulthood. About 50% of adults have occasional nightmares, women more often than men.
Anxiety and stress are the most common causes of nightmares. A major life event occurs before the nightmare in some cases.
Other causes of nightmares include:
If you are under stress, ask for support from friends and relatives. Talking about what is on your mind can help.
Follow a regular fitness routine, with aerobic exercise if possible. You will find that you will be able to fall asleep faster, sleep more deeply, and wake up feeling more refreshed.
Learn techniques to reduce muscle tension (relaxation therapy), which will help reduce your anxiety.
If your nightmares started shortly after you began taking a new medication, contact your health care provider. He or she will let you know whether to stop taking that medication, and may recommend an alternative.
For nightmares caused by the effects of "street drugs" or regular alcohol use, ask for advice from your doctor on the safest and most successful ways to quit.
Contact your health care provider if:
Your doctor will examine you, ask you questions, and possibly recommend tests. You may be asked any of the following questions:
Tests that may be done include:
If reducing stress, medication side effects, and substance use do not improve the nightmares, your health care provider may want to send you to a sleep medicine specialist for a sleep study (polysomnography). In some cases, certain medications may help reduce nightmares.
Moore DP, Jefferson JW. Nightmare disorder. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004:chap 123.
Moser SE, Bober JF. Behavioral problems in children and adolescents. In: Rakel RE, ed. Textbook of Family Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 33.
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