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Nightmares

Description

A nightmare is a dream sequence occurring during REM sleep arousing feelings of fear and terror that normally awakens the sleeper. Unlike night terrors, nightmares happen during the deepest part of sleep; are a long, dreamlike sequences; and can usually be remembered after waking up. They are also associated with a great deal less anxiety and movement when they occur.
Although it is not uncommon for an adult to experience a nightmare, children are much more likely to experience them, especially children between the ages of three and six.
Generally in adolescence, the frequency of nightmare occurrences starts to wane, but a small minority of people will continue get frequent nightmare into adulthood.There are many triggers for nightmares including: anti-depressants, beta blockers, alcohol and drug abuse and withdrawal, stress, and trauma. In addition, people with several types of personality disorders (schizotypal personality disorder, borderline personality disorder, schizophrenia, etc.) have persistent nightmares.
People with frequent nightmares may be more vulnerable than the average person to mental illness.

Diagnosis

Usually occurring in the second half of the night, when one is in a deeper part of the sleep cycle, a person experiencing a nightmare will awake suddenly with full consciousness and little to no disorientation. He will feel of fear and impending harm, and will be able to immediately recall the content of the frightening dream. An increase of heart rate and breathing may also be associated with nightmares.

Treatment

If nightmares are frequent and long-term it may be wise to see a sleep specialist to determine if there’s an underlying contributing factor like psychological problems such as stress or trauma or perhaps medication. In some cases psychotherapy can help to resolve a past traumatic event causing the nightmare. Additionally, desensitization techniques or rehearsing the nightmares over and over with a different ending, can help decrease their frequency and the distress they cause.

Source: Adapted from International Classification of Sleep Disorders Diagnostic & Coding Manual, American Academy of Sleep Medicine.