by Iqra Waheed
WHAT: A nightmare is a disturbing dream associated with negative feelings, such as anxiety or fear that awakens you.
(Mayo Clinic, 2021).
OCCURRENCE OF NIGHTMARES: Nightmares may begin in children between 3 and 6 years old and tend to decrease after 10 years of age. During the teen and young adult years, girls appear to have nightmares more often than boys do. Some people have them as adults or throughout their lives.
(Mayo Clinic, 2021).
NIGHTMARE DISORDER: Nightmare disorder is when nightmares happen often, cause distress, disrupt sleep, cause problems with daytime functioning or create fear of going to sleep. (Mayo Clinic, 2021).
SYMPTOMS: A nightmare may involve these features:
● Your dreams seems vivid and real and is very upsetting
● You feel angry, sad, anxious, scared or disgusted as a result of your dream ● Your dream causes you distress that keeps you from falling back to sleep ● You feel sweaty or have a pounding heartbeat while in bed
(Mayo Clinic, 2021).
WHEN ARE NIGHTMARES CONSIDERED A DISORDER:
● Frequent occurrences
● Daytime sleepiness, fatigue or low energy
● Problems with concentration or memory, or you can’t stop thinking about images from your dreams
● Behavior problems related to bedtime or fear of the dark
● Major distress or impairment during the day, such as anxiety or persistent fear, or bedtime anxiety about having another nightmare
(Mayo Clinic, 2021).
CAUSES OF NIGHTMARES:
● Stress or anxiety
● Trauma
● Sleep deprivation
● Medications
● Substance misuse
● Scary books and movies
● Other mental health disorders disorders or some medical conditions
(Mayo Clinic, 2021).
NIGHTMARES AND RELATED SLEEP DISORDERS:
While nightmares are a significant area of concern, they often coexist or are confused as other sleep disorders. To understand the impact of sleep disturbances, it is important to explore related conditions, such as insomnia, sleep paralysis, and night terrors.
● Insomnia: Insomnia is when you experience disruptions in how you feel or function because you aren’t sleeping well or sleeping enough.
(Cleveland Clinic, 2023).
● Sleep Terrors: Sleep terrors are times of screaming or crying, intense fear, and sometimes waving arms and legs when not fully awake.
(Mayo Clinic Staff, 2025).
● Sleep Paralysis: Sleep paralysis is a feeling of being conscious but unable to move. It happens when you pass between stages of sleep and wakefulness. During these transitions, you may be able to move or speak for a few seconds up to a minute. (Roybal & Amandolare, 2024).
HOW DO YOU TREAT NIGHTMARE DISORDER?
● PSYCHOTHERAPY:
○ Cognitive Behavioural Therapy (CBT)
○ Imagery Rehearsal Therapy (IRT)
○ Exposure, Relaxation and Rescripting Therapy (ERRT)
● MEDICATION:
○ Olanzapine
○ Risperidone
○ Clonidine
○ Prazosin
○ Triazolam
(Cleveland Clinic, 2022).
REFERENCES
● Cleveland Clinic. (November 21, 2022). Nightmare Disorder. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/24464-nightmare-disorder
● Roybal, B. & Amandolare, S. (July 21, 2024). Sleep Paralysis. WebMD. https://www.webmd.com/sleep-disorders/sleep-paralysis
● Mayo Clinic Staff. (January 14, 2025). Sleep terrors (night terrors). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/sleep-terrors/symptoms-causes/syc-20353524 ● Cleveland Clinic. (February 13, 2023). Insomnia. Cleveland Clinic.
● Mayo Clinic Staff. (June 5, 2021). Nightmare Disorder. Mayo Clinic.
https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-2035 3515#:~:text=A%20nightmare%20is%20a%20disturbing,are%20nothing%20to%20worry%20ab out.
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