Nightmare disorder involves disturbing or scary dreams that awaken you, causing distress or preventing adequate sleep.
A nightmare is a disturbing dream associated with negative feelings, such as anxiety or fear that awakens you. Nightmares are common in children but can happen at any age. Occasional nightmares usually are nothing to worry about.
Nightmares may begin in children between 3 and 6 years old and tend to decrease after the age of 10. 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.
Although nightmares are common, nightmare disorder is relatively rare. Nightmare disorder is when nightmares happen often, cause distress, disrupt sleep, cause problems with daytime functioning or create fear of going to sleep.
You're more likely to have a nightmare in the second half of your night. Nightmares may occur rarely or more frequently, even several times a night. Episodes are generally brief, but they cause you to awaken, and returning to sleep can be difficult.
A nightmare may involve these features:
Nightmares are only considered a disorder if you experience:
Having a child with nightmare disorder can cause significant sleep disturbance and distress for parents or caregivers.
Occasional nightmares aren't usually a cause for concern. If your child has nightmares, you can simply mention them at a routine well-child exam. However, consult your doctor if nightmares:
Nightmare disorder is referred to by doctors as a parasomnia — a type of sleep disorder that involves undesirable experiences that occur while you're falling asleep, during sleep or when you're waking up. Nightmares usually occur during the stage of sleep known as rapid eye movement (REM) sleep. The exact cause of nightmares is not known.
Nightmares can be triggered by many factors, including:
Nightmares are more common when family members have a history of nightmares or other sleep parasomnias, such as talking during sleep.
Nightmare disorder may cause:
There are no tests routinely done to diagnose nightmare disorder. Nightmares are only considered a disorder if disturbing dreams cause you distress or keep you from getting enough sleep. To diagnose nightmare disorder, your doctor reviews your medical history and your symptoms. Your evaluation may include:
Treatment for nightmares isn't usually necessary. However, treatment may be needed if the nightmares are causing you distress or sleep disturbance and interfering with your daytime functioning.
The cause of the nightmare disorder helps determine treatment. Treatment options may include:
If nightmares are a problem for you or your child, try these strategies:
If nightmares cause concerns about sleep disturbance or underlying conditions, consider seeing a doctor. The doctor may refer you to a sleep specialist or a mental health professional.
Keeping a sleep diary for two weeks before your appointment may help your doctor understand more about your sleep schedule, factors affecting your sleep and when nightmares occur. In the morning, record as much as you know of bedtime rituals, quality of sleep, and so on. At the end of the day, record behaviors that may affect sleep, such as sleep schedule disruptions, alcohol intake and any medications taken.
You may want to bring a family member or friend along, if possible, to provide additional information.
Before your appointment, make a list of:
Some questions to ask the doctor may include:
Don't hesitate to ask other questions during your appointment.
The doctor is likely to ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to spend more time on. Your doctor may ask: