Nightmare Disorder

Nightmare disorder means frequent, frightening dreams that wake you and start to affect your sleep and your days. You may dread going to bed, or feel tired, anxious or low the next day. Occasional bad dreams are normal. It affects about 4 in 100 adults, is common after trauma, and responds well to a short talking treatment.

Also called: recurrent nightmares; chronic nightmares; trauma nightmares. Sleep specialists class it as a parasomnia of dreaming (REM) sleep.

Our article Nightmares That Won’t Stop explains what drives them and how the main treatment works.

Signs and symptoms

• Bad dreams that wake you fully, usually later in the night, and stay clear in your memory
• The same dream or theme coming back
• Dreading bedtime or putting off sleep
• Tiredness, poor concentration, anxiety or low mood during the day

Fear of the next nightmare can keep you awake, so it often comes with insomnia.

Causes

Trauma is the clearest cause: nightmares that replay a frightening event are a core sign of PTSD. Stress, anxiety, broken sleep, alcohol, sleep apnoea and some medicines, including some antidepressants, can also bring them on. Don’t change a prescription without your doctor.

Treatment

The American Academy of Sleep Medicine recommends imagery rehearsal therapy: while awake, you rewrite the nightmare so it ends differently, then rehearse the new version for a few minutes each day. If the nightmares replay a trauma, do this with a therapist. CBT and treating the underlying problem, such as PTSD or insomnia, also help. Medicine is a doctor’s decision.

In Nigeria

Recurring dreams of being chased, attacked or visited by a dead relative are often read as spiritual, and many people go first for prayer or deliverance. Faith can sit alongside treatment. We found no Nigerian research on nightmare disorder itself.

Nightmare disorder vs night terrors

After a nightmare you wake properly and remember the dream. Night terrors come earlier in the night, mostly in children aged 3 to 8: the child screams or thrashes, seems awake but isn’t, and remembers nothing. Waking unable to move is sleep paralysis.

When to get help

See a doctor or therapist if nightmares come most weeks, you avoid sleep, or they began after a frightening event. You can book a licensed therapist on Mytherapist.ng who works with trauma and PTSD or sleep problems.

For a child, see a family doctor or paediatrician if nightmares are frequent, carry on after about age 6, or follow a frightening event. Parents can book a therapist for themselves through family and parenting therapy.

Read next

• Nightmares That Won’t Stop
• Insomnia
• Post-traumatic stress disorder (PTSD)
• Sleep paralysis: why it happens and what helps

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This entry is awaiting clinical review. It’s based on published research and health guidelines, and we’ll update it once a clinician has reviewed it.