What Is Nightmare Disorder?

When a person has a pattern of "frightening, vivid or unsettling dreams," which are characterized as nightmares, they are said to have nightmare disorder (ND), a sleep problem that causes them to awaken unexpectedly. Nightmare disorder is categorized as parasomnia, a kind of sleep disorder that disrupts a person's sleep by causing unusual or unpleasant experiences. Nightmares only happen during rapid eye movement (REM) sleep, therefore they're more likely to manifest themselves once you've fallen asleep deeply. Only if you encounter the following nightmares , it is considered a disorder:

  1. Significant suffering or impairment throughout the day, such as continuous fear or anxiety, or worry before bed about experiencing another nightmare
  2. difficulties paying attention or remembering things, or you keep thinking about dreams
  3. daytime weariness, poor energy, or sleepiness
  4. functional issues at work, in school, or in social settings
  5. issues with behavior due to fear of the dark or going to bed
  6. Frequent occurrences 

Nightmares can be caused by - 

  1. Anxiety or stress - Sometimes everyday concerns, like a conflict at home or at school, might set off nightmares. The same thing might happen when there is a significant transition, such as moving or losing a loved one. A higher risk of nightmares is linked to experiencing anxiousness.

  2. Trauma - After an accident, injury, physical or sexual abuse, or other traumatic incident, nightmares are frequent. People with post-traumatic stress disorder frequently experience nightmares (PTSD).

  3. Lack of sleep - Changes in your routine that disrupt or shorten your sleep or that generate irregular sleeping and waking hours can raise your risk of nightmares. A higher risk of nightmares is linked to insomnia.

  4. Medications - Several medications, such as antidepressants, blood pressure meds, beta-blockers, therapies for Parkinson's disease, and medications to aid in quitting smoking, might cause nightmares.

  5. Substance misuse - The use or withdrawal from recreational drugs and alcohol can cause nightmares.

Pharmacological and/or psychotherapy therapies may be used to treat nightmare disorder. 

  1. Pharmacological treatment - After various clinical trials throughout the years examining the effectiveness of different medications on the reduction of nightmares, only Prazosin exemplifies the most effective results.  Prazosin is an FDA-approved drug for high blood pressure, but studies have shown that it can also alleviate PTSD-related nightmares. Its advantages in curing nightmares have lately come to light through research.

  2. Psychotherapeutic therapies - Methodologies used in psychotherapeutic interventions are typically used in treatment sessions. Cognitive-behavioral therapies like imagery rehearsal therapy (IRT), which has the client return to a particular nightmare, rewrite it to be a more pleasant dream, and then imagine themselves in the new dream, are some of these techniques. 


An individual's life can be greatly disrupted by nightmares. Consider visiting a psychiatrist if you frequently have nightmares that are affecting your life in any way. Although the disorders/conditions covered in this page can co-occur with nightmare disorder, this does not always mean that you must have one of them in order to experience frequent nightmares. There are many other possible causes for your dreams. Furthermore, having any of these circumstances does not automatically guarantee that you will experience nightmares. 


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