A nightmare is a disturbing dream that elicits negative emotions, such as fear or anxiety, and often leads to waking up.
While nightmares are common in children, they can occur at any age. For most people, occasional nightmares aren’t usually a cause for concern.
Nightmares typically begin in children aged 3 to 6 and usually decrease after age 10.
During adolescence and young adulthood, girls tend to experience nightmares more than boys. Some people may continue to have them into adulthood.
Though nightmares are common, nightmare disorder is less prevalent.
Nightmare disorder is characterized by frequent, distressing nightmares that disrupt sleep, cause significant emotional distress, and impact daily life or create a fear of sleeping.
Symptoms of Nightmares
Nightmares tend to occur during the later part of the night and can happen occasionally or several times during one night.
Although they are generally brief, nightmares can make it hard to fall back asleep.
Common characteristics of nightmares include:
- Vivid and Disturbing Content: The dream feels real and unsettling, often becoming more distressing as it continues.
- Threatening Themes: The dream typically involves threats to safety or survival, but may feature other disturbing scenarios.
- Waking Effect: The nightmare usually causes the person to wake up.
- Negative Emotions: Feelings like fear, anxiety, sadness, anger, or disgust may persist after waking.
- Physical Reactions: Sweating or a rapid heartbeat can occur while in bed.
- Clear Memory: After waking, you may recall details of the dream.
- Difficulty Returning to Sleep: The distress caused by the nightmare can make it hard to go back to sleep.
Nightmares are considered a disorder if you experience:
- Frequent occurrences
- Significant daytime distress or impairment, such as anxiety or fear surrounding sleep
- Trouble with concentration or memory related to the dream content
- Daytime fatigue, sleepiness, or low energy
- Difficulty functioning at work, school, or in social situations
- Behavioral problems related to bedtime or fear of the dark
For parents, a child with nightmare disorder can experience significant sleep disturbances, causing stress.
When to Seek Medical Help
Occasional nightmares are usually not a problem. If your child has them, you might bring them up during a routine check-up. However, it’s a good idea to consult a doctor if nightmares:
- Happen frequently and persistently
- Regularly disrupt sleep
- Create a fear of going to sleep
- Cause daytime behavioral problems or functional difficulties
Causes of Nightmares
Nightmare disorder is classified as a parasomnia, which involves unwanted experiences during sleep or waking.
Nightmares typically occur during rapid eye movement (REM) sleep, though their exact causes are not completely understood.
Possible triggers for nightmares include:
- Stress and Anxiety: Everyday pressures or major life changes can lead to nightmares. Anxiety can also increase their frequency.
- Trauma: Events like accidents, injuries, or abuse are commonly linked to nightmares, especially in those with post-traumatic stress disorder (PTSD).
- Sleep Deprivation: Poor sleep habits or lack of sleep can increase the likelihood of nightmares, and insomnia is often related to them.
- Medications: Certain medications, such as some antidepressants or those used for blood pressure or Parkinson’s disease, may trigger nightmares.
- Substance Misuse: Alcohol, drugs, and withdrawal can lead to nightmares.
- Other Disorders: Mental health issues, like depression, as well as medical conditions like heart disease or cancer, can be associated with nightmares. Other sleep disorders can also contribute.
- Scary Media: Reading or watching scary content, particularly before bed, may provoke nightmares for some individuals.
