Nightmares: A Complete Guide to These Bad Dreams

We’ve all had nightmares at one time or another, those terrifying dreams that wake us up startled. Nightmares are normal, but if they cause discomfort during the day and interfere with our daily lives, they can become a problem! Here you will find a complete guide to nightmares: What they are, why do we have them, are they useful, what can cause them, are there different types, can nightmares be considered a disorder and much more!

What are nightmares?

Nightmares can be defined as long, elaborate dreams with images that cause symptoms of anxiety, fear or sadness.

It is a disturbing dream that is related to negative feelings. The person may wake up trying to avoid the perceived danger within the dream. Nightmares occur during REM (rapid eye movement) sleep and happen later in the night, waking the person from their sleep. People tend to remember what they dreamt of and it might be difficult to fall asleep again after these types of dreams.

Nightmares are common in children. They usually begin to occur between the ages of 3 and 6 and tend to decrease by 10 years old. However, they can continue throughout life. Studies have found that young women have more nightmares than men the same age.

If nightmares are occasional, that is, they don’t happen every night, or interfere with our daily lives, there is no reason to worry. They are considered normal when they do not interfere with your sleep or psychosocial development.

Having nightmares is normal and common. However, when they happen with a certain frequency, disturb sleep, cause insomnia, anxiety, fear of going to bed, or cognitive problems throughout the day it can be considered a disorder.

Are nightmares useful? What are they for?

We know that sleep is essential for our brain to rest and consolidate the day to day experiences in long-term memory and to organize information.

Some researchers believe that dreams are the attempts of the cerebral cortex to find meaning in the random signals it receives during REM sleep. One theory suggests that the attempt to organize and interpret these signals creates a “story” out of the fragmented activity.

However, they have no specific purpose, no specific interpretation. Even though dreams have no meaning, nightmares can be a symptom of something that worries or frightens us. This is a starting point to understanding what might be causing these types of dreams.

Nightmares: Causes- Why do we have them?

When do nightmares appear? Why do we have nightmares? Occasional dreams can have many causes, stress can have an influence, having recently eaten or watched a scary movie. A recurring bad dream is usually linked to some kind of anxiety. Here are the most common causes of nightmares.

• Negative, stressful, or traumatic life experiences, such as the loss of a loved one.
• Increased stress at work or at home.
• Exposure to a shocking situation before bedtime, such as watching a movie or reading a scary book.
• Sleep deprivation.
• Eating large meals before going to bed. Heavy digestion can interfere with our rest.
• Alcohol abuse
• Some drugs, which influence the hormones or neurotransmitters that regulate REM sleep, can cause terrifying dreams.
• Sudden alcohol, drug, or medication withdrawal.
• Drug Consumption
• Fever

Repetitive bad dreams can also be a sign of:

• Breathing disorder during sleep (sleep apnea)
• Post-traumatic stress disorder (PTSD) has been identified as the leading cause of nightmare disorder. These people re-experience the feelings of fear and terror of a traumatic event. Research has found that 80% of those with this condition report regular nightmares.
• Sleep disorder (for example, narcolepsy or night terror disorder)
• Depression or anxiety

Nightmare Disorder or recurring nightmares- When are nightmares considered a disorder?

Nightmare Disorder, or recurring nightmares, is characterized by repetitive nightmares that interfere with an individual’s daily life.

Isolated or punctual bad dreams are completely normal, however, when bad dreams are frequent and cause extreme terror or anxiety, they can interfere with the person’s daily life and can become a sleep disorder. This problem is called Nightmare Disorder or Dream Anxiety Disorder, which refers to a series of nightmares with a repetitive theme.

Symptoms and characteristics of Dream Anxiety Disorder

The criteria for diagnosing nightmare disorder are as follows:

• Sudden awakenings with a detailed recall of long, terrifying dreams that focus on threats to survival, safety, or threats to the physical or psychological integrity and usually occur in the second half of sleep.
• Be alert the moment you wake up.
• Experiencing discomfort or deterioration in areas such as social, work, or others.
• Symptoms cannot be explained by substance or drug use or a medical condition.

When to see your doctor

Nightmares are rarely a cause for concern, but when frequent ones begin to cause sleep avoidance or affect social or work functioning, it is advisable to consult with your doctor.

Risk factors for recurring nightmares

Why do I have nightmares every night?

Nightmares are more common among children and adolescents and become less frequent in adulthood. However, about 50% of adults experience occasional nightmares. Adverse situations, trauma, lack of sleep, irregular sleep schedule, jet lag can cause an increase in nightmares. About 1% of adults who experience frequent nightmares should seek help.

Although it is not fully understood how these terrifying dreams appear, some abnormalities in brain activity have been seen in people with dream anxiety disorder. For example, a brain region called the amygdala, which controls fear and learning, appears overactive in people with PTSD who suffer from regular bad dreams. In addition, other emotional areas of the brain, such as the limbic system, prefrontal cortex, tend to become overactive in those who experience frequent bad dreams.

Types of nightmares

Some issues are recurrent in our nightmares, for example:

• Being haunted by something that can kill you.
• Being naked in public.
• Having to go to the bathroom and you can’t find one.
• Having to take an exam but you haven’t prepared for it.
• Falling.
• Being in a vehicle out of control.
• Being late for an important meeting or event
• Having your teeth fall out
• Harming a loved one
• Losing a loved one

All of these indicate some kind of anxiety or worry, only the one who dreams it can do an analysis of what is worrying them or in a therapuetic process.

Consequences of Nightmares

How do they influence our daily lives?

Nightmares can interfere with our sleep and not allowing us to est as we should. If they are recurrent, we may be able to avoid bedtime. Our sleep is affected and this deteriorates our physical and cognitive state.  Stress in our daily lives, plus anxiety of going to bed because of the nightmare and the lack of sleep can make us irritable, angry and even unable to concentrate. Remember to keep your cognitive skills sharp by training them!

How to avoid nightmares

1. Establish a schedule

Go to bed at the same time every night. Altering the schedule can cause insomnia in sensitive people. Sleeping late on weekends makes it harder to get up on Mondays and let’s remember, a lot of sleep on weekends doesn’t make up for lost sleep during the week. It is best to sleep every day for 7-9 hours.

2. Exercise

Getting 30 minutes of physical activity every day helps people sleep better. But try not to exercise too hard just before bedtime, because it can over-activate us.

3. Avoid caffeine, nicotine and alcohol

Avoid stimulant drinks containing caffeine or other stimulants (coffee, energy drinks, tea, highly sweetened products). Smokers tend to have a very light sleep and get up early in the morning because of their need for nicotine, so the best thing you can do for your health is to quit smoking. Alcohol also has negative effects on sleep, because, although it seems to help us sleep, they cause light sleep.

4. Learn to relax

Nightmares can occur from anxiety and stress. Find out how to manage stress.

Relaxation techniques can help reduce anxiety, spend time with friends and family, and keep track of your hobbies and activities that give you pleasure.

You can create a relaxing ritual before going to bed, associating relaxing activities with going to bed.

5. Have good sleep hygiene

Proper sleep hygiene is important. There are people who, although they have terrible sleep habits, sleep like “logs”. However, people with sleep problems need to have good sleep hygiene.

• Maintain an adequate temperature in the room, neither hot nor cold.
• Just use the bed to sleep or have erotic encounters.
• If you don’t fall asleep, don’t stay in bed, do something else.
• Have dinner 2 hours before you go to sleep.

6. Consult with a professional

If you have experienced any type of trauma that is affecting you in other areas of your life, consult a mental health professional. Talking about what’s on your mind can help you manage the past or the present.

If nightmares have started shortly after taking a medication, consult your doctor.

Nightmares in children

It’s normal for kids to have nightmares about:

• Realistic fears such as aggressive dogs, sharks, spiders, etc.
• Imaginary fears like monsters
• Stressful situations you have seen or experienced.
• Depending on their language level, children can sometimes tell adults about the nightmares they have had in more or less detail.

Occasional nightmares are normal. Just because your child has nightmares once in a while doesn’t mean they have emotional problems. Children with a vivid imagination tend to have more nightmares than others, but there’s nothing to worry about. If your child doesn’t remember what he dreamt about and in the morning doesn’t remember that he/she woke up, they might be night terrors.

However, if your child has a recurring nightmare, or has very bad nightmares, he or she may be experiencing some kind of stress during the day. Traumatic events also cause nightmares.

How to help your child sleep if they have nightmares?

Children often cry and are sad after a nightmare. They need you to comfort them. As the child grows older, they begin to understand that a dream is just a dream.

How to act during a nightmare

Here are some ideas for managing children’s nightmares and helping them overcome them.

• If the child wakes up from a bad dream, explain that it was just a bad dream. Tell them everything’s fine and he’s safe. A kiss and a caress can help calm you down.
• Let them know there’s nothing wrong with being scared by a nightmare. Avoid minimizing their fear or reaction.
• If a preschooler has dreamt of monsters, explain that monsters don’t exist. Although they may seem scary, they can’t really hurt children.
• Be patient if your child talks about the bad dream the next day. Listen to their concerns, don’t minimize them.
• Talking calmly about sleep can help take away the emotional power of these dreams.
  As your child gets older, encourage them to calm down on their own when they have a bad dream.
• A dim light in the room might help the child be less scared.

How to deal with recurring nightmares

If your child has a lot of nightmares or they’re about the same thing:

• Kindly ask about the interactions with other children, TV shows, video games or other daily activities. You can help them avoid those experiences that can trigger nightmares.
• Help him change the recurring dream. For example, reinforcing he has the power to overcome the object of the bad dream. Encourage them to think of ideas of how to overcome them.
• Make sure he gets enough sleep.
• Consult a professional if your child has bad dreams and daytime anxiety or has experienced a traumatic event.

Help your child relax before bedtime

• Establish a sleep routine (going to bed and waking up at the same time).
• Have a sleep routine that helps them to slow down, to feel safe as they fall asleep. It can be a bath, a cuddle, reading a story or having a quiet chat about the positive events of the day.
• Have a comfortable bed, a quiet place to relax.
• Their favorite toy or a night light can help.
• Avoid movies, series or scary stories, especially if they have triggered nightmares before.

Have you ever had a bad dream? Are you having recurring nightmares? Please leave your comment below. 

This article is originally in Spanish written by Andrea García Cerdán and translated by Alejandra Salazar.

Andrea García Cerdán

Psicóloga General Sanitaria, experta en terapia sexual y de pareja. Ayudo a mejorar la calidad de vida de las personas mediante terapia psicológica y la comunicación a través de la red.