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What causes nightmares? 9 possible conditions

What Are Nightmares?

Nightmares are dreams that are scary or disturbing. They cause anxiety and fear, even after you wake up. People of all ages have nightmares, but they are more common in children. Nightmares usually begin before age 10, and girls are more likely to be troubled by them.

Except in the case of post-traumatic stress disorder, nightmares are not indicative of any underlying medical or psychological condition.

Nightmares can become a problem if they persist and interrupt your sleep pattern. This can lead to insomnia and difficulty functioning during the day. Consult with your physician if you are having trouble coping with nightmares.

The medical term for nightmares is parasomnias.

What Causes Nightmares?

Nightmares can be triggered by a variety of factors, including:

  • scary movies, books, or videogames
  • snacking just before going to sleep
  • illness or fever
  • medications such as antidepressants, narcotics, and barbiturates
  • over-the-counter sleep aids
  • alcohol or drug abuse
  • withdrawal from sleeping pills or narcotic pain medications
  • stress, anxiety, or depression
  • sleep apnea (when you stop breathing for short periods during sleep)
  • narcolepsy (a sleep disorder characterized by extreme drowsiness during the day following by quick naps or sleep attacks)
  • post-traumatic stress disorder (PTSD)

It is important to note that nightmares are not the same as sleepwalking (somnambulism), which causes a person to walk around while still asleep. They also differ from night terrors, also known as sleep terrors. Children who have night terrors sleep through the episodes and generally do not recall the incidents in the morning. Sometimes adults who have night terrors also have limited dream recall.

What to Do About Nightmares

Lifestyle changes may help to decrease the frequency of your nightmares. For example:

  • Get regular exercise.
  • Limit the amount of alcohol and caffeine you drink.
  • Avoid tranquilizers.
  • Engage in relaxation techniques such as yoga, tai chi, or meditation before bed.
  • Go to bed at the same time every night and get up at the same time every morning.

If your child is having many nightmares, encourage him or her to talk about them. Explain that nightmares can’t hurt him or her. Other techniques include:

  • creating a bedtime routine (keeping the same bedtime each night)
  • helping your child relax with deep breathing exercises
  • having the child rewrite the nightmare’s ending and talk to the characters from the nightmare
  • having your child keep a dream journal
  • allowing your child to use stuffed animals, blankets, or other items for comfort at night
  • using a nightlight and leaving the bedroom door open at night

Diagnosing Nightmares

Most children and adults have nightmares from time to time. You should consult with your doctor if nightmares persist over an extended period of time, disrupt your sleep patterns, and interfere with your ability to function during the day.

If a new medication prompted your nightmares, ask your doctor if there is an alternative that you might try. Your doctor will ask questions about your use of stimulants like caffeine and alcohol and drug use. Tell you doctor about any prescription or over-the-counter medications or supplements you take.

There are no specific tests for diagnosing nightmares. However, your physician may advise you to undergo a sleep study. During a sleep study, you spend the night in a laboratory. Sensors monitor your heartbeat, brain waves, breathing, blood oxygen levels, eye movements, leg movements, and muscle tension.

Treating Nightmares

Treatment is generally not required for nightmares. However, any underlying medical problems should be addressed. If anxiety, depression, or stress is the cause, your doctor may recommend counseling or stress-reduction techniques. In rare cases, medication for sleep disturbances may be advised.

In early 2012, the Mayo Clinic announced the use of prazosin, a blood pressure drug, to treat nightmares related to post-traumatic stress disorder (Mayo).

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See a list of possible causes in order from the most common to the least.



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Stress And Anxiety

Stress can be triggered by an event that makes you feel frustrated or nervous, such as moving, death, starting a new job, and having a baby. Long-term stress can produce both physical and psychological symptoms.

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Depression Overview

Depression is a mood disorder that can cause extreme and persistent feelings of sadness, hopelessness, and worthlessness. Depression type largely determines what kind of medical treatment is best.

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Narcolepsy is a disorder of the nervous system. It causes drowsiness and sleep attacks. It's also known as daytime sleep disorder and cataplexy. The Center for Narcolepsy (CN) at Stanford University School of Medicin...

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Post Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is an anxiety disorder that occurs after experiencing or witnessing a traumatic event. PTSD can cause disruptive symptoms of panic, increased arousal, and mental/emotional problems.

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Alcohol Withdrawal Syndrome

Alcohol withdrawal syndrome (AWS) is the name for the symptoms that occur when a heavy drinker suddenly stops or significantly reduces their alcohol intake. With AWS, you may feel mild anxiety and fatigue. You may als...

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Central Sleep Apnea

Central sleep apnea is a sleep disorder in which you briefly stop breathing during sleep. The moments of apnea can occur repeatedly throughout the night. The interruption of your breathing happens may indicate a proble...

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Night Terrors

Night terrors are a form of sleep disorder in which a person partially awakens from sleep in a state of terror.

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Cocaine and related disorders

Cocaine is extracted from the coca plant, which grows in Central and South America. It is processed into many forms for use as an illegal drug of abuse.

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.