Nightmare Disorder

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Overview

A nightmare is a disturbing dream accompanied by negative feelings, such as anxiety or fear that awakens you. Nightmares are common in children, but can happen at any age, and occasional nightmares usually are nothing to worry about.

Nightmares may begin in children between 3 and 6 years old and tend to decrease after the age of 10. During the adolescence, girls appear to have nightmares more often than boys do. Some people may have nightmares as adults or throughout their lives.

Although nightmares are common, nightmare disorder is relatively rare. Nightmare disorder can be diagnosed when nightmares happen frequently, cause distress, disrupt sleep, cause problems with daytime functioning and/or cause fear of going to sleep.

 

Symptoms

You are more likely to have a nightmare in the second half of your night. Nightmares may occur rarely or frequently, even several times a night. Episodes are generally brief, but they cause you to awaken, and the return to sleep can be difficult.

A nightmare may involve these features:

  • The nightmare seems vivid and real and is very upsetting, often becoming more disturbing as the nightmare ends.
  • The nightmare story is usually containing threats to safety or life, but it can have other disturbing themes.
  • The nightmare awakens you.
  • The nightmare makes you feel scared, anxious, angry, sad or disgusted.
  • The nightmare makes you feel sweaty or have a pounding heartbeat.
  • You can think clearly upon awakening and can recall details of your nightmare.
  • The nightmare causes distress that makes falling back to sleep very difficult.

Nightmares are only considered a disorder if you experience:

  • Recurrent occurrences.
  • Major distress or problems, such as anxiety or persistent fear, or bedtime anxiety about having another nightmare.
  • Problems with concentration or memory, or you can’t stop thinking about images from the nightmare.
  • Daytime sleepiness, fatigue or low energy.
  • Problems functioning at work or school or in social situations.
  • Behavior problems related to bedtime or fear of the dark.

Having a child with nightmare disorder can cause significant sleep disturbance and distress for parents or caregivers.

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