Nightmares

Nightmares are disturbing visual dreams that cause intense fear. These dreams are complex and often fairly long.


Sleep Terror Disorder

A nightmare disorder can be confused with a sleep terror disorder. An individual having a sleep terror frequently screams, kicks, thrashes around and may even bolt out of bed. Sleep terror is characterized by a partial arousal from sleep during which the person is generally nonresponsive; it can be extremely difficult to awaken a person who is having a sleep terror. When he does wake up he is very confused, fearful, and anxious and will not be able to recall the sleep terror episode. Sleep terrors usually occur in deep non-REM sleep usually within an hour after the subject goes to bed. These episodes can last five to twenty minutes.

Nightmares and Post-traumatic Stress Disorder

Nightmares are also the most defining symptom of PTSD. Persons with PTSD generally report awakening from dreams that involve reliving the trauma they had previously experienced. These dreams involve intense emotions; rage, intense fear or grief, that would have been appropriate reactions to the original traumatic event. Nightmares related to PTSD usually happen during REM sleep but they may also occur at sleep onset.

Treatment

Frequent nightmares not only affect your sleep, they can have undesirable consequences during your waking hours. Recurrent nightmares can result in insomnia, sleep deprivation, anxiety, depression, irritability, poor concentration and difficulty functioning during the day.

Individuals should be assessed by a sleep specialist if they experience frequent nightmares. Sleep physicians do not typically treat nightmares. Sufferers are usually referred to an experienced counselor or psychologist.

Nightmare disorder and PTSD can last a lifetime; however, a general improvement in symptoms often takes place as the patient gets older. Treatment for any underlying psychological disorders can be very successful.

The most common cause of nightmares is stress. Reduction in stress can help an individual who suffers from nightmares. Psychotherapy with a competent psychiatric clinician allows the individual to help identify the underlying stressors and learn effective skills to deal with issues. Stress reduction techniques such as exercise, meditation, and yoga can also be extremely effective in decreasing stress. Relaxation training will help an individual return to sleep after a nightmare. Hypnosis has also been used to address nightmares. When PTSD is the cause of the nightmares systematic desensitization may work. This treatment gradually exposes the individual to the recurrent dream content.

Medications are not commonly used for nightmares, however, they may be considered in extreme cases. There are medications that can help by reducing the percentage of REM sleep. Research shows that Prazosin is effective in reducing PTSD nightmares.

By the way, have you ever experienced the nightmare of being naked in public? It does not reflect anything sexual. It most likely means you feel unprepared and are afraid that others will see your inadequacies.

Nightmares make lasting impressions upon us. Feelings from the terrifying dream can linger all day. However, nightmares do have a function. They serve as a personal wake-up call that something that is psychologically bothering the individual deep down and they are not dealing with it while they are awake.



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