Do I have Nightmare Disorder?

By BetterHelp Editorial Team|Updated July 14, 2022

A nightmare is a dream with disturbing content that causes you to wake up with feelings of anger, disgust, sadness, guilt, fear, or anxiety. You might wake up sweating or with a pounding heart as well. Nightmares differ from bad dreams because they cause you to wake up alert rather than confused or groggy, although both affect sleep quality. You’re also able to remember specific details of what happened in the nightmare. Nightmares occur most often in the second half of the night, during rapid eye movement (REM) sleep and could be a sign of nightmare disorder if persistent and frequent.

Other signs include:

  • Dreams that feel extremely real and vivid
  • Dreams that become more disturbing as they continue
  • A storyline involving threats to survival or safety
  • Dreams that cause enough distress that it's difficult to fall back to sleep

Although nightmares and sleep terrors can be terrifying, they’re usually not a sign of any negative health issues. In fact, they’re quite normal and common. Nightmares are most often experienced by children between the ages of three and six, but they can also happen to older children, teenagers, and adults. Throughout the teen years up to middle age, females are more likely to experience nightmares than males. One survey of college students revealed that 47% of them had intense nightmares within the last two weeks. Most teenagers experience nightmares on occasion, but not consistently. If you are experiencing chronic nightmares at a high nightmare frequency or if your nightmares are causing significant distress, do not hesitate to reach out to a professional through an online therapy service. In some cases, nightmares may be a sign of a mental health condition, such as posttraumatic stress disorder, dream anxiety disorder, nightmare disorder, among other mental health disorders.

Common Causes

What causes nightmares? We’re not sure exactly why nightmares (or dreams in general) occur, but we can point to a few different triggers. If you find yourself wondering, “Why do I keep having nightmares?”  you should check whether you have any of the following risk factors:

  • Nightmares run in your family
  • High levels of stress and anxiety
  • Trauma
  • Various mental health conditions, including PTSD and bipolar disorder
  • Certain medications and drugs
  • Medication and drug withdrawal
  • Sleep deprivation
  • A personal history of nightmares
  • Scary movies, books, or video games
  • Snacking before bedtime
  • Fever or illness
  • Sleep apnea
  • Narcolepsy
  • Nightmare disorder

At times, you may experience nightmares even if none of these triggers are present. If you're wondering whether to see a doctor, occasional nightmares are totally normal and nothing to worry about.

What Is Nightmare Disorder?

Nightmare disorder is much less common than the occasional nightmare. It affects about 2% to 8% of people. You may want to contact a doctor if nightmares persist over time, routinely disrupt sleep, or cause severe distress. If you experience any of the following complications, nightmare disorder might be contributing:

  • Persistent nightmares being frequent occurrences
  • Major distress or impairment the day after a nightmare
  • Fear of going to bed or sleeping
  • Anxiety over having another nightmare
  • Problems with memory or concentration
  • Persistent mental images from nightmares during the daytime
  • Lucid dreams
  • Daytime sleepiness
  • Poor sleep quality
  • Violent eye and leg movements
  • Problems functioning at school, work, or in social situations
  • Behavioral problems that are related to a fear of the dark

There aren’t any specific tests to diagnose nightmare disorder. Instead, your doctor will talk to you about your symptoms and give you a physical exam. If they believe your nightmares might be related to another sleep disorder, they may have you do an overnight sleep study. Depending on the results, a doctor prescribes sleep medicine, reviews the effect, and considers further treatment.

The process to treat nightmare disorder varies. If the nightmares are related to a different sleep disorder, then your doctor will likely treat the underlying disorder, and your nightmares should subside. In other cases, they may recommend stress and anxiety management. A prescription of blood pressure medications can be necessary in some cases, as well. For those living with PTSD, doctors will sometimes prescribe medication to prevent PTSD related nightmares. Often, counseling or therapy, including lucid dreaming therapy, is very helpful for those with nightmare disorder.

How to Stop Nightmares

If you’ve wondered how to stop having nightmares, you’re not alone. The best way to stop nightmares is to get to the root of the issue. If you think stress or anxiety could be causing your nightmares, it’s time to find some healthy coping strategies. If PTSD or trauma is the source of your nightmares, you may wish to speak with a mental health professional. Perhaps another sleep disorder is the culprit; in that case, it’s a good idea to talk to your doctor about various treatment options. Or maybe it’s as simple as the type of content you consume; try avoiding scary movies, books, and video games, and see if your nightmares go away. But regardless of the cause of the nightmares, there are several simple lifestyle changes you can employ for better sleep.

6 Tips for Better Sleep and Sweeter Dreams

These simple tips can make a huge difference in the quality of your sleep and whether or not you have nightmares. Give them a try for at least a couple of weeks to see if they’re helpful for you.

Establish a consistent sleep schedule.

Going to bed and waking up at the same time every day keeps your sleep stable. Try to avoid sleep schedule disruptions.

Create (and stick to) a relaxing and consistent bedtime routine.

Your usual bedtime routine might include a warm shower, your skincare routine, brushing your teeth, and reading a chapter of a book. Many people enjoy drinking a cup of herbal tea before bedtime. Others incorporate meditation, gentle yoga, or breathing exercises to relax their body and mind before drifting off to sleep.

Avoid using screens for an hour before bed.

The blue light from your phone or computer can suppress your body’s release of melatonin, which is a hormone that helps you sleep. Melatonin is typically released in response to darkness, so using screens can keep you awake.

Don’t drink caffeine or alcohol.

Both of these can disrupt sleep and cause nightmares. Try not to drink any caffeine or alcohol in the evening.

Optimize your sleep environment.

Make sure the room where you sleep is sufficiently dark and at a comfortable temperature. Decorating the room with familiar, comforting objects is always a good idea as well. Of course, ensure your bed, pillows, and blankets are nice and comfortable.

Exercise during the day.

Regular daily exercise (but not right before bed) can improve the quality of your sleep. Exercise can be as simple as taking a walk or dancing to your favorite music. All you really need to do is get your body moving in one way or another!

Still Struggling?

Counseling is an option that may be helpful for you. Whether you prefer to speak to a counselor in person or online, they can help you understand why you’re having nightmares. A mental health professional can also suggest various methods to stop your nightmares and improve your sleep overall. If you’re interested in online therapy, BetterHelp is a great choice if you’re 18+ and TeenCounseling offers the same services specifically for teens. BetterHelp and TeenCounseling are online counseling platforms that are accessible and affordable. They match you with a certified counselor who can suggest stress reduction techniques and help you with your nightmares and any other mental health concerns.

User Testimonial

“Natasha is a great counsellor and does her job with ease. She has helped me with stress, anxiety, and friendship issues. She is an amazing counsellor just to talk to. She is very comforting and puts lots of effort into an individual. Before I had this time with her, I was probably in the worst place that I could ever be. It was to the point where I couldn’t sleep because I was too worried about my future. I was also very stressed about school at the time. I didn’t want my marks to drop or my parents to think of me as a failure. In just one month, Natasha has changed me completely. I can sleep properly, I know how to deal with stress and anxiety and I have lots of techniques for these types of situations. She is such a great counsellor to talk to if you need help with stress, anxiety or anything at all. I rate Natasha a 10/10 because of how much effort she puts into changing you for the better.”

Helpful mental health resources delivered to your inbox
For Additional Help & Support With Your Concerns
Speak with a Licensed Therapist
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.