Do I Have A Nightmare Disorder?

Medically reviewed by Elizabeth Erban
Updated February 21, 2024by BetterHelp Editorial Team

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

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Learn about nightmare disorder

More about nightmares

Other signs of a nightmare 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 different types of nightmares and night terrors can be scary, occasional nightmares don’t tend to be a sign of any negative health issues. In fact, they can be quite normal and common. They are most often experienced by young children between ages three and 12, according to the American Academy of Pediatrics, but they can also happen to older children, teenagers, and adults. 

If you are experiencing recurrent nightmares or a high nightmare frequency, 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 post-traumatic stress disorder (PTSD), dream anxiety disorder, nightmare disorder, or other mental health disorders. Even if nightmares are not a sign of a larger problem, those that happen often enough to disrupt your patterns of REM sleep could have a negative impact on your health. National Center on Sleep Disorders Research suggests that not getting enough sleep can cause problems with physical health, attention, memory, and learning.

Common causes of nightmares

What causes nightmares? Scientists are not sure exactly why nightmares (or dreams in general) occur, but over time you could notice certain triggers. If you find yourself wondering, “Why am I experiencing chronic nightmares?” you might consider whether you have any of the following risk factors that could trigger nightmares:

  • High levels of stress and anxiety
  • A traumatic event(s) in your past
  • Any of various mental health and medical conditions, such as PTSD or bipolar disorder
  • Certain medications, including those used to treat heart disease
  • Medication or drug withdrawal
  • Sleep deprivation
  • A history of nightmares among biological family members
  • A personal history of nightmares
  • Recently engaging with 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 nor any type of disorders are present. If you’re concerned, you might consider seeing a counselor or healthcare provider. 

What is nightmare disorder?

Nightmare disorder tends to be much less common than having the occasional nightmare: The American Academy of Sleep Medicine reports that it affects around 4% of adults. You may want to contact a healthcare provider if these types of dreams persist over time, routinely disrupt your sleep, or cause severe distress. If you frequently experience some of the following complications, nightmare disorder might be at play:

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

If your nightmares cause you to experience any of the above problems, you may be experiencing nightmare disorder. It can be difficult to diagnose nightmare disorder as there are generally no specific tests typically administered. Instead, your healthcare provider will likely talk to you about your symptoms and give you a physical exam. If they believe your nightmares might be related to a sleep disorder, they may have you do an overnight sleep study. Depending on the results, they may prescribe sleep medicine, review the effects, and consider further treatment.

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The process of treating nightmare disorders varies. If the nightmares are related to a different sleep disorder, then your healthcare provider will likely treat the underlying disorder and your nightmares may subside. In other cases, they may recommend stress and anxiety management or prescribe blood pressure medication. For those living with post-traumatic stress disorder (PTSD), doctors sometimes prescribe medication to prevent PTSD-related nightmares. Also, counseling or therapy, including lucid dream therapy, could be helpful for those with nightmare disorder.

How to stop nightmares

If you’re wondering how to stop having nightmares, you’re not alone. It may help to get to the root of the issue. If you think stress or anxiety could be causing your nightmares, it may be 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. If a sleep disorder is one of your nightmare causes, it may be a good idea to talk to your doctor about various treatment options. 

It may also help to practice what is known as good sleep hygiene. One example of practicing sleep hygiene is to reconsider the type of content you consume; you might try avoiding engaging with scary movies, books, and video games, which could cause an increased risk of nightmares, especially around the evening hours. Additional sleep hygiene practices include several simple lifestyle changes you can employ to try to get better sleep.

Six tips for better sleep 

  1. Establish a consistent sleep schedule

Going to bed and waking up at the same time every day may help keep your sleep stable. You might try to avoid sleep schedule disruptions.

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

Your usual bedtime routine might include taking a warm shower, following your skincare routine, brushing your teeth, or 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.

  1. Avoid using screens for an hour before bed

The blue light from your phone or computer may 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 before bed could make it more difficult for you to fall asleep or get restful sleep.

  1. Avoid or limit caffeine and alcohol

Both of these can disrupt sleep and may even contribute to nightmares. You might try not to drink any caffeine or alcohol in the evening. As a study in the American Academy of Sleep’s journal suggests, caffeine for one can result in sleep disturbances even if consumed as many as six hours before bed.

  1. Optimize your sleep environment

You also might make sure the room where you sleep is sufficiently dark and at a comfortable temperature. Decorating the room with familiar, comforting objects may also be a good idea. Lastly, you might consider whether your bed, pillows, and blankets are comfortable.

  1. Exercise during the day

Regular daily exercise (but not right before bed) may improve the quality of your sleep in addition to potentially providing overall health benefits. Exercise can be as simple as taking a walk or dancing to your favorite music. 

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Learn about nightmare disorder

Talk to a counselor

Counseling is an option that may help you address your nightmares or sleep problems. Whether you prefer to speak to a counselor in person or online, they may be able to 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. The American Academy of Sleep Medicine has found that engaging in cognitive-behavioral therapy can be an effective treatment for nightmare disorder, per the Academy of Sleep’s website.

If you’re interested in online therapy, BetterHelp is one option if you’re 18 or older, and TeenCounseling offers the same services specifically for teens. BetterHelp and TeenCounseling are online counseling platforms. They can match you with a certified counselor who can suggest stress reduction techniques and help you with your nightmares and other mental health concerns (such as post-traumatic stress disorder, for example).

You can talk to a licensed therapist virtually from the comfort of your own home. Also, you can contact your therapist in between sessions via in-app messaging, and they’ll get back to you as soon as they are able. Research suggests that online therapy can be as effective as in-person sessions in many cases. See below for client reviews of BetterHelp counselors.

Counselor reviews

“Natasha is a great counselor and does her job with ease. She has helped me with stress, anxiety, and friendship issues. She is an amazing counselor 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 counselor 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.”

Takeaway

If you have questions about nightmares or how to sleep better, you’re not alone. A licensed therapist may be able to help get to the root of your problem—including if it’s related to nightmare disorder, a stress disorder, or post-traumatic stress—so that you can have a better chance of enjoying a more positive sleep routine.

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