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.
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.
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:
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.
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:
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.
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.
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.
Going to bed and waking up at the same time every day keeps your sleep stable. Try to avoid sleep schedule disruptions.
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.
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.
Both of these can disrupt sleep and cause nightmares. Try not to drink any caffeine or alcohol in the evening.
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.
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!
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.
“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.”
Here are some of the most frequently asked questions related to recurrent nightmares, night terrors, and disturbing dreams.
What mental illnesses have nightmares?
Many mental illnesses have nightmares as a symptom. Nightmares occur for a variety of reasons, and sleep problems are often a sign of something going on with the body or mind. Sleep research shows that severe nightmares can be a symptom of the following mental health disorders:
Other conditions such as high blood pressure, diabetes, and unhealthy sleep habits can also trigger nightmares. For some people, sleep terrors nightmare disorders can be caused by Parkinson’s disease. In this case, it is essential to treat Parkinson’s disease in the person experiencing the terrors. Nightmares happen most commonly in those who have sleep terrors associated with PTSD or dissociative conditions, however, any person can have a bad dream during sleep.
What are nightmares trying to tell you?
Often, a disturbing dream may have something to do with something in your life. This doesn’t mean that terrors will come true. It simply means that they may be based on fears that occur frequently in your awake life. You may experience anxiety symptoms during the day that translate into your dreams at night.
Nightmare disorders in adults are quite common, and certain sleep medicine may help. Other sleep conditions like REM sleep conditionss, sleep paralysis, and sleep terrors can also cause nightmares.
If you are having negative feelings about nightmares related to the things you remember, it doesn’t necessarily mean you need to learn anything from the dreams. However, deep breathing exercises, rescripting therapy, and keeping a sleep diary can help you find meaning and relief.
Is there a cure for nightmare disorder?
Clinical sleep medicine is very advanced these days, and it is more possible than ever to treat nightmares and disturbing dreams. The academy of sleep medicine recommends improving your sleep quality, falling asleep earlier, relaxation and rescripting therapy, and stress reduction techniques.
Outside of the American Academy of Sleep, you can find resources online or from a therapist who has experience in treating sleep terrors. Although the American Academy of Sleep lists sleep problems, so does the American Psychiatric Association. A person’s sleep schedule is directly related to their mental health and daytime functioning.
A sleep disturbance caused by a mental health concern, trauma such as sexual assault, or things that trigger nightmares can be best treated by a mental health professional. Your therapist can help you with your sleep disturbance by utilizing methods such as cognitive behavioral therapy, imagery rehearsal therapy, exposure, relaxation, and rescripting therapies.
Sometimes, sleep disturbances or nightmares can be treated with sleep medicine. Some medications have been shown to reduce sleep terrors related to trauma or anxiety. Reducing sleep disruptions can also have other positive effects, such as reducing excessive daytime sleepiness or gaining future perspectives.
Know that even if you’re having severely disturbed sleep terrors, everyday tasks can be possible for you again with help. The diagnostic and statistical manual (DSM) does list nightmares as a symptom of many mental health conditions, and it is also constantly being studied in clinical trials.
Up-to-date information can be found at the most recent sleep medicine position paper. If you want to learn more about risk factors for nightmares or why you’re experiencing them, consider speaking to a sleep therapist today. This condition doesn’t have to control your life.