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Nightmare News: Causes and Cures for Bad Dreams in Adults

PTSD and Nightmares

We usually think of nightmares as a problem that occurs in childhood. In reality, however, at least half of all adults experience occasional nightmares, and some individuals even suffer from frequent bad dreams, says psychologist Shelby Freedman. The problem with nightmares: They can ruin the quality and quantity of your sleep, causing you to feel groggy the next day and to dread going to sleep the following night.

In addition, nightmares can lead to depression or anxiety, according to Dr. Freedman. You feel stressed throughout the day, resulting in more nightmares during your sleep. The result: A miserable cycle of insomnia, nightmares, fatigue and anxiety during the night and day.

Nightmares Defined
A nightmare is defined as a very realistic dream that disturbs you and causes you to wake up. They usually happen during REM (Rapid Eye Movement) sleep. During this sleep cycle, your brain is processing memories and emotions. And because we stay in REM sleep longer than during other cycles, more nightmares can occur as the night goes on.

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If you suffer from night terrors, you should note that there is a difference, says Dr. Freedman. "Night terrors tend to occur in the first third of the night and the patient awakens with a scream and look of fear. However, the patient typically has very little to no recollection of the event and what may have provoked it. Nightmares, on the other hand, usually happen in the later part of the night and patients awaken with a vivid recall of the disturbing dream. A good rule of thumb to distinguish between the two events is to see who is more distressed in the morning—the patient or the observer," she explains.

Why Nightmares Occur
Reasons can range from eating late at night to getting into the habit of having bad dreams. In addition, sleep apnea and restless leg syndrome may cause or exacerbate nightmares, says Dr. Freedman.

Certain medications can result in nightmares, such as narcotics, antidepressants and certain blood pressure medications. Withdrawal from medications, drugs and/or alcohol also can cause them.

What to Do
Your first step should be to talk with your doctor to see if a medication or sleep disorder such as restless leg syndrome could be causing your problem. Then try these steps:

  • Develop good sleeping habits, such as going to bed and getting up at the same time and avoiding heavy meals and alcohol three hours before bedtime.
  • Consider talking with a specialist in Imagery Rehearsal Therapy (IRT). "Typically conducted by psychologists who specialize in Behavioral Sleep Medicine, IRT is a promising, effective, simple and short-term treatment targeted at changing the imagery of nightmares," says Dr. Freedman.
  • A medication called Prazosin may be helpful if your nightmares are caused by PTSD. Talk with your doctor if that is the case