15 Frightful Facts About Nightmares
Research on nightmares tends to focus on mental health of sufferers.
Posted Jun 21, 2019
A dream is a recollection of subjective experiences that happen during rapid-eye movement (REM) sleep. On the other hand, nightmares are markedly dysphoric dreams with intense negative emotions which primarily manifest during late-night REM sleep.
Due to dreams themselves being subjective, the research on dreams has been largely empirical. Lots of dream research connects it to mental health. Ever since Freud wrote that “the interpretation of dreams is the royal road to a knowledge of the unconscious activities of the mind” in his book Interpretation of Dreams in 1899, experts have been interested in the relationship between mental pathology and dreams.
To learn more, let’s take a look at these 15 facts about nightmares:
- In the general population, 1 out of 20 people have nightmares every week. This ratio is much higher in those with psychiatric illness. For instance, three-quarters of those with PTSD have nightmares, and about half of those with borderline personality disorder have nightmares.
- A small number of prospective studies suggest that nightmares could predict the onset of psychosis, PTSD, and sleep disturbances.
- Nightmares often happen after a traumatic life event—such as that leading to PTSD—but onset can occur after any life stressor.
- Increased levels of worry, hallucinatory experiences and longer sleep duration have been found to be significantly linked to nightmare occurrence. This effect was sustained even after controlling for psychiatric illness including negative affect, PTSD, and life stressors.
- Worry appears to be the strongest predictor of nightmares. Additionally, people who are bigger worriers have worse nightmares. Worry could be a worse stressor because it primes your body for distress, preoccupation, and impairment.
- The reason people who sleep more experience more nightmares is because they stay in REM sleep longer. Duh!
- The content of nightmares can be recalled in detail, unlike night terrors, which are parasomnias that occur in non-REM sleep.
- In the ICD-10, nightmares can be coded as either nightmare disorder or PTSD.
- People with PTSD also experience a higher prevalence of non-trauma related nightmares. In other words, not all their nightmares are about trauma experience; these people experience more nightmares overall.
- Drugs like selective-serotonin reuptake inhibitors (SSRIs) can cause nightmares.
- Genetics, life stressors, and mental health can all play a role in the occurrence of nightmares.
- For the most part, psychotropic medications like benzodiazepines and antidepressants don’t help with nightmares.
- Psychotherapy can help with nightmares. Examples include psychological desensitization, exposure therapy, imagery rehearsal therapy, and lucid dreaming therapy.
- With imagery rehearsal therapy, the following happens:
- the patient recounts a recent nightmare
- the patient imagines a new ending
- the new ending is rehearsed daily between 5 and 10 minutes for 2 weeks
- People with psychosis have bizarre and disorganized nightmares.
Rek, S, Sheaves, B, and Freeman, D. Nightmares in the general population: identifying potential causal factors. Social Psychiatry and Psychiatric Epidemiology. 2017; 52: 1123-1133.
Schredl, M. Dreams and Nightmares in Personality Disorders. Current Psychiatry Reports. 2016; 18:15.