Verified by Managing Nightmares
Not every dream is pleasant; many are disconcerting or even terrifying. Unpleasant dreams—particularly those that are frightening or deeply upsetting—are referred to as “nightmares,” and are experienced by most people from time to time. Certain mental health disorders, as well as traumatic life events, may make someone more likely to experience more frequent nightmares.
Having scary dreams night after night can severely disrupt sleep and ultimately decrease quality of life. Luckily, many cases of persistent nightmares appear to respond to treatment, improving sleep quality and mental well-being for many with trauma, depression, or other challenges.
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Nightmares, though upsetting, are a normal (if infrequent) occurrence for the vast majority of people. Like dreams, nightmares often involve people, places, or other elements from an individual’s real life that are made distorted, frightening, or otherwise unpleasant; also like dreams, they are theorized to help humans process memories or come to terms with difficult feelings from their waking life.
Nightmares may be more likely to occur when an individual is stressed, anxious, or struggling with other difficult emotions in daily life; they may also occur seemingly randomly. In some cases, they may be triggered (or exacerbated) by mental health disorders.
According to the DSM, nightmares are generally thought to be caused by anxiety or stress; trauma or an upsetting event; sleep disorders; a fluctuating sleep schedule; or medication or drug use. (For more on the causes of nightmares, see our Diagnosis Dictionary.)
In some cases, yes. Chronic nightmares have been associated with depression, schizophrenia, PTSD, and some personality disorders, like borderline personality disorder. Some researchers believe that assessing the frequency and content of nightmares may help clinicians determine the progression and severity of mental health disorders; more frequent dreams of death, for instance, may reveal the presence of suicidal thoughts.
Yes; approximately half of patients with diagnosed PTSD report experiencing nightmares in the wake of the traumatic event. Post-traumatic nightmares may contain detailed memories of the traumatic event itself, but they don’t always; some incorporate themes or a sense of danger from the trauma but don’t replay the event verbatim. Regardless of themes, nightmares are associated with more severe symptoms overall; on the other hand, targeting nightmares with treatment has been linked to improvement on all symptoms.
The phrase “night terrors” refers to a kind of sleep disturbance in which an individual screams, cries, or otherwise appears consumed by intense fear during sleep; the individual may also flail wildly or even walk around. While night terrors can be quite alarming for family members or other witnesses, the person who experienced them will most likely not recall the episode in the morning. Night terrors are a normal part of development for many children; they are significantly less common in adulthood but are experienced by approximately 2 percent of adults.
No. Night terrors involve physical movement and crying out, and typically occur during non-REM sleep; because they occur in a deeper, slow-wave phase of sleep, upon waking, the individual will usually have no memory of what occurred. Nightmares are unpleasant dreams that occur during REM sleep. Screaming, thrashing, and other forms of extreme movement are not common during nightmares. In addition, because they occur during REM sleep (when brain activity is highest) the individual will usually have some memories of the nightmare when they wake up.
Nightmares often feel like one-of-a-kind horror shows to the individual experiencing them. But in reality, like dreams, there actually exist myriad “universal” nightmare themes that have been reported across cultures, genders, and ages.
In general, nightmares of any kind are thought to be related to stress, sadness, or anxiety. Some people believe that particular nightmare themes are indicative of particular real-world problems, dilemmas, or fears, but these exact connections have not tended to hold up consistently in research. Knowing that an upsetting nightmare theme is not uncommon, though, may help someone deal with any anxiety, shame, or sadness that the nightmare triggers.
Common nightmare themes include physical aggression, interpersonal conflicts, or experiences in which the dreamer feels helpless or unable to escape a particular situation, according to one large study that analyzed approximately 10,000 dreams. Nightmares may also feature large-scale calamities like war or natural disasters. Fear, guilt, sadness, and disgust are emotions that often characterize nightmares.
Dreams involving teeth falling out, rotting, or breaking are common around the world. Some evidence suggests that they may be related to real-life dental irritation, though this relationship is inconclusive. Other researchers hypothesize that such dreams are triggered by psychological distress like anxiety or nervousness, though this has also not been definitively proven. Ultimately, the nightmare may not mean anything; many neurologists argue that dreams are merely random collections of images generated by the human brain.
Some evidence has found that dreams of falling are associated with periods of heightened daytime stress or anxiety. But this research is inconclusive. Ultimately, even those who argue that falling dreams have a specific meaning are divided on what that meaning is; thus, it’s best left to the individual to determine the meaning of their own dream, if they so choose.
Nightmares that occur only occasionally are often not cause for concern. But persistent nightmares could be indicative of a larger problem—like depression or trauma—or may themselves interfere with well-being by disrupting sleep or triggering daytime anxiety.
Fortunately, there are several options for treating nightmares; strategies range from self-help (i.e. practicing relaxation techniques before bed) to improved sleep hygiene to formal therapy. If frequent nightmares came on suddenly with no discernible psychological trigger, it may be best to talk to a doctor; certain medications or physical disorders like sleep apnea may be causing persistent nightmares.
The best place to start is by improving sleep hygiene; sticking to a more consistent sleep schedule, engaging in a relaxing bedtime routine, limiting caffeine and alcohol, and exercising consistently may help curb nightmares in many cases. The next step may be to explore the issue with a doctor to determine if the nightmares have any medical causes.
If no medical causes are found, certain types of psychotherapy—including cognitive behavioral therapy and image reversal therapy—have been found to be effective at reducing the frequency of nightmares by helping an individual navigate the stress, anxiety, or trauma that may be responsible for the bad dreams. (For more on treating nightmares, visit our Diagnosis Dictionary.)
Yes; medications that are used to treat PTSD, depression, or anxiety have also shown some efficacy in treating nightmares. Some possible medications that a doctor may prescribe for nightmares include olanzapine, clonidine, trazodone, and tricyclic antidepressants, among others.
Many people hold the lay belief that eating certain foods—such as dairy products or spicy food—too close to bedtime is responsible for nightmares. Some research has found an association between people’s self-reported eating habits and nightmares, but the researchers warn that such results should be interpreted with caution. While it’s possible that particular foods do trigger digestive upset or influence mood—and may indeed lead to nightmares as a result—such findings may also be the result of confirmation bias or mere coincidence. Ultimately, whether certain foods actually cause nightmares remains to be seen.
