Nightmares

Considerations:
Nightmares tend to be more common among children and decrease in frequency toward adulthood. In children, the content of the nightmare may be influenced by daytime experiences such as television viewing, movies, or scary real-life events. In adults, there is a less specific association between nightmares and daytime events. The majority of adults tend not to remember the content of their dreams or nightmares or only small portions of them.

Occasional nightmares without other symptoms are common occurrences requiring no treatment.

Eating just prior to going to bed which raises the body's metabolism and brain activity, can cause nightmares to occur more often.

Common Causes:

Note: There may be other causes of nightmares. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as location, quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for nightmares, occurring alone or in combination with other problems.

Home Care:
For nightmares resulting from the effects of drugs or alcohol, discontinue use. For persistent alcohol problems, join an Alcoholics Anonymous group and attend regularly (see alcoholism - support group ). Also, reassess lifestyle--friends, work, family--to identify and alter factors that encourage substance abuse .

For nightmares resulting from anxiety or stress , follow a regular energetic fitness routine, using aerobic exercises if possible. Learn techniques to reduce muscle tension (relaxation therapy).

Avoid long-term use of tranquilizers, and avoid caffeine and other stimulants .

Call Your Healthcare Provider If:

  • nightmares persists longer that 6 weeks or remain unexplained.



What to Expect:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting nightmares in detail may include:

  • time pattern
    • Do the nightmares occur repeatedly (recurrent)?
    • Do they occur in the second half of the night?

  • quality
    • Is there a sudden full awakening from sleep?

  • associated complaints
    • Does the nightmare cause intense fear and anxiety ?
    • Is there memory of a frightening dream (one with vivid visual imagery and story-like plot)?

  • aggravating factors
    • Has there been a recent illness?
    • Has there been a fever ?
    • Has an emotionally stressful situation occurred recently?

  • other
    • Is alcohol used? How much?
    • What medications are used?
    • Are "street drugs" being taken? Which?
    • What other symptoms are also present?

Physical examination may included a physical, neurological, and psychological examination.

Diagnostic tests that may be performed include:

After seeing your health care provider:
You may want to add a diagnosis related to recurrent nightmares to your personal medical record.