HOME

TheInfoList



OR:

A nightmare, also known as a bad dream, Retrieved 11 July 2016. is an unpleasant
dream A dream is a succession of images, ideas, emotions, and sensations that usually occur involuntarily in the mind during certain stages of sleep. Humans spend about two hours dreaming per night, and each dream lasts around 5 to 20 minutes, al ...
that can cause a strong emotional response from the mind, typically
fear Fear is an intensely unpleasant emotion in response to perceiving or recognizing a danger or threat. Fear causes physiological changes that may produce behavioral reactions such as mounting an aggressive response or fleeing the threat. Fear ...
but also despair,
anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil Turmoil may refer to: * ''Turmoil'' (1984 video game), a 1984 video game released by Bug-Byte * ''Turmoil'' (2016 video game), a 2016 indie oil tycoon video ...
or great
sadness Sadness is an emotional pain associated with, or characterized by, feelings of disadvantage, loss, despair, grief, helplessness, disappointment and sorrow. An individual experiencing sadness may become quiet or lethargic, and withdraw them ...
. The dream may contain situations of discomfort, psychological or physical terror, or
panic Panic is a sudden sensation of fear, which is so strong as to dominate or prevent reason and logical thinking, replacing it with overwhelming feelings of anxiety and frantic agitation consistent with an animalistic fight-or-flight reac ...
. After a nightmare, a person will often awaken in a state of distress and may be unable to return to sleep for a short period of time. Recurrent nightmares may require medical help, as they can interfere with sleeping patterns and cause
insomnia Insomnia, also known as sleeplessness, is a sleep disorder in which people have trouble sleeping. They may have difficulty falling asleep, or staying asleep as long as desired. Insomnia is typically followed by daytime sleepiness, low energy ...
. Nightmares can have physical causes such as sleeping in an uncomfortable position or having a fever, or psychological causes such as stress or anxiety. Eating before going to sleep, which triggers an increase in the body's metabolism and brain activity, can be a potential stimulus for nightmares. The prevalence of nightmares in children (5–12 years old) is between 20 and 30%, and for adults is between 8 and 30%. In common language, the meaning of ''nightmare'' has extended as a metaphor to many bad things, such as a bad situation or a scary monster or person.


Etymology

The word ''nightmare'' is derived from the Old English , a mythological demon or
goblin A goblin is a small, grotesque, monstrous creature that appears in the folklore of multiple European cultures. First attested in stories from the Middle Ages, they are ascribed conflicting abilities, temperaments, and appearances depending on t ...
who torments others with frightening dreams. The term has no connection with the Modern English word for a female horse. The word ''nightmare'' is cognate with the Dutch term and German (dated).


History/Folklore

The sorcerous demons of Iranian mythology known as Divs are likewise associated with the ability to afflict their victims with nightmares. The
mare A mare is an adult female horse or other equine. In most cases, a mare is a female horse over the age of three, and a filly is a female horse three and younger. In Thoroughbred horse racing, a mare is defined as a female horse more than f ...
of Germanic and
Slavic folklore Slavic folklore encompasses the folklore of the Slavic peoples from their earliest records until today. Folklorists have published a variety of works focused specifically on the topic over the years.See, for example, Kononenko 2007. See also * ...
were thought to ride on people's chests while they sleep, causing nightmares.


Signs and symptoms

Those with nightmares experience abnormal sleep architecture. The impact of having a nightmare during the night has been found to be very similar to that of
insomnia Insomnia, also known as sleeplessness, is a sleep disorder in which people have trouble sleeping. They may have difficulty falling asleep, or staying asleep as long as desired. Insomnia is typically followed by daytime sleepiness, low energy ...
. This is thought to be caused by frequent
nocturnal awakenings Middle-of-the-night insomnia (MOTN) is characterized by having difficulty returning to sleep after waking up during the night or very early in the morning. This kind of insomnia (sleeplessness) is different from initial or sleep-onset insomnia, wh ...
and fear of falling asleep. Nightmare disorder symptoms include repeated awakenings from the major sleep period or naps with detailed recall of extended and extremely frightening dreams, usually involving threats to survival, security, or self-esteem. The awakenings generally occur during the second half of the sleep period.


Classification

According to the
International Classification of Sleep Disorders The International Classification of Sleep Disorders (ICSD) is "a primary diagnostic, epidemiological and coding resource for clinicians and researchers in the field of sleep and sleep medicine". The ICSD was produced by the American Academy of Sl ...
-Third Edition (ICSD-3), the nightmare disorder, together with REM sleep behaviour disorder (RBD) and recurrent isolated
sleep paralysis Sleep paralysis is a state, during waking up or falling asleep, in which one is conscious but is completely paralyzed. During an episode, one may hallucinate (hear, feel, or see things that are not there), which often results in fear. Episod ...
, form the REM-related
parasomnia Parasomnias are a category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep. Parasomnias are dissociat ...
s subcategory of the Parasomnias cluster. Nightmares may be idiopathic without any signs of psychopathology or associated with disorders like stress, anxiety, substance abuse, psychiatric illness or
PTSD Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a ...
(>80% of PTSD patients report nightmares). As regarding the dream content of the dreams they are usually imprinting negative emotions like sadness, fear or rage. According to the clinical studies the content can include being chased, injury or death of others, falling, natural disasters or accidents. Typical dreams or recurrent dreams may also have some of these topics.


Cause

Scientific research shows that nightmares may have many causes. In a study focusing on children, researchers were able to conclude that nightmares directly correlate with the stress in children's lives. Children who experienced the death of a family member or a close friend or know someone with a chronic illness have more frequent nightmares than those who are only faced with stress from school or stress from social aspects of daily life. A study researching the causes of nightmares focuses on patients who have
sleep apnea Sleep apnea, also spelled sleep apnoea, is a sleep disorder in which pauses in breathing or periods of shallow breathing during sleep occur more often than normal. Each pause can last for a few seconds to a few minutes and they happen many tim ...
. The study was conducted to determine whether or not nightmares may be caused by sleep apnea, or being unable to breathe. In the nineteenth century, authors believed that nightmares were caused by not having enough oxygen, therefore it was believed that those with sleep apnea had more frequent nightmares than those without it. The results actually showed that healthy people have more nightmares than sleep apnea patients. Another study supports the hypothesis. In this study, 48 patients (aged 20–85 yrs) with obstructive airways disease (OAD), including 21 with and 27 without asthma, were compared with 149 sex- and age-matched controls without respiratory disease. OAD subjects with asthma reported approximately 3 times as many nightmares as controls or OAD subjects without asthma. The evolutionary purpose of nightmares then could be a mechanism to awaken a person who is in danger. Lucid-dreaming advocate
Stephen LaBerge Stephen LaBerge (born 1947) is an American psychophysiologist specializing in the scientific study of lucid dreaming. In 1967 he received his bachelor's degree in mathematics. He began researching lucid dreaming for his Ph.D. in psychophysiol ...
has outlined a possible reason for how dreams are formulated and why nightmares occur. To LaBerge, a dream starts with an individual thought or scene, such as walking down a dimly lit street. Since dreams are not predetermined, the brain responds to the situation by either thinking a good thought or a bad thought, and the dream framework follows from there. If bad thoughts in a dream are more prominent than good thoughts, the dream may proceed to be a nightmare. There is a view, possibly featured in the story '' A Christmas Carol'', that eating
cheese Cheese is a dairy product produced in wide ranges of flavors, textures, and forms by coagulation of the milk protein casein. It comprises proteins and fat from milk, usually the milk of cows, buffalo, goats, or sheep. During product ...
before sleep can cause nightmares, but there is little scientific evidence for this. Severe nightmares are also likely to occur when a person has a
fever Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using val ...
, these nightmares are often referred to as fever dreams.


Treatment

Sigmund Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies explained as originatin ...
and
Carl Jung Carl Gustav Jung ( ; ; 26 July 1875 – 6 June 1961) was a Swiss psychiatrist and psychoanalyst who founded analytical psychology. Jung's work has been influential in the fields of psychiatry, anthropology, archaeology, literature, phil ...
seemed to have shared a belief that people frequently distressed by nightmares could be re-experiencing some stressful event from the past. Both perspectives on dreams suggest that therapy can provide relief from the dilemma of the nightmarish experience. Halliday (1987) grouped treatment techniques into four classes. Direct nightmare interventions that combine compatible techniques from one or more of these classes may enhance overall treatment effectiveness: * Analytic and
cathartic In medicine, a cathartic is a substance that ''accelerates'' defecation. This is similar to a laxative, which is a substance that ''eases'' defecation, usually by softening feces. It is possible for a substance to be both a laxative and a cathart ...
techniques * Storyline alteration procedures * Face-and-conquer approaches * Desensitization and related behavioral techniques


Post-traumatic stress disorder

Recurring
post-traumatic stress disorder Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a ...
(PTSD) nightmares in which traumas are re-experienced respond well to a technique called imagery rehearsal. This involves dreamers coming up with alternative, mastery outcomes to the nightmares, mentally rehearsing those outcomes while awake, and then reminding themselves at bedtime that they wish these alternate outcomes should the nightmares reoccur. Research has found that this technique not only reduces the occurrence of nightmares and insomnia, but also improves other daytime PTSD symptoms. The most common variations of imagery rehearsal therapy (IRT) "relate to the number of sessions, duration of treatment, and the degree to which
exposure therapy Exposure therapy is a technique in behavior therapy to treat anxiety disorders. Exposure therapy involves exposing the target patient to the anxiety source or its context without the intention to cause any danger (desensitization). Doing so is thou ...
is included in the protocol"., p. 234


Medication

*
Prazosin Prazosin is an α1 blocker medication primarily used to treat high blood pressure, symptoms of an enlarged prostate, and nightmares related to post-traumatic stress disorder (PTSD). It is a less preferred treatment of high blood pressure. Oth ...
(
alpha-1 blocker Alpha-1 blockers (also called alpha-adrenergic blocking agents or alpha-1 antagonists) constitute a variety of drugs that block the effect of catecholamines on alpha-1-adrenergic receptors. They are mainly used to treat benign prostatic hyperpla ...
) appears useful in decreasing the number of nightmares and the distress caused by them in people with PTSD.<