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Nightmare Disorder

Nightmare Disorder is a medical condition where the patient suffers intense and vivid dreams during the latter half of the sleep cycle. Nightmare disorder is a sleep disorder where people have nightmare episodes much more frequently than normal people have them.

While Nightmare Disorder can be accompanied by other mental disorders, they can also be precipitated by periods of intense stress, or immediately after high stress situations. The association of Nightmare Disorder (DSM 307.47) with Post Traumatic Stress Disorder is well documented, as well as with other psychiatric disturbance.

It is also a feature of drug abuse, especially stimulants like cocaine and amphetamines. It also occurs as side effects in some medications like anti-hypertensives.

What is Nightmare Disorder?

In Nightmare Disorder, the patient has recurrent nightmares about being in a possibly fatal situations, either them, or their family, or any loved ones dying or being exposed to death. Their frequency is more in the REM stage of the sleep cycle (Rapid Eye Movement stage) Because of this timing, patients are often able to recall their dreams in explicit detail. Apparently they just show restless sleep movements, mumbling in their sleep or occasionally crying out loud, which can be confirmed by a partner or spouse or parent. The patient is in REM sleep and is roused easily, often accompanied by hyperventilation, palpitations ad sweating, but otherwise well oriented to time, space and person on being roused. Another feature is fear of falling asleep again, because of the re-occurrence of nightmares. This feature is responsible for the lack of sleep, exhaustion and fatigue seen in the patients, which adversely affects their performance in school and the workplace, etc.

Nightmare disorder is more common in adults who have a childhood history of nightmares as well. But since nightmares are a common feature in children, Nightmare Disorder is generally not diagnosed in children.

Treatment of Nightmare Disorder

Treatment of Nightmare Disorder is to first and foremost attempt to isolate the cause of anxiety. Dealing with the cause of anxiety helps to prevent further stress. Lifestyle changes have a big impact as well. A daily routine incorporating exercise helps in building a regular daily sleep time. Working on the bedroom area, eliminating harsh artificial lights or sources of noise also helps. Yoga and meditation are also beneficial. Therapy is always an open option if the initial measures are not helping.

In persons who have associated psychiatric disorders as well along with Nightmare Disorder, medication can be prescribed accordingly.

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