Dear Alice,

What, if anything, can a person do about their nighttime dreams? I have had nightmares every night for the past few months. I can't remember when I last had a pleasant dream. I don't attribute this to any daytime stresses; I am doing what I want to be doing. But I truly dread going to sleep some nights, because I can count on a nightmare or a very vivid, disturbing dream. I am on no medications and I try to eat a healthy diet. There are many nights where I feel very exhausted, but I do not sleep well. Any insight would be helpful. I am afraid that this will continue for years.

Dear Reader,

Sounds like the Sandman has been sending you some bad dreams. Nightmares occur during REM (rapid eye movement) sleep in the middle and latter parts of the nightly sleep cycle. Many find they can be remembered in detail. They're very common, but when they become persistent, they can be distressing. However, fret not — there are ways to alleviate your nighttime scaries. Often, daytime stress and habits can affect your nighttime well-being. Here are a few different reasons you may be experiencing these nightmares:

  • Stress: While ordinary stresses of daily life can trigger nightmares, major changes can have the same effect. Has anything changed in your life in the past few months, such as quitting smoking, a move, or the death of a loved one? Do you relax before bedtime or is it "go, go, go" until you hit the sack? If stress is the culprit, perhaps try some relaxation techniques beforehand, such as taking a warm bath, meditating, or practicing deep breathing. Physical activity, meditation, and yoga all have a sleep-improving component, according to many practitioners of these stress reduction strategies.
  • Bedtime snacks: Even when eating a nutritious diet, some people experience a boost in metabolism and brain activity that leads to nightmares from eating close to bed. Alcohol and illicit drugs can trigger nightmares, too. Do you eat close to bedtime or use any of these substances? Eating earlier or cutting down on (or avoiding) substance use before bedtime may help reduce the burden of nightmares. 
  • Illness: Being sick can sometimes lead to nightmares, especially if an illness involves a fever. Nightmares have been associated with colds, respiratory infections or other breathing difficulties. Have you been sick recently? In addition, some drugs, such as antidepressants, benzodiazepines, and beta-blockers (used to lower blood pressure and regulate an erratic heart rate) can lead to nightmares.
  • Scary stories: Reading or seeing something scary before sleep may lead to nightmares. Have you been reading a scary book or watching scary movies or television shows just before bed? Consider the content of what you consume just before bed and perhaps opt for something less scary.
  • Trauma: Traumatic events are common nightmare triggers for people. If you believe trauma to be the cause of your nightmares, it's best to seek care from a mental health professional. 

Even though nightmares and night terrors don't appear to cause any long-term dangers, they can affect sleep quality and mood. In your case, don't be too quick to rule out everyday stressors such as classes, work, partners and family, or child-rearing responsibilities. It's key to remember that stress can result from activities and emotions that are considered positive. Given that, here are a couple of questions to ponder: Are you getting any time to yourself? Do you have a support network of friends or relatives with whom you can share concerns and vent possible frustrations? Discussing your thoughts with others – particularly with others in similar roles – and writing about them in a journal may be ways to avoid taking tension to bed with you.

Since nightmares are often caused by mental disturbances, sleep deprivation, or have no identifiable cause, seeking care from a mental health professional is another option if your nightmares persist. You might also mention them to your health care provider, and give details such as how long the nightmares have been occurring, when you began experiencing them, if you’ve had sleep problems in the past, and if anyone else in your family has had sleep problems. Nightmares are rarely related to any other sleeping disorders, but if your sleep continues to be severely disturbed, they may recommend an overnight sleep study with a sleep specialist to help determine if the nightmares are connected to another sleep disorder. This study is called nocturnal sleep study (polysomnography). Sensors placed on the body will record and monitor brain waves, oxygen level in the patient’s blood, heart rate and breathing, as well as eye and leg movements while asleep. In some cases, the patient may be videotaped to document their behavior during sleep cycles.

Rest assured, however, that for most people, nightmares eventually subside. Behavioral changes were found to be effective for nightmares not related to illness. Besides avoiding nightmares, good sleep hygiene can help you feel more rested. For additional online resources, you can check out the Sleep section of the Go Ask Alice! General Health archives.

Here's to hopefully achieving peaceful, nightmare-free shut-eye soon!

Alice!

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