Bad Dreams Trying To Sleep
If you are dealing with nightmares resulting from PTSD you are most definitely not alone. The U.S. Department of Veterans Affairs has done a lot of research on PTSD. Their data shows that, of people who arent dealing with PTSD, only 5% report persistent nightmares.
Compared to the people struggling with PTSD, where anywhere from 70% to 96% are dealing with nightmares, it is obvious the problem is widespread and common.
Every time I close my eyes, I would have a nightmare, said Valerie Ovalle of the U.S. Army. It can have massive impacts on our overall health when one of our ultimate forms of comfort and rest is taken from us.
Similarly, P.K. Philips wrote I saw violent images every time I closed my eyes, after experiencing many different traumas. For her the nightmares were only one part of her struggle other symptoms followed along.
One thing you might experience, or see and read about from others who suffer from PTSD nightmares, is how they stick with you. If you wake up right in the middle of a nightmare the chances are high your brain wont let go of those details quickly.
This can disrupt your entire night of sleep and then affect the next day even. Its a horrible cycle that might seem like its never ending.
But there is help!
Beat Nightmares And Get Back To Restful Nights
You’re being chased by someone or something. Whatever it is, it always seems to be just behind you. You run and run, your whole body on fire with fear, and you can’t shake your pursuer. You jump into the air, and suddenly you’re free-falling. Your teeth start rattling and falling out. Then, somehow you’re on stage, under a spotlight, and you realize you’re not wearing pants, and everyone in the audience is staring at you.
Hopefully, you haven’t experienced any of those events in real life. But I bet you’ve gone through at least one of these common themes in the snooze world and woken up in a cold sweat with your heart pounding.
What are nightmares, and who has them more often?
Nightmares can be a mystery. Around the world, folklore tales have attributed nightmares to be demons, the souls of dead people who were wronged in life, and malicious spirits. Although we still haven’t fully solved the mystery of why nightmares exist and how they come about, we do know that they’re intense mental activity that happens mostly during rapid eye movement sleep. Most commonly, we experience nightmares as very vivid dreams that are terrifying or distressing. And, naturally, they can disrupt our sleep and affect our mood.
Whether you have Nightmare Disorder, PTSD, or just experience more nightmares than you’d like, there are things you can do to decrease nightmares and regain a good relationship with sleep.
Management Of Nightmare Disorder In Adults
Erin D. Callen, PharmD, BCPSProfessor of Health-System Pharmacy
Tiffany L. Kessler, PharmD, BCPSAssociate Professor of Pharmacy Practice
Krista G. Brooks, PharmDAssociate Professor of Pharmacy Practice
Tom W. Davis, MDAssociate Professor of Pharmaceutical SciencesSouthwestern Oklahoma State University College of PharmacyWeatherford, Oklahoma
US Pharm. 2018 43:21-25.
ABSTRACT: Occasional nightmares are fairly common, but nightmare disorder occurs in 2% to 6% of adults. Recurrent nightmares may be idiopathic, but they are often related to posttraumatic stress disorder , underlying psychiatric disorders, or medication use. The American Academy of Sleep Medicines 2018 position paper provides guidance on nonpharmacologic and pharmacologic treatment. Behavioral intervention with imagery-rehearsal therapy is currently the only treatment strategy recommended for all patients with recurrent nightmares. Prazosin may be used to treat both PTSD-associated and idiopathic nightmare disorder. Antidepressants, anxiolytics, anticonvulsants, antipsychotics, and other agents have been studied, with mixed results.
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After A Bad Dream The Area Of The Brain That Prepares Us For Being Afraid Is More Effective As Though The Dream Trained Us For This Situation
After a bad dream, the area of the brain that prepares us for being afraid is more effective, as though the dream trained us for this situation. The longer people had felt fear during their dreams, the less their emotion centres were activated when they were shown stressful images.
Our amygdala might need this period of processing to reset before the next day. Perhaps dumping the emotional baggage of the previous day overnight allows us to start from a new baseline in the morning. Studies on stressed workers show that our cortisol level, the hormone that helps to regulate our stress response, is highest in the morning, meaning we are better able to react well to stress early on. While cortisol is produced elsewhere, our amygdala is used to detect stressful situations.
During REM our brain produces low-frequency, slow theta waves in the hippocampus, amygdala and neocortex . Studies in rats, in which some were subjected to stressful tasks found that those rats who had to do something unpleasant had more periods of REM and increased theta waves during REM in the following night’s sleep.
Emotional dreams might better prepare us for the stresses of the day ahead
How do you treat nightmares?
Exposure and rescription therapies have helped people with nightmares to sleep through the night
What Are Common Themes In Bad Dreams
According to psychology researcher Geneviève Robert, common nightmare themes are death, health concerns, and threats. She adds that men tend to have more disaster-related scenarios such as floods, earthquakes, and war. However, womens narratives are typically centered around interpersonal conflicts.
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Nightmares And Cultural Differences
Nightmares may be viewed differently in different cultures. For example, in some cultures, nightmares are thought to mean that the dreamer is open to physical or spiritual harm. In other cultures, it is believed that the dreams may contain messages from spirits or may forecast the future. These beliefs may lead those with nightmares to use certain practices in an effort to protect themselves.
Avoidance And Emotional Numbing
Trying to avoid being reminded of the traumatic event is another key symptom of PTSD.
This usually means avoiding certain people or places that remind you of the trauma, or avoiding talking to anyone about your experience.
Many people with PTSD try to push memories of the event out of their mind, often distracting themselves with work or hobbies.
Some people attempt to deal with their feelings by trying not to feel anything at all. This is known as emotional numbing.
This can lead to the person becoming isolated and withdrawn, and they may also give up pursuing activities they used to enjoy.
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Treating Sleep Disorders In People With Ptsd
The most appropriate treatment for PTSD nightmares varies from person to person and is determined by the individual and the providers assessment of the severity of the nightmares, and access to treatment options. After a thorough assessment of the individuals life experiences and symptoms, a treatment plan can be initiated to help them overcome PTSD nightmares. There are currently many types of treatment available to help people cope with PTSD, including image rehearsal therapy, cognitive behavioral therapy, EMDR therapy and medication.
Treating Flashbacks Nightmares And Intrusive Memories
If you have stabilized your sympathetic nervous system and reduced your daily Hyper-arousal symptoms but still suffer from Intrusive Symptoms like flashbacks, nightmares and intrusive memories, you might want to consider Exposure Therapy . The goal here is to disconnect your triggers from your traumatic memory and integrate a revised memory back into your normal memory flow.
There are many different ways to accomplish this goal, but they all contain the following steps:
1) Let Go of negative emotions and pain
2) Explore the trauma in detail
3) Reexamine your feelings, both emotional and physical, how have they changed?
4) Reexamine your beliefs about the memory
5) Repeat the process until the memory no longer triggers you
This is ahighly repetitive process, like peeling skin off an onion one layer at a time. The first time you approach the memory, you probably wont be able to let go of feelings or explore the memory in detail. But as you repeat the process, it should get easier each time. If not, you could be triggering into a flashback and may need to choose a slightly different approach.
Ways to Let Go:
1) Share with others and accept support.
2) Cry, scream, curse
3) Use art, music, poetry, theater, or dance to express yourself
4) Visualize draining the feelings and pain into an object, another person, or pet.
5) Exercise
6) Mindfulness
7) Meditation
8) Eye movements
9) Massage and body work
Other Treatments:
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Why Does Trauma Affect Dreams
While there isnt broad consensus as to why trauma affects our dreams, scientists have long wondered about this connection. Sigmund Freud, the founder of psychoanalysis, offered an early perspective, suggesting that dreams allow a view into the unconscious. He proposed that dreams protected sleep by containing the anxiety associated with repressed desires.
Later hypotheses were developed in response to repetitive nightmares experienced by war veterans. Researchers thought that dreams allowed people to revisit and attempt to work through old trauma. Nightmares were often seen as a failure to work through or master the trauma. Other researchers thought nightmares were a way in which the mind transformed shame associated with the traumatic event into fear.
While science has come a long way since Freud, more recent hypotheses are surprisinglyconsistent with these early ideas. Many neuroscientists and psychologists believe that dreams help to integrate our experiences into long-term memory, a process called memory consolidation. When our experiences are traumatic, dreams may reflect the body attempts to cope and learn from these situations
What Do Nightmares That Follow Trauma Look Like
Nightmares that follow trauma often involve the same scary elements that were in the trauma. For example, someone who went through Hurricane Katrina may have dreams about high winds or floods. They may dream about trying to escape the waters or being in a shelter that does not feel safe. A survivor of a hold-up might have nightmares about the robber or about being held at gunpoint.
Not all nightmares that occur after trauma are a direct replay of the event. About half of those who have nightmares after trauma have dreams that replay the trauma. People with PTSD are more likely to have dreams that are exact replays of the event than are survivors without PTSD.
Lab research has shown that nightmares after trauma are different in some ways from nightmares in general. Nightmares after trauma may occur earlier in the night and during different stages of sleep. They are more likely to have body movements along with them.
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Skills For Managing Nightmares
Although individual treatment is very powerful in managing trauma-based nightmares, there are skills that you can try yourself. Such as grounding, and relaxation or breathing exercises.
Grounding and Relaxation skills to try yourself:
Grounding techniques are helpful to distract or temporarily get some distance from the distress caused by nightmares by focusing on the present moment.
First, be sure to completely wake up after having a nightmare. The idea is to help you get oriented in the here and now and to re-establish your sense of safety before you go back to sleep .
Tip: it is useful to have a nightlight or a lamp near your bedside to aid you in getting oriented in the present moment
After waking up, begin this grounding technique.
Its all about your senses. Focus on:
- 5 things you can see
- 4 things you can feel
- 3 things you can hear
- 2 things you can smell
- 1 thing you can taste
If you need a little more help, you can follow a grounding technique with a simple breathing exercise.
Breathing Exercise skill to try yourself:
- Start by sitting or lying down in a comfortable position
- When comfortable, gently close your eyes
- Inhale through your nose for 4 counts
- Exhale through your nose for 4 counts
- Repeat at least 3-4 times or as needed
If you or someone you know is experiencing trauma-related nightmares, I hope this article has been helpful.
Learn more about PTSD and the treatments we offer here!
Thank you and sleep well!
If You Fix The Nightmares First You Can Fix The Other Symptoms Of Ptsd Joanne Davis
Davis understands the importance of treating nightmares as more than just a symptom of a wider problem. “Just a few decades ago our field saw nightmares as a symptom of PTSD,” she says. “But if it’s not too grand to say, there has been a paradigm shift to thinking of nightmares as the hallmark of many of the problems. If you fix the nightmares first, you can fix the other things that are happening .”
Psychologists like Davis now considered nightmares a primary concern when treating PTSD, rather than only a symptom
Davis says it is important to look at nightmares as an early indicator of future problems. Emotional dreams sometimes occur in the night after the significant event, and sometimes five to seven days later. Penny Lewis, a professor of psychology at Cardiff University, and her colleagues propose that we store everyday memories immediately after they happen, but there is a “dream lag” when it comes to things of deep, personal significance.
While our understanding of the cause and treatment of nightmares has improved considerably in the last few years, the strict lockdowns since the onset of the coronavirus pandemic threw up new challenges for those people undergoing treatment.
William Park is a senior journalist for BBC Future and tweets at
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Are Nightmares A Disorder
While bad dreams from time to time are normal, frequent episodes may be cause for concern. According to the Mayo Clinic, nightmare disorder is considered a parasomnia. A parasomnia is a type of sleep disorder that involves unusual or disturbing experiences.
Nightmare disorder is diagnosed when the patients bad dreams cause significant sleep deprivation. In this case, you will want to contact your physician, who will likely discuss your symptoms, perform an exam, and suggest you undergo an overnight sleep study.
- Stages of Sleep, University of Michigan Health, October 26, 2020
- Priyanka A. Abhang, Suresh C. Mehrotra, Technological Basics of EEG Recording and Operation of Apparatus, 2016
- Nightmare Disorder, Mayo Clinic, June 5, 2021
- Nightmares and the Brain, Harvard Medical School, 2015
- Cuddle and Hug Your Way to Better Health, Intermountain Healthcare, February 12, 2020.
- Richard J. Corelli MD, Nightmares, Stanford University
- Study Analyzes Content of Nightmares, Bad Dreams, Science Daily
When To Seek Medical Advice
It’s normal to experience upsetting and confusing thoughts after a traumatic event, but in most people these improve naturally over a few weeks.
You should visit your GP if you or your child are still having problems about 4 weeks after the traumatic experience, or the symptoms are particularly troublesome.
Your GP will want to discuss your symptoms with you in as much detail as possible.
They’ll ask whether you have experienced a traumatic event in the recent or distant past and whether you have re-experienced the event through flashbacks or nightmares.
Your GP can refer you to mental health specialists if they feel you’d benefit from treatment.
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Fda Permits Marketing Of New Device Designed To Reduce Sleep Disturbance Related To Nightmares In Certain Adults
- For Immediate Release:
Today, the U.S. Food and Drug Administration permitted marketing of a new device intended for the temporary reduction of sleep disturbance related to nightmares in adults 22 years or older who suffer from nightmare disorder or have nightmares from post-traumatic stress disorder . The device provides gentle vibration through touch based on an analysis of heart rate and motion during sleep.
Sleep is an essential part of a persons daily routine. However, certain adults who have a nightmare disorder or who experience nightmares from PTSD are not able to get the rest they need. Todays authorization offers a new, low-risk treatment option that uses digital technology in an effort to provide temporary relief from sleep disturbance related to nightmares, said Carlos Peña, Ph.D., director of the Office of Neurological and Physical Medicine Devices in the FDAs Center for Devices and Radiological Health.
PTSD is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. People may experience a range of reactions after trauma, and most will recover from their symptoms over time. Those who continue to experience symptoms, which can include sleep problems and nightmares, may be diagnosed with PTSD. Certain medications may help address specific PTSD symptoms, such as sleep problems and nightmares. An experienced mental health professional can help people find the treatment plan that meets their symptoms and needs.
The Impact Of Nightmares On Ptsd
Nightmares are considered a central feature of PTSD. While a generic nightmare may feel extreme and life-threatening, it is usually unrelated to actual events. PTSD nightmares, however, are usually directly related to a previously experienced, traumatic event. For veterans, an example of a PTSD nightmare usually involves the replaying of traumatic events they witnessed or took part in. Similar to civilians who suffer from PTSD, their nightmares could be a replay of the traumatic event, such as physical abuse or violence.
One sleep therapist described whatPTSD nightmares are like based on the experience of their clients. They involved a replay of traumatic and vivid images, such as being knocked over by blown up body parts of a close friend, seeing the face of a person they killed in battle, or seeing the same image over and over again, such as what occurred with many people who witnessed the terrorist attacks of 9/11.
The trauma of reliving these nightmares causes many to dread or fear sleep. The avoidance of sleep in combination with an already inefficient sleep cycle causes many to become irritable and affects family, professional and social life. In one study, the risk of becoming suicidal or having suicidal thoughts was three times more likely in PTSD sufferers. With the addition of nightmares, individuals can be made to feel defeated and hopeless, contributing to the risk for suicidal ideation.
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