Living with Nightmare Disorder: Symptoms, Causes, And Treatment

Last Update on April 24, 2023 : Published on April 24, 2023
Nightmare Disorder

I’ll be honest with you; there are nights when I wake up in the middle of the night, terrified because of nightmares. I had nightmares when I was a kid and still have nightmares, but the frequency of my nightmares has decreased, and yet many people experience frequent nightmares.

There are probably some vivid nightmares that you still remember and I get it. Nightmares can be distressing, no matter when you experience them. When your sleep is disturbed by nightmares, you may feel fear and anxiety – not only soon after waking up but also during the daytime.

Nightmares are a common occurrence especially when you’ve lived through something traumatic in your life. However, the more frequently you experience nightmares, the more there’s a risk of developing a nightmare disorder.

Let’s explore what is a nightmare disorder, what are its symptoms, what causes nightmares, and how you can stop nightmare disorder from affecting your quality of life.

Nightmare Disorder: What Is It?

Nightmare disorder is a chronic sleep disorder also commonly known as a dream anxiety disorder. It is a type of parasomnia disorder that causes severe distress, anxiety, and sleep issues in adults.

Nightmare disorder is recognized as a sleep disorder in the DSM-5, where it is described as a disorder that causes the repetitive occurrence of long-term, unnerving, and vivid dreams. These unnerving dreams or nightmares can often involve life-or-death scenarios that can make you feel afraid of your surroundings and threaten your sense of safety.

The nightmares under this disorder occur during the REM – Rapid Eye Movement – stage of sleep. When you wake up, you are immediately in hyper-alert mode. This sleep disturbance can also contribute to uneasiness and distractions during the daytime, eventually leading to poor quality of life and well-being.

Some people easily confuse night terrors with nightmare disorders. However, there’s a difference between nightmare disorder and sleep terrors. Sleep terrors or night terrors are similar to nightmares, but night terrors don’t occur during REM sleep. Again, nightmares are different from bad dreams. Bad dreams do not cause you to wake up in the middle of the night, startled and alert.

The Symptoms of Nightmare Disorder

Nightmares are one of the common aftereffects of PTSD. In a small-scale study from 2008, it was found that nightmare disorder may be connected with borderline personality disorder too. Nightmare episodes are not usually the result of substance use, but there is evidence that suggests otherwise.

Here are some common symptoms of nightmare disorder;

  • Fatigue during the day
  • Poor emotional and physical health
  • Trouble concentrating
  • Fixation with nightmares during the daytime
  • Poor performance at work, school, or social activities
  • Increased anxiety, fear, and distress
  • Fear of sleeping

What Causes Nightmares?

Nightmare disorder can be caused by hyperarousal that occurs during the day and continues into the night, suggests a 2019 research study. It is believed that nightmare disorder can be linked with memories born out of fear that is quiet during the day, but when we go to sleep, those memories become aroused.

Some potential causes of nightmares can include;

  • Childhood trauma experiences
  • Sensitivity to negative experiences
  • An inability to control unwanted and intrusive thoughts and feelings
  • Sleep apnea or other psychological causes of sleep disorders
  • Medication withdrawal
  • Drugs that chemically alter the breakdown of neurotransmitters

How Do Nightmares Impact Your Life?

Nightmares can affect the quality of your sleep, mood, and even energy levels. When you’re constantly waking up in the middle of the night, feeling scared and distressed, it can make it harder for you to fall asleep again, impacting your sleep quality as well as quantity.

Sleep is an important part of our well-being and not getting enough sleep can affect not only mental but physical health as well. Poor sleep can cause inflammation, fatigue, body aches, chronic illnesses, and mental exhaustion. Lack of sleep can also affect how you interact with others at work, school, or in social situations.

Waking frequently to nightmares can also make you feel scared and a loss of safety during the day as well. If you’re experiencing nightmares every night, then it is recommended that you speak to a professional therapist or seek help from a sleep therapist.

How to Stop Nightmare Disorder?

While an occasional nightmare may not need professional treatment, nightmare disorder, and PTSD-related sleep disorders might need professional intervention. One of the most common treatment options for treating nightmare disorder can be Imagery Rehearsal Therapy.

IRT is a type of cognitive-behavioral therapy that is based on the belief that nightmare imagery in the daytime can help affect the dreams you experience at night.

IRT is also a type of exposure therapy where you re-script your nightmare and rehearse the modified nightmare regularly.

Other than IRT, the other approaches that can help treat nightmares can include;

If you’re struggling with severe nightmares, then a doctor may prescribe medications to help control the frequency of nightmares. It is advised that you speak to your physician about the side effects of the medications before taking them.

Prevention Tips to Keep in Mind…

With the right interventions and treatments, you can control the frequency of your nightmares. If the nightmares persist, then you can engage in self-help strategies such as;

  • Having and following a regular bedtime routine
  • Having a healthy sleep schedule
  • Avoiding screens and electronic at least an hour before bed
  • Lowering the temperature in the bedroom to ensure a good sleep environment
  • Reducing unnatural lighting in your bedroom
  • Using aromatherapy or essential oils like lavender to improve sleep

Writer’s Thoughts…

An occasional nightmare or bad dream may not be an indication of a chronic sleep disorder, but chronic nightmares can be an indication of a nightmare disorder. You can speak to a sleep specialist or a professional therapist to learn more about nightmare disorders and how to stop them from affecting your sleep quality.

I hope this article helped you understand what nightmare disorder is, its symptoms, what causes chronic nightmares, and how to treat them. For more, you can write to us at or leave us a message on our social media.

Take care and sleep well!

About The Author

Swarnakshi Sharma
Swarnakshi Sharma

Swarnakshi is a content writer at Calm sage, who believes in a healthier lifestyle for mind and body. A fighter and survivor of depression, she strives to reach and help spread awareness on ending the stigma surrounding mental health issues. A spiritual person at heart, she believes in destiny and the power of Self. She is an avid reader and writer and likes to spend her free time baking and learning about world cultures.

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