Imagine, you are sleeping soundly. Suddenly you wake up in a sweat, your chest heaving. You had a very scary dream. It still feels like you are spinning in your head. It's okay for a day or two, but if you keep having bad dreams like this, your whole day can be a mess. Maybe you also have this condition called ``Nightmare Disorder'' . Shall we talk about this in detail today?
What is this ``Nightmare Disorder''?
Simply put, ``Nightmare Disorder`` is the occurrence of frequent, very vivid, frightening dreams. These dreams cause you great distress or prevent you from performing your daily activities properly. This is also a type of behavioral abnormality that occurs during sleep, which we call ``Parasomnias`` .
The severity of this condition can vary, depending on how often you have these dreams:
- Mild: Less than once a week.
- Moderate: Once a week or more, but not every night.
- Severe: I have nightmares every night.
Also, how long it has been around also affects:
- Short-term `(Acute nightmare disorder)`: Lasts a month or less.
- Short-term moderate `(Subacute nightmare disorder): Present for at least a month, but less than six months.
- Chronic nightmare disorder: lasts for six months or more.
Most of these nightmares occur during the second half of sleep, called REM (rapid eye movement) sleep . The special thing about nightmare disorder is that you remember the dream vividly when you wake up. This is different from sleep terrors. This condition can be very disruptive to your sleep and can affect your quality of life. It can also worsen underlying mental health conditions, such as depression or anxiety.
Who is most affected by this situation?
This ``Nightmare Disorder'' can develop in anyone, from young children to adults.
However, some people are more likely to develop it, especially if you have any of the following conditions:
- REM behavior disorder (RBD)
- Narcolepsy
- Sleep apnea
- Periodic limb movement disorder (PLMD)
- Post-traumatic stress disorder (PTSD)
- Generalized anxiety disorder
- Social anxiety disorder
- Depression
Did you know that people with social anxiety disorder or generalized anxiety disorder are three times more likely to develop nightmare disorder? Also, this condition affects between 50% and 90% of people with PTSD.
How common is this condition?
Although there are no exact statistics in Sri Lanka, it is said that between 2% and 8% of the general population in a country like America has this ``Nightmare Disorder.'' That is not as rare as you might think.
What are the symptoms of ``Nightmare Disorder''?
The main symptom is frequent nightmares . While it's normal to have nightmares every now and then, if you have them regularly and they interfere with your daily activities, you may have ``Nightmare Disorder''.
Common themes in these nightmares are:
- Your life is being threatened .
- Harm to your physical well-being .
- A threat to your safety .
Imagine, someone is chasing you, you are falling from a high place, or you are in a very helpless situation. These are the dreams that appear most often.
When you have a nightmare, you may also experience physical symptoms such as:
- Sweating
- Difficulty breathing
- Heart palpitations
The main emotion caused by nightmares is fear . However, other emotions may also arise, such as:
- Anger
- Anxiety
- Embarrassment
- Disgust
- Shame
- Sadness
These physical symptoms and emotions can occur during the dream, upon awakening from the dream, or later when remembering the dream.
Nightmare Disorder can also cause you to experience the following:
- Mood changes , for example, anxiety or depression.
- Reluctance to go to sleep (for fear of having another dream).
- Very tired .
- Daytime sleepiness (Hypersomnia) .
- Difficulty concentrating .
- Behavioral problems .
- Impairment of work or school performance .
- Disruption of social relationships .
Good sleep is very important for our overall health. Therefore, if you think you have ``Nightmare Disorder'', it is very important to talk to a doctor.
Why does this ``Nightmare Disorder'' occur?
In fact, researchers are still studying sleep and how it affects us. Although they have discovered a lot about sleep, dreams, and nightmares, there are still many things we don't know.
Researchers don't know exactly what causes nightmares and nightmare disorder, but they have different theories.
One theory is that this condition may be caused by hyperarousal, a state of heightened activity that accumulates throughout the day and continues into the night. Hyperarousal is a state of mind where you are constantly irritable, angry, and suspicious of everything. This is a common symptom of PTSD and insomnia. This hyperarousal can cause parts of the brain to become overactive while you are sleeping, causing nightmares.
There is another theory about the concept of ``Fear extinction.`` Under normal circumstances, our brains are able to associate fearful memories with new and unrelated things, allowing for normal sleep and dreams. This is called ``Fear extinction.`` According to this ``impaired fear extinction`` theory, the brains of people with ``Nightmare Disorder`` continue to process fearful memories even during sleep. According to this theory, people who have difficulty controlling their emotions in stressful situations, and who react negatively to stress, are more prone to nightmares.
How to recognize ``(Nightmare Disorder)``?
There is no specific medical test to diagnose this. Instead, doctors will take a good history of your nightmares and other symptoms. They will also ask about your medical and mental health history.
Some medications can also cause nightmares . Therefore, your doctor may want to ask about any medications you are currently taking, or they may order a drug test to see if that is a cause. Medications and substances that can cause nightmares include:
- Beta-blockers (a type of medicine given for blood pressure)
- Antidepressants
- Nicotine (from tobacco products and smoking)
Bad dreams can also be caused by withdrawal symptoms that occur when you suddenly stop using substances like alcohol.
How is ``Nightmare Disorder'' treated?
To treat this, your doctor may recommend a combination of treatments, including psychotherapy ( talk therapy) and medication .
The main psychological treatments used for ``Nightmare Disorder`` are treatments based on ``Cognitive Behavioral Therapy (CBT) .`` That is:
- Imagery Rehearsal Therapy (IRT)
- Exposure, Relaxation, and Rescripting Therapy (ERRT)
A little more detail about psychotherapy
The American Academy of Sleep Medicine (AASM) recommends IRT and ERRT as the most effective treatments for nightmare disorder in adults.
These `(IRT)` and `(ERRT)` are treatments tailored to each individual. This includes several factors:
- Keeping a sleep diary (sleep log) and recording daily sleep/wake patterns.
- Keep a sleep diary to record how often and how severe your nightmares are.
- Learning about the nature of nightmares.
- Training skills that target the images, thoughts, and feelings associated with nightmares. This can reduce the frequency and severity of nightmares.
These CBT-based treatments suggest that nightmares are initially useful, helping you process past events, but over time they become disruptive.
These treatments look at nightmares as habits or learned behaviors that can be changed if practiced . A mental health professional , such as a psychologist or therapist, can help you reimagine your nightmares in a different, less frightening, or less distressing way.
Homework is very important in this treatment. That means rehearsing the newly imagined dream every day. The goal here is to "reprogram" your nightmares to be less frightening if they reappear.
Medications for `(Nightmare Disorder)`
If the previously mentioned psychological therapies don't help, your doctor may consider medication.
There are several types of medications that can help with Nightmare Disorder associated with PTSD. Here are a few examples:
- `Olanzapine`
- `Risperidone`
- `Aripiprazole`
- `Clonidine`
- `Cyproheptadine`
- `Fluvoxamine`
- `Gabapentin`
- `Nabilone`
- `Phenelzine`
- `Prazosin` (this is often used)
- `Topiramate`
- `Trazodone`
- Tricyclic antidepressants
Medications that may help with Nightmare Disorder that is not related to PTSD include:
- `Prazosin`
- `Triazolam`
The most important thing is that all medications can have side effects . Therefore, it is very important to talk to your doctor about the pros and cons of a particular medication, and to see him or her if you experience side effects.
What is the prognosis of this condition?
The outlook for this ``Nightmare Disorder`` condition can vary from person to person.
For some people, this may get better without any treatment . However, for others, the condition can persist for decades if left untreated.
Untreated, long-term ``Chronic nightmare disorder'' increases the risk of suicide attempts and repeated attempts .
For this reason, and because sleep is essential for overall health, it is very important to seek help if you are experiencing frequent nightmares.
When should I see a doctor?
If you have frequent nightmares, and they are interfering with your quality of life, see a doctor or mental health counselor immediately .
If you have been diagnosed with ``Nightmare Disorder'' and your current treatments are not helping, talk to your doctor about other options.
Are nightmares a mental illness?
Although nightmares are associated with certain mental health conditions, such as PTSD, anxiety, and depression, nightmares are not considered a mental illness . They are a type of behavioral abnormality called parasomnias, which occur during sleep.
Is ``Nightmare Disorder'' the same as ``PTSD''?
Many people with post-traumatic stress disorder (PTSD) also have nightmare disorder. However, you can have nightmare disorder without PTSD. This means that the two are not the same.
Finally, things to remember (Take-Home Message)
Getting a good night's sleep is essential to our lives. It helps our bodies rest, recharge, and repair themselves. Having Nightmare Disorder can have a huge impact on the quality of your sleep and your quality of life.
But, the good news is that this is a treatable condition . Various talk therapies and medications can help. So, if nightmares are disrupting your life, don't be afraid to see a doctor. You are not alone, and there are ways to get help.
` Nightmares, sleep, mental health, REM sleep, PTSD, anxiety, treatment
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න