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A nightmare, also called a bad dream,1 is an unpleasant dream that can cause a strong emotional response from the mind, typically fear but also despair, anxiety and great sadness The dream may contain situations of discomfort, psychological or physical terror or panic Sufferers often awaken in a state of distress and may be unable to return to sleep for a small period2

Nightmares can have physical causes such as sleeping in an uncomfortable or awkward position, having a fever, or psychological causes such as stress, anxiety, and as a side effect of various drugs Eating before going to sleep, which triggers an increase in the body's metabolism and brain activity, is a potential stimulus for nightmares3

Recurrent nightmares may require medical help, as they can interfere with sleeping patterns and cause insomnia


  • 1 Etymology
  • 2 Incidence and types
  • 3 Theories on causes
  • 4 Possible effects
  • 5 Treatment
    • 51 Post-traumatic stress disorder
  • 6 See also
  • 7 References
  • 8 Further reading
  • 9 External links


The word "nightmare" is derived from the Old English "mare", a mythological demon or goblin who torments others with frightening dreams4 Subsequently, the prefix "night-" was added to stress the dream aspect The word "nightmare" is cognate with the older Dutch term nachtmerrie and German Nachtmahr

Incidence and typesedit

Fearfulness in waking life is correlated with the incidence of nightmares5 Studies of dreams have estimated that about 75% of the time, the emotions evoked by dreams are negative5 However, it is worth noting that people are more likely to remember unpleasant dreams

One definition of "nightmare" is a dream which causes one to wake up in the middle of the sleep cycle and experience a negative emotion, such as fear This type of event occurs on average once per month They are not common in children under five, but they are more common in young children 25% experiencing a nightmare at least once per week, most common in teenagers, and common in adults dropping in frequency about one third from age 25 to 555

Theories on causesedit

Scientific research shows that nightmares may have many causes In a study focusing on children, researchers were able to conclude that nightmares directly correlate with the stress in the children's lives Children who experienced the death of a family member or a close friend or know someone with a chronic illness have more frequent nightmares than those who are only faced with stress from school or stress from social aspects of daily life6

Another study researching the causes of nightmares focuses on patients suffering from sleep apnea The study was conducted to prove whether or not nightmares may be caused by sleep apnea, or being unable to breathe In the nineteenth century, authors believed that nightmares were caused by not having enough oxygen, therefore it was believed that those with sleep apnea had more frequent nightmares than those without The hypothesis, however, was proven wrong and the results actually showed that healthy people have more nightmares than the sleep apnea patients7

Possible effectsedit

A study involving a large group of undergraduate students analyzes the effects of nightmares on the quality of sleep The study showed that the participants experienced abnormal sleep architecture and that the results of having a nightmare during the night were very similar to those of people who suffer from insomnia This means that, like insomniacs, people who suffer from nightmares do not get as much rest as those who do not suffer from chronic nightmares Therefore, they experience a lesser quality of sleep than others This is thought to be from frequent nocturnal awakenings and fear of falling or going back to sleep8


The Nightmare Henry Fuseli, 1781

Freud and Jung seemed to have shared a belief that people frequently distressed by nightmares could be re-experiencing some stressful event from the past9 Both perspectives on dreams suggest that therapy can provide relief from the dilemma of the nightmare experience

Halliday 1987, grouped treatment techniques into four classes Direct nightmare interventions that combine compatible techniques from one or more of these classes may enhance overall treatment effectiveness:10

  • Analytic and cathartic techniques
  • Story-line alteration procedures
  • Face-and-conquer approaches
  • Desensitization and related behavioral techniques

Post-traumatic stress disorderedit

Reoccurring post-traumatic stress disorder nightmares in which real traumas are re-experienced respond well to a technique called imagery rehearsal First described in the 1996 book Trauma and Dreams11 by Harvard psychologist Deirdre Barrett, this contemporary dream interpretation involves dreamers coming up with alternative, mastery outcomes to the nightmares, mentally rehearsing those outcomes awake, and then reminding themselves at bedtime that they wish these alternate outcomes should the nightmares reoccur Research has found that this technique not only reduces the occurrence of nightmares and insomnia,12 but also improves other daytime PTSD symptoms13 According to Bret Moore and Barry Kraków, the most common variations of Imagery Rehearsal Therapy IRT "relate to the number of sessions, duration of treatment, and the degree to which exposure therapy is included in the protocol"14 Another kind of treatment not only helping the reduction of nightmares, sleep disturbance, and other PTSD symptoms is prazosin There have been multiple studies conducted under placebo-controlled conditions Am J Psychiatry 2003; 160:371–373

A comprehensive model has been put forth by Krakow and Zadra 2006 that includes four group treatment sessions, ~225 to 25 hr in length The first two sessions focus on how nightmares are closely connected to insomnia and how they become an independent symptom or disorder that warrants individually tailored and targeted intervention The last two sessions focus on the imagery system and how IRT can reshape and eliminate nightmares through a relatively straightforward process akin to cognitive restructuring via the human imagery system First, the patient is asked to select a nightmare, but for learning purposes the choice would not typically be one that causes a marked degree of distress Second, and most commonly, guidance is not provided on how to change the disturbing content of the dream; the specific instruction developed by Joseph Neidhardt is "change the nightmare anyway you wish" Neidhardt et al, 1992 In turn, this step creates a "new" or "different" dream, which may or may not be free of distressing elements Our instructions, unequivocally, do not make a suggestion to the patient to make the dream less distressing or more positive or to do anything other than "change the nightmare anyway you wish" Last, the patient is instructed to rehearse the "new dream" through imagery and to ignore the old nightmarep 23414

Some people may experience recurring nightmares due to posttraumatic stress disorder PTSD, or they may have some other source of anxiety that influences their dreams at night9 Whatever the cause, there are treatments available, some of them medical and some psychological While most treatments are meant for people who have a true disorder, the techniques discussed above will work well for any person dealing with nightmares9

See alsoedit

  • False awakening
  • Hag in folklore
  • Lucid dream
  • Mare folklore
  • Mora mythology
  • Moroi folklore
  • Night terror
  • Nightmare disorder
  • Nocnitsa
  • Sleep disorder
  • Sleep paralysis
  • Horror and terror
  • A Christmas Carol


  1. ^ Harper, Douglas "nightmare" Online Etymology Dictionary  Retrieved July 11, 2016
  2. ^ American Psychiatric Association 2000, Diagnostic and Statistical Manual of Mental Disorders, 4th ed, TR, p 631
  3. ^ Stephen,, Laura 2006 "Nightmares" Psychologytodaycom Archived from the original on 31 August 2007 
  4. ^ Liberman, Anatoly 2005 Word Origins And How We Know Them Oxford: Oxford University Press p 87 ISBN 978-0-19-538707-0 Retrieved 29 March 2012 
  5. ^ a b c The Science Behind Dreams and Nightmares, Talk of the Nation, National Public Radio 30 October 2007
  6. ^ Schredl, Michael, et al "Nightmares and Stress in Children" Sleep and Hypnosis 101 2008: 19-25 ProQuest Web 29 Apr 2014
  7. ^ Schredl, Michael, et al "Nightmares and Oxygen Desaturations: Is Sleep Apnea Related to Heightened Nightmare Frequency" Sleep and Breathing 104 2006: 203-9 ProQuest Web 24 Apr 2014
  8. ^ Simor, Pé, et al "Disturbed Dreaming and Sleep Quality: Altered Sleep Architecture in Subjects with Frequent Nightmares"European archives of psychiatry and clinical neuroscience 2628 2012: 687-96 ProQuest Web 24 Apr 2014
  9. ^ a b c Coalson 1985, Web
  10. ^ Halliday 1987
  11. ^ ISBN 0-674-00690-9
  12. ^ Davis, J L; Wright, D C 2005 "Case Series Utilizing Exposure, Relaxation, and Rescripting Therapy: Impact on Nightmares, Sleep Quality, and Psychological Distress" Behavioral Sleep Medicine 3 3: 151–157 doi:101207/s15402010bsm0303_3 PMID 15984916 
  13. ^ Krakow, B; Hollifield, M; Johnston, L; Koss, M; Schrader, R; Warner, T D; Tandberg, D; Lauriello, J; McBride, L 2001 "Imagery Rehearsal Therapy for Chronic Nightmares in Sexual Assault Survivors with Posttraumatic Stress Disorder: A Randomized Controlled Trial" JAMA: the Journal of the American Medical Association 286 5: 537 doi:101001/jama2865537 
  14. ^ a b Lu, M; Wagner, A; Van Male, L; Whitehead, A; Boehnlein, J 2009 "Imagery rehearsal therapy for posttraumatic nightmares in US Veterans" Journal of Traumatic Stress 22 3: 236–239 doi:101002/jts20407 PMID 19444882 , p 234

Further readingedit

  • Anch, A M; Browman, C P; Mitler, M M; Walsh, J K 1988 Sleep: A Scientific Perspective New Jersey: Prentice-Hall 
  • Harris, J C 2004 "The Nightmare" Archives of General Psychiatry 61 5: 439–40 doi:101001/archpsyc615439 PMID 15123487 
  • Husser, J-M; Mouton, A, eds 2010 Le Cauchemar dans les sociétés antiques Actes des journées d'étude de l'UMR 7044 15–16 Novembre 2007, Strasbourg Paris: De Boccard  French
  • Jones, Ernest 1951 On the Nightmare ISBN 0-87140-912-7 
  • Forbes, D; et al 2001 "Brief Report: Treatment of Combat-Related Nightmares Using Imagery Rehearsal: A Pilot Study" Journal of Traumatic Stress 14 2: 433–442 doi:101023/A:1011133422340 
  • Siegel, A 2003 "A mini-course for clinicians and trauma workers on posttraumatic nightmares" 
  • Burns, Sarah 2004 Painting the Dark Side : Art and the Gothic Imagination in Nineteenth-Century America Ahmanson-Murphy Fine Are Imprint University of California Press ISBN 0-520-23821-4 
  • Davenport-Hines, Richard 1999 Gothic: Four Hundred Years of Excess, Horror, Evil and Ruin North Point Press pp 160–61 
  • Hill, Anne 2009 What To Do When Dreams Go Bad: A Practical Guide to Nightmares Serpentine Media ISBN 1-887590-04-8 
  • Simons, Ronald C; Hughes, Charles C, eds 1985 Culture-Bound Syndromes Springer 
  • Sagan, Carl 1997 The Demon-Haunted World: Science as a Candle in the Dark 
  • Coalson, Bob 1995 "Nightmare help: Treatment of trauma survivors with PTSD" Psychotherapy: Theory, Research, Practice, Training 32 3: 381–388 doi:101037/0033-3204323381 
  • "Nightmares Bad Dreams, or Recurring Dreams Lucky You!" Archived from the original on 19 March 2012 Retrieved 8 December 2015 
  • Halliday, G 1987 "Direct psychological therapies for nightmares: A review" Clinical Psychology Review 7: 501–523 doi:101016/0272-73588790041-9 
  • Doctor, Ronald M; Shiromoto, Frank N, eds 2010 "Imagery Rehearsal Therapy IRT" The Encyclopedia of Trauma and Traumatic Stress Disorders New York: Facts on File p 148 
  • Mayer, Mercer 1976 There's a Nightmare in My Closet New York: Puffin Pied Piper 
  • Moore, Bret A; Kraków, Barry 2010 "Imagery rehearsal therapy: An emerging treatment for posttraumatic nightmares in veterans" Psychological Trauma: Theory, Research, Practice, and Policy 2 3: 232–238 doi:101037/a0019895 

External linksedit

Media related to Nightmares at Wikimedia Commons

  • Night-Mares: Demons that Cause Nightmares

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