Types Of Nightmares And How To Cope With Them

Nightmares can be normal, but if they happen frequently, you may wish to seek the help of a doctor or mental health professional. Frightening dreams can have a multitude of causes, such as major life changes, various mental health disorders, and certain medications. Different types of nightmares can occur based on their frequency, severity, or underlying cause. 

Treatment often involves therapy, medication, or a combination of the two. You may also experience relief through various lifestyle changes and stress management strategies. You may want to consider online therapy if you are living with physical or mental health issues due to nightmares.

What causes nightmares?

You may wonder why humans have nightmares in the first place. Nightmares, or disturbing vivid dreams that cause feelings of fear or anxiety, can be triggered by various factors, such as stress, personal life events, or even a sleep disorder. While nightmares tend to occur during REM sleep, the exact cause of these distressing dreams remains uncertain.

There can be many reasons for this phenomenon. Some can be related to medical conditions, while others may have more to do with psychological stress. Sometimes, nightmares may seem to come from nowhere and resolve quickly, but nightmares can happen every night for some people. 

Here are some potential risk factors for nightmares:

• Eating late at night
• Eating spicy foods before bed
• Feelings of guilt
• Major life changes
• Deep regret
• Watching horror films or consuming other frightening content
• Taking certain antidepressants
• Using narcotics
• Taking certain blood pressure medications
• Withdrawal from prescription medications, alcohol, or street drugs
• Sleep deprivation
• Anxiety
• Depression
• Bipolar disorder
• Sleep apnea
• Post-traumatic stress disorder (PTSD)
• Restless legs syndrome
• Nightmare disorder

Does everyone have nightmares?

In general, everyone dreams, but it can be hard to determine whether every individual experiences nightmares or recurring dreams. Still, occasional nightmares can be common. Around 2% to 6% of adults experience nightmares every week, and around 35% to 45% of adults experience nightmares at least once per month. While having an occasional bad dream may be nothing to cause concern, it may be a good idea to address frequent nightmares so that they don’t cause further issues in your life.

Are nightmares dangerous to your health?

Nightmares can be so intense that you may wake up feeling you have narrowly escaped death. Your heart may be racing, and you may be breathing rapidly. This often results from a combination of emotional stress caused by the nightmare and your physical reaction to the emotional stress.

Nightmares aren't likely to cause any immediate harmful effects. However, there is evidence that nightmares can affect both our physical and mental health. If you have frequent nightmares, you may become sleep-deprived. Sleep deprivation can contribute to heart disease or obesity-related diseases. It can also increase depression or anxiety and exacerbate other mental health conditions.

Types of nightmares

Nightmares occur in various forms and often differ from person to person. However, many share common themes or plots. People report a wide range of nightmare themes, which may involve certain events that reflect universal fears and anxieties. Some of the most common nightmares include:

• Being chased by something or someone that could kill you
• Being naked in public
• Teeth falling out
• Needing to relieve yourself but can't find a toilet
• Having to take a test you aren’t prepared for
• Falling from great heights
• Being trapped somewhere
• Being in a car, truck, or bus that's out of control
• Being extremely late for a very important meeting or event
• Getting injured or attacked in some way, either by another person or an animal

Nightmares can leave people feeling anxious, vulnerable, and embarrassed. They can be a classic example of the brain's mysterious activity, as it's not always clear why certain nightmares happen or what triggers them. 

Regardless of the content of your nightmares, having nightmares every night can be a significant problem that you may wish to address. Even if you don't have frequent nightmares, you may have bad dreams that affect your daytime functioning. To understand whether you have nightmares that need to be addressed, you might consider the types of nightmares below.

Single-occurrence nightmares

Having a nightmare once a year or so is generally not cause for concern. Even if you have nightmares once a month, you may not be likely to experience any harmful effects. Some experts have recently suggested that the occasional nightmare may be helpful because it can be a way to process stressful but non-traumatic events that happened during the day. However, a single nightmare can still be distressing. If you find you can’t stop thinking about a nightmare you experienced, you may wish to reach out to a mental health professional who can help you process it.

Frequent nightmares

When nightmares become frequent, they may start to affect your sleep and health. Why do I keep having nightmares? Frequent or chronic nightmares may happen due to psychological or physical reasons. If you have chronic nightmares, it may be important to see a doctor to ensure a medical problem isn't causing these dreams. If there are no physical problems contributing to the nightmares, a mental health professional may be able to identify psychological reasons behind the nightmares.

Recurring nightmares

Recurring nightmares are frightening dreams that may include the same content each time you experience them. Although there may be small differences, the same people may be involved in the same activities each time, or you may dream of the same danger or specific situation every night. Recurring nightmares can be a sign that you could be experiencing an unresolved psychological issue that you've never completely coped with. In this case, seeing a therapist may allow you to work through the event or situation behind the nightmares to help put it behind you.

Nightmares during pregnancy

It may not be surprising that nightmares can be common during pregnancy. Pregnancy can be a time of uncertainty and upheaval, as well as inconsistent hormone levels. Some of the most common pregnancy dreams can include:

• Nightmares about birth, including giving birth publicly
• Nightmares about giving birth to something unexpected, such as an animal or inanimate object
• Nightmares about the baby being born with a serious health condition
• Nightmares about being trapped
• Nightmares about drowning
• Nightmares about forgetting the baby and leaving it unprotected
• Nightmares that you or your baby are being physically harmed

Something you may wish to remember about pregnancy nightmares is that a few nightmares are typically nothing to worry about, and they may even help you face current fears. Having some nightmares during pregnancy can be normal as you process what may be happening to you during the pregnancy and what may be about to happen to you as a parent. However, if the nightmares recur or cause severe emotional distress, you may need to address them with a healthcare professional.

PTSD nightmares

Nightmares are often an integral part of PTSD and can be one of the most common symptoms. PTSD nightmares can often be filled with images of a traumatic event. You may have trouble waking up completely and even have nightmares that affect your daytime behavior. If you have post-traumatic nightmares, you may want to seek a professional for help.

Waking nightmares

In a condition called sleep paralysis, you may experience a short period of waking nightmares just before you fall asleep or wake up. Scientists suggest that these dreams may not be nightmares at all, but instead, they could be hallucinations caused by lying on your back. These hallucinations are often accompanied by an inability to move for a short period. If you have this type of nightmare, it may be possible to stop them by sleeping on your side or stomach rather than your back.

Treatment for nightmares

In most cases, no treatment is required for nightmares, but if nightmares are causing physical or emotional problems, you might consider seeing a doctor or therapist for treatment. The two main types of treatment available are therapy and medication. There are also some home remedies you can practice on your own, which will be discussed below. These may help to eliminate or reduce your nightmares. Remember to always consult a qualified medical professional before taking any medication for nightmares or other issues.

If your doctor discovers an underlying health condition, like anxiety or severe stress, they may treat that condition rather than the nightmares themselves, which may be considered a symptom and not the root of the issue. Once those underlying conditions improve, it’s likely the nightmares may decrease as a result.

Medication for nightmares

If you report severe, disturbing, and frequent nightmares to your doctor or psychiatrist, they might prescribe medication. Currently, the medication that may be most used for nightmares is prazosin, which has been shown to decrease the intensity and frequency of nightmares and is often used for the treatment of PTSD nightmares. Again, always consult a doctor before taking any type of medication.

Lifestyle changes

Non-medication strategies to reduce nightmares can be effective. You may be able to prevent or lessen nightmares by following a few simple dietary and lifestyle recommendations, such as getting a good night's sleep, not eating immediately before bedtime, avoiding spicy foods, and taking care of medical problems as they arise.

However, for those who have frequent nightmares, additional psychological techniques and strategies may help you reduce or eliminate nightmares.

• Do systematic relaxation or meditation immediately before you sleep.
• Let your worries go when you get ready to sleep. Manage difficult situations while you're awake.
• Try not to ruminate over stressful situations and events in your mind, especially before bed.
• Try to avoid viewing every disappointment or difficult situation as a catastrophe.
• Don't assume that something that happens in a nightmare will happen in real life.
• Practice imagery rehearsal therapy, which is a technique in which you remember a recent dream while reminding yourself that it won't harm you or be too stressful for you.
• Consider learning to lucid dream, which is a skill that may allow you to control the outcome of your dreams.
• Keep a dream journal to write down and analyze your nightmares in terms of their symbolic content.
• Imagine a recent nightmare differently by changing the ending to be more positive.
• Write down your worries in a journal before bed. Having them on paper may prevent you from needing to store them in your brain and having them come up in a dream.

To improve sleep quality and achieve a good night's rest, it's vital to practice good sleep hygiene and self-care. However, when nightmares persist, recur, or affect your ability to stay asleep, it's essential to consult a mental health expert to address any potential underlying issues.

For instance, recurrent nightmares could be related to PTSD, bipolar disorder, or unresolved issues from one's personal life. In such cases, addressing the root cause can help stop or reduce the frequency of distressing dreams, allowing for better sleep.

How to calm down after waking from a nightmare

When nightmares occur, brain activity increases, which may cause the bad dream to stop abruptly and result in a sudden awakening. If you find yourself startled awake in the middle of the night, the following techniques may help you calm down and return to sleep to get a good night's rest.

• Practice progressive muscle relaxation techniques.
• Come up with a mantra. For example, you might think or say aloud, "I was having a nightmare, but it's not real. Nothing can hurt me now. I am safe”.
• Do breathing exercises.
• Write in a journal.
• Read or watch content that makes you feel calm and happy.

Online therapy may help relieve nightmares

Nightmares can be challenging to cope with and manage on your own, but working with a mental health professional in therapy can be one way to minimize the effects of nightmares and reduce them overall. However, traditional therapy can sometimes be challenging to fit into your schedule, and online therapy can be an effective alternative. For instance, you may wish to engage in stress-relief exercises with your therapist before bed. Online therapy may allow for more flexible session times that would be considered after-hours at most traditional therapists’ offices.

Studies have found that online image rehearsal therapy can be useful and effective at treating recurring nightmares, particularly for those living with PTSD. In one study, internet-based therapy for nightmares was found to be effective in decreasing nightmare frequency and reducing nightmare distress.

Conclusion

Although nightmares are an occasional and normal occurrence for most people, they can cause problems when they happen frequently and impact your quality of sleep. There are multiple potential causes of nightmares, such as certain medications, excessive stress, major life changes, and some mental health disorders. Treatment typically consists of therapy, medication, or both. Stress management and lifestyle changes may also provide relief from nightmares. If you are experiencing mental health challenges related to nightmares, please know that online therapy may be effective.