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 for nightmares often involves therapy, medication, or a combination of the two. Some people experience relief through various lifestyle changes and stress management strategies. Therapy is often recommended if you are living with physical or mental health issues due to nightmares.

What causes nightmares?

Some may wonder why humans have nightmares. Nightmares are disturbing, vivid dreams that cause feelings of fear or anxiety and are often incited by stress, personal life events, or sleep disorders. While nightmares tend to occur during REM sleep, the exact cause of these distressing dreams remains uncertain.

Some nightmares may 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. Below are some 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 substances 
• 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 helpful 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 reaction often results from a combination of emotional stress caused by the nightmare and your physical response to that stress.

Nightmares aren't likely to cause any immediate harmful effects. However, there is evidence that nightmares can affect 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 and may increase depression or anxiety or 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
• Having your teeth fall out
• Needing to relieve yourself but struggling to 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 causes 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 to address, 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 occasional nightmares may be beneficial because they can serve as a way to process stressful but non-traumatic events that occur 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 can start to impact your sleep and overall 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 no physical problems are 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

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 a baby being born with a serious health condition
• Nightmares about being trapped
• Nightmares about drowning
• Nightmares about forgetting your baby and leaving it unprotected
• Nightmares that you or your baby are being physically harmed

Having a few pregnancy nightmares may not be worrying, and they may 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, address them with a healthcare professional.

PTSD nightmares

Nightmares are often one of the most common symptoms of PTSD. PTSD nightmares can often be filled with images of a traumatic event. You may experience difficulty waking up completely and have nightmares that impact your daytime behavior. If you have post-traumatic nightmares, seek a professional for help. You may also be able to receive a prescription for a medication that could potentially stop your nightmares to help you sleep. 

The BetterHelp platform is not intended to provide any information regarding which medication or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. Do not take any action without consulting a qualified medical professional.

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 it 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 that you can practice on your own, which are discussed below. These options may eliminate or reduce your nightmares. However, consult a qualified medical professional before taking any medication for nightmares or other issues.

Suppose your doctor discovers an underlying health condition, like anxiety or severe stress. In that case, they may treat the condition rather than the nightmares themselves, which may be considered a symptom rather than the root of the issue. Once those underlying conditions improve, 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. Certain medications may decrease the intensity and frequency of nightmares and are often used for the treatment of PTSD nightmares. Always consult a doctor before starting, changing, or stopping a 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, avoiding eating immediately before bedtime, limiting spicy foods, and addressing medical issues as they arise.

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

• Practice systematic relaxation or meditation immediately before going to sleep.
• Let your worries go as you prepare for sleep and 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, a technique in which you recall a recent dream while reassuring yourself that it won't harm or be too stressful for you.
• Consider learning to lucid dream, a skill that may enable you to control the outcome of your dreams.
• Keep a dream journal to record and analyze your nightmares in terms of their symbolic meaning.
• 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 storing them in your memory and having them appear in a dream.

To improve sleep quality and achieve a restful night's sleep, consider practicing good sleep hygiene and self-care. However, if nightmares persist, recur, or affect your ability to stay asleep, 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 prevent or reduce the frequency of distressing dreams, leading to 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, allowing you 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 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 through a platform like BetterHelp can be an effective alternative. For instance, you may wish to engage in stress-relief exercises with your therapist before bed. Online therapy may offer more flexible session times, which are often considered after-hours at most traditional therapists’ offices.

Studies have found that online image rehearsal therapy can be helpful 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.

Takeaway 

Although nightmares are occasional 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 involves a combination of therapy and medication. 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.