Nightmare disorder

Last updated
Nightmare disorder
Henry Fuseli (1741-1825), The Nightmare, 1781.jpg
The Nightmare, by Johann Heinrich Füssli
Specialty Psychiatry   OOjs UI icon edit-ltr-progressive.svg
Frequencyc. 4% [1]

Nightmare disorder is a sleep disorder characterized by repeated intense nightmares that most often center on threats to physical safety and security. [2] The nightmares usually occur during the REM stage of sleep, and the person who experiences the nightmares typically remembers them well upon waking. [2] More specifically, nightmare disorder is a type of parasomnia, a subset of sleep disorders categorized by abnormal movement or behavior or verbal actions during sleep or shortly before or after. Other parasomnias include sleepwalking, sleep terrors, bedwetting, and sleep paralysis. [3]

Contents

Nightmare disorders can be confused with sleep terror disorders. [4] The difference is that after a sleep terror episode, the patient wakes up with more dramatic symptoms than with a nightmare disorder, such as screaming and crying. [4] Furthermore, they do not remember the reason of the fear, while a patient with a nightmare disorder remembers every detail of the dream. [4] Finally, the sleep terrors usually occur during NREM Sleep. [5] [6]

Nightmares also have to be distinguished from bad dreams, which are less emotionally intense. [7] Furthermore, nightmares contain more scenes of aggression than bad dreams and more unhappy endings. [7] Finally, people experiencing nightmares feel more fear than with bad dreams. [7]

The treatment depends on whether or not there is a comorbid PTSD diagnosis. [1] About 4% of American adults are affected. [1] Studies examining nightmare disorders have found that the prevalence rates ranges 2–6% with the prevalence being similar in the US, Canada, France, Iceland, Sweden, Belgium, Finland, Austria, Japan, and the Middle East. [8]

Signs and symptoms

During the nightmare, the sleeper may scream and yell out things. The nightmare sufferer is often awakened by these threatening, frightening dreams and can often vividly remember their experience. Upon awakening, the sleeper is usually alert and oriented within their surroundings, but may have an increased heart rate and symptoms of anxiety, like sweating. They may have trouble falling back to sleep for fear they will experience another nightmare.

A person experiencing nightmare disorder may have trouble going through everyday tasks; anxiety and lack of sleep caused by the fearful dreams may hinder the individual from completing everyday tasks efficiently and correctly. Upon experiencing this, these nightmare sufferers may consult with a psychiatrist.

The sleeper may have recurring episodes of awakening while recalling the intensely disturbing dream manifestations which usually result from fear or anxiety, but can also be triggered by anger, sadness, disgust, and other dysphoric emotions. Additionally, the sleeper may experience at least one of the following two features: delayed return of going back to sleep after episodes, and having episodes in the latter half of the sleep period. [9]

Consequences

Nightmare disorder is common: it affects about 4% of the adult population. Even if children have more nightmares than adults, only 1% of children meet the criteria of the disorder. [10] Nightmare disorder can impair the quality of life for people who are affected by the condition. It can make the patient avoid sleep, which leads to sleep deprivation, which in turn may lead to even more intense nightmares. Some other consequences of the nightmare disorder are fatigue and insomnia. [9]

Nightmare disorders have negative consequences on several aspects of the patient's life, such as sleep, cognitive and emotional functioning and well-being. [11] Nightmares can also have negative impact on the bed partner's life. [12]

Content of idiopathic nightmares

Physical aggression is the main theme of nightmares. [7] Other fields, such as interpersonal conflict, failure, helplessness, apprehension, being chased, accidents, evil forces, disasters, insects and environmental abnormalities may also feature in nightmares. [7] Fear is the most frequent emotion associated with nightmares, even if other emotions such as sadness, anger, and confusion can also be present. [7]

Criteria

According to the International Classification of Sleep Disorders, the criteria needed to diagnose a nightmare disorder are the following. [13] First, the presence of frequent nightmares that imply danger for the person and impact mood in a negative way is needed. [13] Second, when waking up from nightmares, the person behaves in an alert way. [13] Finally, the disorder has to have a significant impact on the patient's personal, social or professional functioning, in areas like mood, sleep, cognition, behaviour, fatigue, family and occupation. [13]

Causes

Nightmares can be caused by extreme pressure or irritation if no other mental disorder is discovered. The death of a loved one or a stressful life event can be enough to cause a nightmare but conditions such as post-traumatic stress disorder and other psychiatric disorders have been known to cause nightmares as well. [14] If the individual is on medication, the nightmares may be attributed to some side effects of the drug. Amphetamines, antidepressants, and stimulants like cocaine and caffeine can cause nightmares. Blood pressure medication, levodopa and medications for Parkinson's disease have also been known to cause nightmares. [15]

The nightmares may be idiopathic or could be associated with psychiatric disorders like post-traumatic stress disorder, schizophrenia, and borderline personality disorder. Nightmares can also be triggered by stress and anxiety and substance abuse, such as drugs that affect the neurotransmitters norepinephrine and dopamine and serotonin. Nevertheless, causality between drugs such as beta-blockers or alpha-agonists and nightmares is still unclear and further research needs to be done to investigate the biochemical mechanisms of nightmares. [5]

Eighty percent of patients who have PTSD report nightmares. Patients with PTSD have symptoms that are classified into three clusters: intrusive/re-experiencing, numbing, and hyperarousal. Nightmares are usually considered to be part of the intrusive/re-experiencing symptom. [9]

Some differences are existing between idiopathic and PTSD related nightmares. [16] A person with PTSD having nightmares would wake up during the night more frequently and for a longer time than with idiopathic nightmares. [16] Consequently, people with PTSD would have a poorer sleep quality. [16] Furthermore, nightmares related to PTSD would be more stressful than idiopathic ones. [16] However, further studies have to be conducted in this area to obtain more reliable results. [5]

Assessment

Polysomnography records physiological parameters, such as electroencephalography (EEG), electromyography (EMG) and electrooculography (EOG) in a sleep laboratory. [17] However, the frequency of posttraumatic nightmares tends to decrease in an artificial lab setting, which would impact the content of nightmares. [5] Consequently, assessment of nightmare disorders using polysomnography has to last for a longer period, in order to let the patient get used to the artificial environment. [5]

Self-report by a questionnaire or by a diary is another way to investigate nightmare disorders. [5] However, these methods are questionable. [5] Indeed, when filling out questionnaires with questions about a long period, people often tend to underestimate the frequency of their nightmares because of forgetting. [5] On the contrary, filling out a diary every day may lead to an overestimation of the numbers of nightmares, because of the focusing on this phenomenon. [5]

Comorbidity

Studies have reported that nightmare disorders were present in 50–70% of the cases for PTSD, in 17.5% for depression, in 18.3% for insomnia, in 16.7% for schizophrenia and in 49% for borderline personality disorder. [18] For all psychiatric disorders taken together, nightmare disorders are present in 29.9% of the cases, a much bigger rate than for the general population, which is 2–5%. [18] Nightmare disorders can also be associated with sleep disorders such as night terrors, chronic insomnia and sleep-disordered breathing. [5] The presence of nightmares before a trauma would influence severity of PTSD symptoms. [12] Furthermore, having nightmares is linked to a significantly higher risk of attempting suicide and of death by suicide. [12]

Treatment

Stress reduction techniques such as yoga, meditation and exercise may help to eliminate stress and create a more peaceful sleeping atmosphere. [19]

Diagnosis and medication can only be given to patients that report the recurring nightmares to a psychiatrist or other physician. Medications like prazosin are sometimes used to treat nightmares in people with PTSD. [20] [21] [22] Therapy usually helps to deal with the frightening themes of the nightmares and alleviate the recurrence of the dreams. The persistent nightmares will usually improve as the patient gets older. Therapy is usually efficient to treat chronic nightmares in PTSD disorder or in other population. [22]

Eye Movement Desensitization and Reprocessing (EMDR) is a specialized intervention in which the focus is to stimulate neural mechanisms to induce disturbing memories and experiences. [23] It has demonstrated a significant nightmares' reduction, especially for the treatment of PTSD. [24] Silver, Brooks and Obenchain have found a decrease of the nightmares with Vietnam War veterans after 90 days of EMDR. [25] Jayatunge has found significant results with people who have survived to a tsunami. [26] Greenwald has successfully used the EMDR with children. [27] There wasn't any negative consequence due to the EMDR sessions.

Imagery rehearsal therapy is a cognitive behavioral therapy where the patient rescripts the nightmare in any way they choose and then practices the new dream they choose to have using imagery. [8] It has been shown as efficient to treat nightmare disorder in PTSD as well as in non PTSD populations. [22] In this treatment, the person has to write a new scenario of the nightmare with positive images that will be rehearsed during 10 to 20 minutes per day, in order to change the negative content of the nightmare. [22] Cognitive behavioral therapy for insomnia (CBT-I) is also efficient to treat nightmares in the PTSD population. [28] This method aims to change sleep habits with a clinician's help and the use of tools such as a sleep diary. [29] Although many studies have been done in which positive results were recorded, there are few studies in which results were inconclusive or had a delayed effect. [8]

Exposure, relaxation and rescripting therapy is used to treat PTSD-related nightmares. [12] This intervention combines Imagery Rehearsal Therapy with exposure and relaxation techniques. [12] The main objective is to work on changing maladjusted sleep habits and the trauma-related themes of nightmares. [8] [12]

Research has been undertaken to investigate if sufferers of nightmares could benefit from the ability to be aware that they are indeed dreaming, a process known as lucid dreaming. [30] [31] The Lucid Dreaming Therapy is a specific method of the Imagery Rehearsal Therapy. The dreamer is conscious during their dream and can modulate it. Consequently, anxiety decreases, controllability increases, expectations change, which will impact the frequency of nightmares. [5] [32] Several studies have shown significant results with the lucid dreaming therapy. Two studies indicate a decrease of the nightmare frequency after only 12 weeks and one study shows, in 80% of the cases, a total disappearance of the nightmares after one year. [24] Although these studies showed the efficacy of this therapy in the reduction of nightmare frequency on patients from the general population, [33] so far evidence for this treatment is still weak. [34]

Systematic Desensitization, using graduated exposure, has been shown to be efficient to treat chronic nightmares. [22] The person has to face the frightening elements of nightmares in a gradual way, from least to most stressful. [22] When the person starts to feel unsecure, she has to manage the stress by applying a relaxation technique. [22]

Pharmacological treatments

Pharmacological treatments could be also efficient to treat nightmare disorder. [12] Most of the treatments were assessed to patients with PTSD. [24] The most efficient is an alpha-blocker, Prazosin, which reduces tone during sleep by blocking noradrenergic receptors. [12] Prazosin would significantly decrease the number of PTSD related nightmares and would therefore improve sleep quality. [12] However, only few studies considered the effect of Prazosin in idiopathic nightmares. [12] Benzodiazepines are also often used to treat nightmare disorder, despite the lack of efficacy demonstrated in empirical studies. [12] Some patients were also treated with atypical antipsychotic medications. [24] Olanzapine has quickly decreased the nightmares. [24] Two studies have shown the positive effects of Risperidone. [24] Aripiprazole is more tolerated than olanzapine and has demonstrated substantial improvement in the nightmare frequency. [24] Some other drugs as clonidine, cyproheptadine, fluvoxamine, gabapentin, nabilone, phenelzine, topiramate or trazodone have presented an amelioration of the nightmares. [24] But some further researches are needed. [24] Medication has shown efficacy to treat chronic nightmares among a PTSD population but the impact of pharmacological treatments on other populations, such as drug-related nightmares, are unknown. [22] Furthermore, patients usually take more than one medication at a time, whatever the cause related to nightmares, leading to possible interactive effects. [22]

Epidemiology

About 2–6% of American adults are affected by nightmare disorders. [8] About 4% of American adults are affected by nightmare disorders. [1] Women seem to be more affected than men, the ratio being 2–4 : 1. [5] This inequality decreases with aging because of a less high prevalence in elderly women. [5] The rate of nightmares increases from ages 10–19 to 20–39, and then decreases during the ages of 50–59. [8] The rates of nightmares for men increases from ages 10–19 to 30–39, and then decreases at the age of 50–59. [8] However, it is still unclear if the difference of prevalence between men and women is real or if it reflects a higher dream recall capacity of women. [5]

According to studies, children at the age of 6–10 years are 41% more likely to experience nightmares and 22% at the age of 11. [35] Children with persistent nightmares range from 10% to 50%. [4] However, only 1% of children meet the criteria of a nightmare disorder. [10] Some factors tend to predict the development of a disorder from the presence of nightmares during childhood, such as a fear of going to sleep or going back to bed after a nightmare, an irregular sleep life and an avoidance of thinking about the nightmare. [5]

Research

Related Research Articles

A nightmare, also known as a bad dream, is an unpleasant dream that can cause a strong emotional response from the mind, typically fear but also despair, anxiety, disgust or sadness. The dream may contain situations of discomfort, psychological or physical terror, or panic. After a nightmare, a person will often awaken in a state of distress and may be unable to return to sleep for a short period of time. Recurrent nightmares may require medical help, as they can interfere with sleeping patterns and cause insomnia.

<span class="mw-page-title-main">Sleep disorder</span> Medical disorder of a persons sleep patterns

A sleep disorder, or somnipathy, is a medical disorder of an individual's sleep patterns. Some sleep disorders are severe enough to interfere with normal physical, mental, social and emotional functioning. Sleep disorders are frequent and can have serious consequences on patients' health and quality of life. Polysomnography and actigraphy are tests commonly ordered for diagnosing sleep disorders.

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

<span class="mw-page-title-main">Sleep paralysis</span> Sleeping disorder

Sleep paralysis is a state, during waking up or falling asleep, in which a person is conscious but in a complete state of full-body paralysis. During an episode, the person may hallucinate, which often results in fear. Episodes generally last no more than a few minutes. It can recur multiple times or occur as a single episode.

<span class="mw-page-title-main">Night terror</span> Sleep disorder causing feelings of panic or dread

Night terror, also called sleep terror, is a sleep disorder causing feelings of panic or dread and typically occurring during the first hours of stage 3–4 non-rapid eye movement (NREM) sleep and lasting for 1 to 10 minutes. It can last longer, especially in children. Sleep terror is classified in the category of NREM-related parasomnias in the International Classification of Sleep Disorders. There are two other categories: REM-related parasomnias and other parasomnias. Parasomnias are qualified as undesirable physical events or experiences that occur during entry into sleep, during sleep, or during arousal from sleep.

<span class="mw-page-title-main">Dialectical behavior therapy</span> Psychotherapy for emotional dysregulation

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy that began with efforts to treat personality disorders and interpersonal conflicts. Evidence suggests that DBT can be useful in treating mood disorders and suicidal ideation as well as for changing behavioral patterns such as self-harm and substance use. DBT evolved into a process in which the therapist and client work with acceptance and change-oriented strategies and ultimately balance and synthesize them—comparable to the philosophical dialectical process of thesis and antithesis, followed by synthesis.

Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy that is controversial within the psychological community. It was devised by Francine Shapiro in 1987 and originally designed to alleviate the distress associated with traumatic memories such as post-traumatic stress disorder (PTSD).

<span class="mw-page-title-main">Prazosin</span> Antihypertensive drug

Prazosin, sold under the brand name Minipress among others, is a medication used to treat high blood pressure, symptoms of an enlarged prostate, and nightmares related to post-traumatic stress disorder (PTSD). It is an α1 blocker. It is a less preferred treatment of high blood pressure. Other uses may include heart failure and Raynaud syndrome. It is taken by mouth.

Alpha-1 blockers constitute a variety of drugs that block the effect of catecholamines on alpha-1-adrenergic receptors. They are mainly used to treat benign prostatic hyperplasia (BPH), hypertension and post-traumatic stress disorder. Alpha-1 adrenergic receptors are present in vascular smooth muscle, the central nervous system, and other tissues. When alpha blockers bind to these receptors in vascular smooth muscle, they cause vasodilation.

Complex post-traumatic stress disorder is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.

Parasomnias are a category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep. Parasomnias are dissociated sleep states which are partial arousals during the transitions between wakefulness, NREM sleep, and REM sleep, and their combinations.

<span class="mw-page-title-main">Catathrenia</span> Sleep-related breathing disorder

Catathrenia or nocturnal groaning is a sleep-related breathing disorder, consisting of end-inspiratory apnea and expiratory groaning during sleep. It describes a rare condition characterized by monotonous, irregular groans while sleeping. Catathrenia begins with a deep inspiration. The person with catathrenia holds her or his breath against a closed glottis, similar to the Valsalva maneuver. Expiration can be slow and accompanied by sound caused by vibration of the vocal cords or a simple rapid exhalation. Despite a slower breathing rate, no oxygen desaturation usually occurs. The moaning sound is usually not noticed by the person producing the sound, but it can be extremely disturbing to sleep partners. It appears more often during expiration REM sleep than in NREM sleep.

A sympatholytic (sympathoplegic) drug is a medication that opposes the downstream effects of postganglionic nerve firing in effector organs innervated by the sympathetic nervous system (SNS). They are indicated for various functions; for example, they may be used as antihypertensives. They are also used to treat anxiety, such as generalized anxiety disorder, panic disorder and PTSD. In some cases, such as with guanfacine, they have also shown to be beneficial in the treatment of ADHD.

Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.

Idiopathic hypersomnia(IH) is a neurological disorder which is characterized primarily by excessive sleep and excessive daytime sleepiness (EDS). Idiopathic hypersomnia was first described by Bedrich Roth in 1976, and it can be divided into two forms: polysymptomatic and monosymptomatic. The condition typically becomes evident in early adulthood and most patients diagnosed with IH will have had the disorder for many years prior to their diagnosis. As of August 2021, an FDA-approved medication exists for IH called Xywav, which is oral solution of calcium, magnesium, potassium, and sodium oxybates; in addition to several off-label treatments (primarily FDA-approved narcolepsy medications).

Cognitive behavioral therapy for insomnia (CBT-I) is a technique for treating insomnia without medications. Insomnia is a common problem involving trouble falling asleep, staying asleep, or getting quality sleep. CBT-I aims to improve sleep habits and behaviors by identifying and changing the thoughts and the behaviors that affect the ability of a person to sleep or sleep well.

PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.

MDMA-assisted psychotherapy is the use of prescribed doses of MDMA as an adjunct to psychotherapy sessions. Research suggests that MDMA-assisted psychotherapy for post-traumatic stress disorder (PTSD), including Complex PTSD, might improve treatment effectiveness. In 2017, a Phase II clinical trial led to "breakthrough therapy" designation by the US Food and Drug Administration (FDA) for potential use as a treatment for PTSD.

<span class="mw-page-title-main">Behavioral sleep medicine</span>

Behavioral sleep medicine (BSM) is a field within sleep medicine that encompasses scientific inquiry and clinical treatment of sleep-related disorders, with a focus on the psychological, physiological, behavioral, cognitive, social, and cultural factors that affect sleep, as well as the impact of sleep on those factors. The clinical practice of BSM is an evidence-based behavioral health discipline that uses primarily non-pharmacological treatments. BSM interventions are typically problem-focused and oriented towards specific sleep complaints, but can be integrated with other medical or mental health treatments. The primary techniques used in BSM interventions involve education and systematic changes to the behaviors, thoughts, and environmental factors that initiate and maintain sleep-related difficulties.

Borderline personality disorder (BPD) is a personality disorder characterized by a pervasive, long-term pattern of significant interpersonal relationship instability, a distorted sense of self, and intense emotional responses, which can be misdiagnosed. Misdiagnosis may involve erroneously assigning a BPD diagnosis to individuals not meeting the specific criteria or attributing an incorrect alternate diagnosis in cases where BPD is the accurate condition.

References

  1. 1 2 3 4 Morgenthaler, Timothy I.; Auerbach, Sanford; Casey, Kenneth R.; Kristo, David; Maganti, Rama; Ramar, Kannan; Zak, Rochelle; Kartje, Rebecca (15 June 2018). "Position Paper for the Treatment of Nightmare Disorder in Adults: An American Academy of Sleep Medicine Position Paper". Journal of Clinical Sleep Medicine. 14 (6): 1041–1055. doi:10.5664/jcsm.7178. PMC   5991964 . PMID   29852917.
  2. 1 2 Fariba, Kamron A.; Tadi, Prasanna (2023), "Parasomnias", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   32809359 , retrieved 2023-03-24
  3. ↑ Singh, Shantanu; Kaur, Harleen; Singh, Shivank; Khawaja, Imran (2018-12-31). "Parasomnias: A Comprehensive Review". Cureus. 10 (12): e3807. doi: 10.7759/cureus.3807 . ISSN   2168-8184. PMC   6402728 . PMID   30868021.
  4. 1 2 3 4 "Nightmare disorder". minddisorders.com.
  5. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Spoormaker, Victor I.; Schredl, Michael; Bout, Jan van den (2006-02-01). "Nightmares: from anxiety symptom to sleep disorder". Sleep Medicine Reviews. 10 (1): 19–31. doi:10.1016/j.smrv.2005.06.001. ISSN   1087-0792. PMID   16377217.
  6. ↑ Hockenbury, Don H. (2011). Discovering psychology. Hockenbury, Sandra E. (5th ed.). New York, NY: Worth Publishers. p. 157. ISBN   978-1-4292-1650-0. OCLC   463639317.
  7. 1 2 3 4 5 6 Zadra, Antonio; Robert, Geneviève (2014-02-01). "Thematic and Content Analysis of Idiopathic Nightmares and Bad Dreams". Sleep. 37 (2): 409–417. doi:10.5665/sleep.3426. ISSN   0161-8105. PMC   3900621 . PMID   24497669.
  8. 1 2 3 4 5 6 7 Nadorff, Michael R.; Lambdin, Karen K.; Germain, Anne (2014-04-01). "Pharmacological and non-pharmacological treatments for nightmare disorder". International Review of Psychiatry. 26 (2): 225–236. doi:10.3109/09540261.2014.888989. ISSN   0954-0261. PMID   24892897. S2CID   7331480.
  9. 1 2 3 "Journal of Clinical Sleep Medicine - Research & Review Articles in Sleep Medicine". jcsm.aasm.org. Retrieved 2018-10-07.
  10. 1 2 Agargun, Mehmet Y; Cilli, Ali Savas; Sener, Sahnur; Bilici, Mustafa; Ozer, Omer Akil; Selvi, Yavuz; Karacan, Elvan (June 2004). "The Prevalence of Parasomnias in Preadolescent School-aged Children: a Turkish Sample". Sleep. 27 (4): 701–705. doi: 10.1093/sleep/27.4.701 . ISSN   1550-9109. PMID   15283005.
  11. ↑ Schagen, Annette van; Lancee, Jaap; Swart, Marijke; Spoormaker, Victor; Bout, Jan van den (2017). "Nightmare Disorder, Psychopathology Levels, and Coping in a Diverse Psychiatric Sample". Journal of Clinical Psychology. 73 (1): 65–75. doi:10.1002/jclp.22315. ISSN   1097-4679. PMID   27100372.
  12. 1 2 3 4 5 6 7 8 9 10 11 Nadorff, Michael R.; Lambdin, Karen K.; Germain, Anne (2014-04-01). "Pharmacological and non-pharmacological treatments for nightmare disorder". International Review of Psychiatry. 26 (2): 225–236. doi:10.3109/09540261.2014.888989. ISSN   0954-0261. PMID   24892897. S2CID   7331480.
  13. 1 2 3 4 Sateia, Michael J (2014-11-01). "International Classification of Sleep Disorders-Third Edition". Chest. 146 (5): 1387–1394. doi:10.1378/chest.14-0970. ISSN   0012-3692. PMID   25367475.
  14. ↑ Gieselmann, Annika; Ait Aoudia, Malik; Carr, Michelle; Germain, Anne; Gorzka, Robert; Holzinger, Brigitte; Kleim, Birgit; Krakow, Barry; Kunze, Anna E.; Lancee, Jaap; Nadorff, Michael R.; Nielsen, Tore; Riemann, Dieter; Sandahl, Hinuga; Schlarb, Angelika A. (August 2019). "Aetiology and treatment of nightmare disorder: State of the art and future perspectives". Journal of Sleep Research. 28 (4): e12820. doi:10.1111/jsr.12820. PMC   6850667 . PMID   30697860.
  15. ↑ "Nightmare Disorder". The Gale Encyclopedia of Mental Health. January 1, 2008. Archived from the original on May 29, 2016. Retrieved April 14, 2016. Nightmares can be a side effect of some medications or drugs of abuse, including drugs given for high blood pressure; levodopa and other drugs given to treat Parkinson's disease; amphetamines, cocaine and other stimulants; and some antidepressants.
  16. 1 2 3 4 Germain, Anne; Nielsen, Tore A (2003-11-15). "Sleep pathophysiology in posttraumatic stress disorder and idiopathic nightmare sufferers". Biological Psychiatry. 54 (10): 1092–1098. doi:10.1016/S0006-3223(03)00071-4. ISSN   0006-3223. PMID   14625152. S2CID   13545798.
  17. ↑ Berry, Richard B.; Budhiraja, Rohit; Gottlieb, Daniel J.; Gozal, David; Iber, Conrad; Kapur, Vishesh K.; Marcus, Carole L.; Mehra, Reena; Parthasarathy, Sairam (2012-10-15). "Rules for Scoring Respiratory Events in Sleep: Update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events". Journal of Clinical Sleep Medicine. 08 (5): 597–619. doi:10.5664/jcsm.2172. ISSN   1550-9389. PMC   3459210 . PMID   23066376.
  18. 1 2 Swart, Marijke L.; van Schagen, Annette M.; Lancee, Jaap; van den Bout, Jan (2013). "Prevalence of Nightmare Disorder in Psychiatric Outpatients". Psychotherapy and Psychosomatics. 82 (4): 267–268. doi:10.1159/000343590. ISSN   1423-0348. PMID   23735876. S2CID   207612810.
  19. ↑ "Nightmare Disorder". The Gale Encyclopedia of Mental Health. January 1, 2008. Archived from the original on May 29, 2016. Retrieved April 14, 2016. Because stress is thought to be the most common cause of nightmares, stress reduction techniques may prove to be effective complementary treatments. Typical relaxation techniques such as yoga, meditation or exercise may be helpful.
  20. ↑ Murray A. Raskind, Elaine R. Peskind, Evan D. Kanter, (February 2003). Reduction of Nightmares and Other PTSD Symptoms in Combat Veterans by Prazosin: A Placebo-Controlled Study, American Journal of Psychiatry, (160) 371-373.
  21. ↑ "Drug Helps PTSD Nightmares" (Press release). Department of Veteran Affairs. March 30, 2008. Archived from the original on July 3, 2009. Retrieved 2012-06-23. (Archived page)
  22. 1 2 3 4 5 6 7 8 9 Kartje, Rebecca; Zak, Rochelle; Ramar, Kannan; Maganti, Rama; Kristo, David; Casey, Kenneth R.; Auerbach, Sanford; Morgenthaler, Timothy I. (2018-06-15). "Position Paper for the Treatment of Nightmare Disorder in Adults: An American Academy of Sleep Medicine Position Paper". Journal of Clinical Sleep Medicine. 14 (6): 1041–1055. doi:10.5664/jcsm.7178. ISSN   1550-9389. PMC   5991964 . PMID   29852917.
  23. ↑ Morgenthaler, Timothy I.; Auerbach, Sanford; Casey, Kenneth R.; Kristo, David; Maganti, Rama; Ramar, Kannan; Zak, Rochelle; Kartje, Rebecca (2018-06-15). "Position Paper for the Treatment of Nightmare Disorder in Adults: An American Academy of Sleep Medicine Position Paper". Journal of Clinical Sleep Medicine. 14 (6): 1041–1055. doi:10.5664/jcsm.7178. ISSN   1550-9389. PMC   5991964 . PMID   29852917.
  24. 1 2 3 4 5 6 7 8 9 Morgenthaler, T. I., Auerbach, S., Casey, K. R., Kristo, D., Maganti, R., Ramar, K., ... & Kartje, R. (2018). Position paper for the treatment of nightmare disorder in adults: an American Academy of Sleep Medicine position paper. Journal of Clinical Sleep Medicine, 14(06), 1041-1055.
  25. ↑ Silver, S. M., Brooks, A., & Obenchain, J. (1995). Treatment of Vietnam War veterans with PTSD: A comparison of eye movement desensitization and reprocessing, biofeedback, and relaxation training. Journal of Traumatic Stress, 8(2), 337–342.
  26. ↑ Jayatunge, R. M. (2008). Combating Tsunami Disaster Through EMDR. Journal of EMDR Practice and Research, 2(2), 140‑145. https://doi.org/10.1891/1933-3196.2.2.140
  27. ↑ Greenwald, G. (1993b). Treating children’s nightmares with EMDR. EMDR Network Newsletter, 3 (1), 7–9.
  28. ↑ Lynch, John; Leszczyszyn, David J.; Vrana, Scott R.; Rybarczyk, Bruce; Margolies, Skye Ochsner (2013-10-01). "Efficacy of a Cognitive-Behavioral Treatment for Insomnia and Nightmares in Afghanistan and Iraq Veterans With PTSD". Journal of Clinical Psychology. 69 (10): 1026–1042. doi:10.1002/jclp.21970. ISSN   1097-4679. PMID   23629959.
  29. ↑ "CBT for Insomnia: Techniques & Case Study - National Sleep Foundation". www.sleepfoundation.org. Retrieved 2019-06-17.
  30. ↑ Spoormaker, Victor I.; van den Bout, Jan (October 2006). "Lucid Dreaming Treatment for Nightmares: A Pilot Study" (PDF). Psychotherapy and Psychosomatics. 75 (6): 389–394. doi:10.1159/000095446. PMID   17053341. S2CID   15457895. Archived from the original (PDF) on 2018-05-09. Retrieved 2013-12-14. Conclusions: LDT seems effective in reducing nightmare frequency, although the primary therapeutic component (i.e. exposure, mastery, or lucidity) remains unclear.
  31. ↑ Colic, M. (2007). "Kanna's lucid dreams and the use of narrative practices to explore their meaning." The International Journal of Narrative Therapy and Community Work (4): 19–26.
  32. ↑ Zadra, A. L., & Pihl, R. O. (1997). Lucid Dreaming as a Treatment for Recurrent Nightmares. Psychotherapy and Psychosomatics, 66(1), 50‑55. https://doi.org/10.1159/000289106
  33. ↑ Bout, Jan van den; Spoormaker, Victor I. (2006). "Lucid Dreaming Treatment for Nightmares: A Pilot Study". Psychotherapy and Psychosomatics. 75 (6): 389–394. doi:10.1159/000095446. ISSN   0033-3190. PMID   17053341. S2CID   15457895.
  34. ↑ R. Nisha Aurora.; et al. (2010). "Best Practice Guide for the Treatment of Nightmare Disorder in Adults" (PDF). Journal of Clinical Sleep Medicine. 6 (4): 549–553.
  35. ↑ Salzarulo, P.; Chevalier, A. (September 1983). "Sleep Problems in Children and Their Relationship with Early Disturbances of the Waking-Sleeping Rhythms". Sleep. 6 (1): 47–51. doi: 10.1093/sleep/6.1.47 . ISSN   0161-8105. PMID   6844797.
  36. ↑ Agargun, MY; Kara, H; Ozer, OA; Selvi, Y; Kiran, U; Ozer, B (December 2003). "Clinical importance of nightmare disorder in patients with dissociative disorders". Psychiatry and Clinical Neurosciences. 57 (6): 575–9. doi: 10.1046/j.1440-1819.2003.01169.x . PMID   14629705.
  37. ↑ Semiz, UB; Basoglu, C; Ebrinc, S; Cetin, M (February 2008). "Nightmare disorder, dream anxiety, and subjective sleep quality in patients with borderline personality disorder". Psychiatry and Clinical Neurosciences. 62 (1): 48–55. doi: 10.1111/j.1440-1819.2007.01789.x . PMID   18289141.
  38. ↑ Kennedy, G. (2002, November). A review of hypnosis in the treatment of parasomnias: Nightmare, sleepwalking, and sleep terror disorders. Australian Journal of Clinical & Experimental Hypnosis, 30(2), 99-155.
  39. ↑ Agargun, MY; Gulec, M; Cilli, AS; Kara, H; Sekeroglu, R; Dulger, H; Besiroglu, L; Inci, R (May 2005). "Nightmares and serum cholesterol level: a preliminary report". Canadian Journal of Psychiatry. 50 (6): 361–4. doi: 10.1177/070674370505000613 . PMID   15999954.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.