Nightmare disorder: what it is and how to overcome it

Maintaining adequate sleep hygiene, with stable routines and relaxation exercises, can help improve nightmare disorders. Learn more tips to overcome them.

At some point in life, all of us can have a nightmare: being attacked by an animal, being in a catastrophe, and suddenly losing our teeth. When it comes to a frequent situation, which is repeated several times a week and alters our daily lives, we speak of a nightmare disorder.

It is very common to find these dreams that we remember with discomfort when we wake up. Until then, nothing to worry about if it’s just once in a while. However, its repetition deserves our attention.

What is nightmare disorder?

Not every nightmare is a disorder, but a disorder does become a nightmare. It seems like a play on words, however, it is important to understand the difference.

Nightmares are experienced as dreams that trigger unpleasant emotions (fear, anxiety, sadness, anguish). They look very real and vivid; therefore, when we wake up we have clear memories of the discomfort and may experience difficulties in falling asleep again.

Nightmares arise in the REM sleep phase, in what would be the second half of the night.

Why do we talk about a nightmare disorder? Because its presence is continuous and affects daily functioning and well-being. That is to say, it is not something limited to a specific moment, but rather it extends over time.


Some of the symptoms of a nightmare disorder are as follows:

  • Frequent and continuous presentation.
  • During the day we remember the nightmare. It is difficult for us to disconnect from it and, by evoking it, it causes us discomfort again. We may also have difficulty concentrating and continuing our tasks.
  • We experienced exhaustion and tiredness, so the moment of rest was not restful.
  • We have changes in mood, such as irritability, reluctance, or anguish.


There are different classifications for this disorder. First, depending on its duration:

  • Acute: Nightmares last less than 1 month.
  • Subacute: the occurrence is from 1 to 6 months.
  • Persistent: occurs for more than 6 months.

Regarding gravity:

  • Mild: Nightmares occur less than once a week.
  • Moderate: They happen several times a week, but not every night.
  • Serious: Happens almost every night for a week.


Now, nightmares can function as an indicator or a warning sign of something else that is happening to us, such as anxiety, stress, trauma, or depression. For example, nightmares are considered to be one of the ways the brain tries to process post-traumatic stress. The intensity of the lived experience is so strong that during wakefulness its “processing” or “transformation” is difficult. However, the “unsaid” seeks to resolve itself in some way.

On the other hand, to identify the origin of the nightmare disorder, it is convenient to recognize if there were changes in diet, routine, and daily habits, if any particular event occurred, etc. Having insomnia is also a predisposing factor for nightmares.

In this sense, to talk about this disorder a differential diagnosis is required. For example, it cannot be diagnosed if it occurs concomitantly with substance use or if there is an underlying mental disorder.

How to overcome nightmare disorder?

There are different recommendations to take into account to overcome nightmare disorder. Some of them are the following.

Make a medical consultation

In this way, you will be able to determine if there is any organic cause that may be influencing your rest. For example, nightmares can occur with heart disease.

Take care of your night feeding

The quality of sleep also depends on the food at the last hour of the day, having consumed alcohol or some other type of substance. To promote rest, it is recommended to have a light dinner at least two hours before rest.

Practice proper sleep hygiene

One of the ways to collaborate with a restful sleep has to do with the previous preparation. For example, try to maintain a routine of going to bed and getting up at the same time. It is also possible to practice some breathing and relaxation exercises.


Practicing imagination with endings that modify the content of the nightmare is possible. During the day, anxiety about dreams can cause us to try to avoid remembering them.

However, such attempts often fail and lead to further frustration. Instead, we can make emotions conscious, identify what it is that worries us about the dream, and think of a more pleasant ending. For example, if we dream that an animal attacks us, we can plan a different version in which someone notices that we are attacked and comes to our aid.

Ask for professional help

You can start psychological therapy to develop stress-coping and problem-solving skills, heal past hurts, and build resilience from a traumatic situation. It is a way of becoming active around our discomfort and not letting the dream (or rather, the nightmare) solve it by itself.

Quality of sleep is quality of life

When we sleep, the brain recovers from the activity and demands of the day. It allows us to clarify our ideas to make better decisions, but other processes also take place, such as the consolidation of learning.

Addressing the nightmare disorder is essential since the lack of rest is a limitation to having a good quality of life. Even when it lasts over time, it can cause anxiety or a phobia.

Sometimes it leads to compensatory behaviors, such as leaving the lights on or not being able to sleep alone. Over time, if this disorder is not addressed, it creates difficulties.

Billie Eilish

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