Nightmares and What to Do about Them

Unlike night terrors, nightmares occur during REM sleep. The miserable experience of awakening from a nightmare afflicts people from the youngest to the oldest age. Although experts vary in their calculations of the age when children are most prone to nightmares, the average seems to be about seven years old.

Moreover, in contrast to night terrors that are more frequent in males, more females—three times as many—complain of nightmares. We do not know why.

Compared to ordinary bad dreams, nightmares are clearer, more elaborate, and exceedingly more unpleasant. They involve greater apprehensiveness, more physical activity and more vivid color. The content of nightmares usually threatens the dreamer's safety, survival, or self-esteem. Some victims report three attacks or more each week.

People suffer nightmares from a number of causes. Although episodes are thought to be unconnected to the developmental abnormalities sometimes found in night terrors, there is a physical basis for some nightmares.

Physical Causes

1. Withdrawal from drugs

Any person who has been taking sleeping pills (barbiturates) or stimulants (amphetamines) or large doses of alcohol, is suppressing their REM sleep. When the person stops ingesting the substance, he or she is certain to experience vivid, bizarre, and extremely frightening dreams. (People undergoing cancer treatments tell me that chemo-therapy has a similar effect.) During the first few nights following drug withdrawal, REM periods are often twice as long as normal, and much more intense.

In children, this means that medication following operations or injury will probably lead to a surge of nightmares after the medication is stopped. Ask your physician whether any prescribed medication suppresses REM sleep. Be prepared to cope with nightmares.

Adults withdrawing from sleeping pills sometimes feel forced to return to them to avoid nightmares, thus prolonging and exacerbating the problem. Some people develop "REM-interruption insomnia," a condition that involves waking as soon as a dream begins. This creates other difficulties, including depression and general insomnia. If you should become aware of not dreaming, consult a physician; we all need our dreams to stay healthy.

2. Fevers

High fevers can cause terrifying nightmares, even hallucinations. If your child becomes ill and runs a fever, being aware of this likelihood can help you provide prompt aid. Nightmares resulting from fevers, like those from drugs, have a weird and ghastly quality for the victim.

3. Sleep Deprivation and Fatigue

Going without sleep for long periods leads to "REM rebound." Once deprived people have an opportunity to sleep, their brains first restore deep sleep; thereafter, REM periods are long and intense, with disturbing dreams. Keep this in mind when traveling with children. Try to provide opportunities for periodic rest to avoid creating conditions favorable to nightmares.

4. Indigestion

Poor digestion from overeating or from tainted food can provoke nightmares. A two-year-old girl suffered a violent nightmare after eating mounds of pink popcorn at the zoo. Some caution is called for in monitoring food intake, especially just before bed.

5. Food Allergies

Some parents tell me that their children have more nightmares after having eaten a food to which they are allergic. One mother, for instance, says that her son's nightmares increase following meals of dairy products to which the boy is allergic. If your child has allergies, notice whether nightmares occur after eating "forbidden" foods. If so, avoidance of these foods becomes even more important.

6. Hypersensitivity

Some children are especially sensitive to their environment. These boys and girls may be unduly upset by such changes as new routines, the presence of strangers, pressures at school, and so forth. This disturbance is often expressed in nightmares.

Parents whose children are plagued with frequent nightmares (three times a week or more) over a long period of time would do well to consult their physician or to contact a psychological or psychiatric clinic at the local hospital or university. Extremely anxious children have more nightmares; professional counseling can resolve their underlying problems.

Most sensitive children, however, can benefit from opportunities for creative expression and development. We can give children a chance to direct their sensitivity away from fearful or destructive modes and into constructive channels.

7. Family Association

Are nightmares "catching"—learned by living in the same environment with people who have them—or inherited? We do not yet know. Researchers in one study found that many adults (20 percent) who have frequent nightmares had first-degree relatives who also have nightmares.

Sleepwalkers are prone to having nightmares as well as night terrors; 60 percent of people who walk in their sleep also report nightmares.

8. Psychological Causes

In contrast to night terrors, nightmares are closely correlated to the dreamer's psychological state. Most authorities agree that nightmares are usually a reaction to life pressures, such as:

9. A traumatic or significant negative life event.

Change in a loving relationship, living conditions, work, or family life can trigger nightmares. Death, divorce, or any emotionally painful event is likely to provoke nightmarish responses.

10. A period of stress.

Smaller, day- to-day problems can also elicit nightmares. Anything that makes us feel insecure or puts us into emotional turmoil can serve as a stimulus.

In general, nightmares indicate the level of stress that is in our daily life as we combat our problems; in our dreams we try to cope with the anxieties, fears, and angers that are evoked. Just as ordinary dreams help us to deal with our everyday difficulties, so do our nightmares attempt to handle more serious situations and outright crises. They express our concerns over traumatic events, or worries about upcoming ones, and give us a chance to practice coping. Thus, nightmares, too, help us successfully encounter life. Yet we may be so frightened by a nightmare that we are unable to benefit from it; this is especially true for children.

11. Long Term Treatment for Nightmares

Everyone has extremely bad dreams now and then; an occasional nightmare is normal. When our children go through periods of stress or anxiety or change, we can expect them to have nightmares. Boys and girls are more aware of their dreams under stress than when life flows smoothly.

As children go through phases of developing self-reliance, they often feel frustrated by parents, siblings, or others who interfere with their efforts to grow up; hence they have hostile feelings that are usually kept inside. Children are scared of their own aggressive impulses; they become afraid of not being able to control their emotions and fear punishment for having angry thoughts. They are also frightened of aggressive behavior in people around them. These emotions take the shape of wild beasts or villains or monsters in their dreams.

Nightmares are an extension of normal dreaming and are a natural part of growing up. Unless nightmares are severe and persistent, disturbing the child's whole personality, parents need not be unduly concerned.

Working with dreams helps remove the fear from them. It is especially important to encourage a child to express bad dreams in some waking form—in discussion or in artistic product. The nightmare that is held in secret and brooded upon is the one that festers. Help your child to cope with any bad dreams by using the following guide.