Nightmares are vivid, upsetting dreams that wake a person and are clearly remembered.
When they are frequent and cause fear of sleeping, they need attention.
Key concepts
- Nightmares are common after traumatic events
- Imagery rehearsal therapy can rewrite recurring dreams
- Some medicines and alcohol withdrawal can trigger them
Symptoms and signs
- Waking with fear, sweating or a racing heart
- Same or similar dream repeating
- Avoiding sleep or dreading bedtime
Causes
- Trauma, accidents, violence or loss
- Stress and anxiety
- Irregular sleep and alcohol use
Risk factors
- PTSD or anxiety disorders
- Depression
- Withdrawal from alcohol or sedatives
Evidence-based management
- Imagery rehearsal: write a new, safer ending and rehearse it daily
- Trauma-focused psychotherapy when linked to trauma
- Grounding after waking: name what you see, slow breathing
- Medicines in selected cases, as advised by a psychiatrist
When to seek professional help
- Nightmares most weeks for over a month
- Flashbacks or fear during the day too
- Using alcohol to sleep
Frequently asked questions
Do nightmares mean something supernatural?
No. They reflect stress, memory and emotion processing in the brain, and they respond to treatment.
Are nightmares in children worrying?
Occasional nightmares are normal; frequent ones with daytime fear or after a frightening event should be discussed.
Medical references
Guidelines and official sources used for this article.
- Post-traumatic stress disorder (NG116). NICE, UK, 2018.
- ICD-11 for Mortality and Morbidity Statistics. World Health Organization.
- Author
- Dr. Kuldeep Budania, MBBS, MD Psychiatry
- Medical reviewer
- Dr. Kuldeep Budania, MD Psychiatry
- Last reviewed
This article is for general information and is not a substitute for personal medical advice.
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