"Nightmares are often referred to as parasomnia," says psychotherapist Lee Phillips, LCSW, EdD. (Parasomnia is an umbrella term for several sleep-disturbance disorders that include nightmares, sleepwalking, and sleep paralysis.) "Nightmares can occur while the person is falling asleep, during sleep, or when waking up," Dr. Phillips says. Most people report having nightmares during rapid eye movement (REM) sleep, a stage of sleep characterized by increased brain activity, increased heart rate, and quicker breathing.
What causes nightmares is a bit of a mystery. We know it doesn't involve Vecna dragging you into the Upside Down, but studies are slowly beginning to reveal more on this topic. "Research shows nightmares may be caused by trauma, lack of sleep, medications, substance use, the viewing of horror films, reading scary books, and other disorders," says Dr. Phillips. He notes that his own clients have experienced nightmares in conjunction with stress, anxiety, and depression.
Although nightmare science is still in its early stages, researchers have managed to identify three specific types of nightmares. Below, Dr. Phillips breaks them down and explains why you may be experiencing them. Plus, he offers a few ways to attempt to keep you sleep full of good dreams. Just remember: If your nightmares are inhibiting you from a good night's sleep or persisting, it's a good idea to talk to your doctor to find out what personalized changes you can make to keep your time in bed more peaceful.
The three types of nightmares
1. Idiopathic nightmares
Idiopathic nightmares are imaginative dream sequences that are not the result of trauma. (They're the most common type of disturbed dreaming.) A person often starts having this type of dream in childhood, and it can follow you into your adult years. For example, growing up, I had nightmares about the purple Teletubby ("Tinky-Winky") trying to join my volleyball team. (Luckily, I don't have this one anymore.)
"Idiopathic nightmares occur when a person is highly stressed," says Dr. Phillips. "The person may also have these types of nightmares due to other mental health concerns such as anxiety, depression, bipolar disorder, and psychotic disorders."
Dr. Phillips says that idiopathic nightmares can lead to emotional irritability during the day. "Because of the high levels of stress, the person can experience emotional instability causing them to experience initial—can't fall asleep—and middle insomnia—waking in the middle of REM sleep," he says.
2. Recurrent nightmares
As the name implies, recurrent nightmares are nightmares that repeat on a semi-frequent basis. Recurring dreams are common in times of unmanaged stress and may reflect ongoing conflicts you can't or won't resolve. A classic example is a dream where you show up to school stark naked because you feel unprepared for what the day has in store. If you continue to feel overwhelmed at work, these dreams may continue to visit you.
"Recurrent nightmares can cause irritability due to lack of sleep. Often, people get annoyed because it is the same dream repeatedly," says Dr. Phillips. "They can also experience anxiety and worry because they fear the nightmares will not end."
3. Post-traumatic nightmares
Post-traumatic nightmares essentially re-enact a traumatic moment in vivid detail, and are very common in people who have post-traumatic stress disorder (PTSD).
"Post-traumatic nightmares can cause severe symptoms of anxiety and panic. The person can also experience irritability and depression," says Dr. Lee. He adds that this type of dream will lead to having trouble falling asleep and staying asleep. In the worst cases, sufferers may self-medicate to help themselves stay asleep (a measure that will only make things worse.)
Fortunately, researchers are beginning to develop treatment options for folks whose past is showing up in their dreams. If this sounds like you, it's a good idea to work directly with a mental health expert.
How to deal if your nighttime hours are plagued by bad dreams
If you find yourself dreading bedtime, Dr. Phillips recommends prioritizing self care above all else. "Nightmares tend to take their own course of action, and they may decrease over time. We may not be able to stop them, but we may be able to calm them by engaging in self care—like exercise, mindfulness, healthy eating habits, and psychotherapy," he says.
He also recommends refraining from drinking and making sure you leave at least a few hours between the time you take your last bite of dinner and the time you go to bed.
You can also try meditating beneath the covers, listening to a sleep story, or doing something else that feels relaxing and safe for you. And, just to really emphasize this point, make sure you're seeking professional help if your dreams are getting out of hand. You deserve a good night's rest.
Have trouble falling back to sleep after a weird dream? Here's some guidance:
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