What causes bad dreams

Nightmares (Nightmare Disorder)

Sleep disorders (page 7/9)

Mostly in the REM phase, those affected experience vivid, threatening dreams and wake up from them (parasomnias)

With this disorder, those affected repeatedly experience vivid, threatening dreams that they can still remember in detail when they wake up. The content of dreams is often a threat to one's own safety or a threat to self-esteem. Often people with nightmares are still very afraid after they wake up and therefore cannot go back to sleep. The disorder usually occurs in the second half of the night during REM sleep. In contrast to sleepwalking and pavor nocturnus, those affected are not confused and disoriented after waking up, but rather quickly awake and oriented. The lack of sleep and the strong fear that often persists during the day mean that people with nightmares are impaired in their psychological and social functioning.

Frequency and course

Nightmares are particularly common in children: 10 to 50 percent of children have nightmares at times. They are most common between the ages of three and six, after which they usually stop on their own with increasing age. With persistent, severe psychological stress, nightmares can also occur over a longer period of time.

Many adults also have nightmares every now and then, around 50 percent. However, only about three percent of young adults and only one percent of adults as a whole are affected by repeated, prolonged nightmares. In these people, the disorder is usually chronic, with nightmares recurring in phases. Women are two to four times more likely to experience nightmares than men.

A 25-year-old woman repeatedly has a nightmare in which she is in an apartment. She actually feels comfortable and safe here - but there is something threatening outside and she is very afraid of going outside. There are friendly beings in the house who will try to get you to open the door and go out. But whenever she tries to open the door, she gets very scared and wakes up bathed in sweat. These dreams preoccupy the woman during the day too, and her mood is often depressed throughout the day.

In psychotherapy it turns out that the patient suffers greatly from the conflict with her parents, who were very strict in her childhood. She broke off contact for some time, but this situation also weighs heavily on her. In therapy, the patient is encouraged to face the conflict with her parents and tell them how she would like contact with them. After that, the nightmares gradually recede.

Causes and explanatory models

It is believed that nightmares are triggered by fear or extreme stress.

Nightmares are common in children and are usually not a sign of a mental disorder. Small children between the ages of three and six in particular are not yet able to distinguish well between reality and their imagination. They often believe that there are monsters or ghosts in their room and also consider the terrifying experiences in the nightmares to be real.

In adults, nightmares often occur after acute psychological stress. Long periods of nightmares are often associated with another mental illness, e. B. Post Traumatic Stress Disorder (PTSD) or Anxiety Disorder.

Treatment approaches and self-help options

It is often possible to get the nightmares under control without special therapy. For children, when they wake up from a nightmare, hugging them and calming them down is often enough. It can also be helpful to talk about the nightmare the next day or to have the dream painted, as the child can process the dream better this way. Sometimes the themes of the dream also give clues to underlying fears or problems - e.g. For example, if the child keeps dreaming of a "bad man" and it turns out that it is afraid of the grim-looking neighbor. The parents can then look for solutions to the problem together with the child.

In adults who repeatedly suffer from nightmares, it is often useful to get the stress or fears behind them under control - e. B. using stress management strategies. Relaxation methods such as Jacobson's progressive muscle relaxation or autogenic training can help reduce stress and help you fall asleep better in the evening or after waking up at night.

If the nightmares are very persistent and the stress associated with them is very pronounced, psychotherapy is often useful. It can help to identify the problems behind the nightmares and to reduce stress and anxiety. At the same time, typical, recurring themes of the nightmares can be worked on until the nightmares no longer or only rarely occur.

Medical therapy

Drug treatment is usually not useful for nightmares.