What Causes Nightmares?

Dreams are a succession of images, thoughts, or emotions passing through the mind during sleep. A nightmare is an unpleasant dream. It occurs during rapid eye movement (REM) sleep that arouses strong unpleasant emotional responses of intense, inescapable fear, terror, distress, or extreme anxiety that usually awakens the sleeper. Other disturbing emotions such as anger, guilt, sadness or depression may occur in a nightmare. Nightmares tend to be complex and fairly long.
Nightmares occur exclusively during REM sleep. REM sleep phases grow longer in the latter part of the sleep cycle, and the majority of nightmares occur from the middle of the night onward. Nightmares can be vivid and will usually result in the sleeper waking up just as the danger or threat reaches it climax; there is usually some recollection of the dream. Nightmares are different from night terrors which are episodes of extreme fright during sleep. Persons usually have no recollection of a night terror.
Nightmare themes vary from one individual to the other and can take place at anytime during sleep. The most common theme experienced in a nightmare is the dreamer being chased. Adults are commonly chased by an unknown male figure whereas children are commonly chased by an animal or some fantasy figure.

Children typically have nightmares between the ages of three to four and seven to eight. These nightmares appear to be a part of normal development, and do not generally signal unusual problems. Nightmares are less common in adults.

Causes of Nightmares


Some nightmares can be caused by certain drugs or medications or by rapid withdrawal from them. Prescription drugs such as levodopa, reserpine, beta blockers, and antidepressants, as well as withdrawal from addictive drugs can lead to nightmares. Other drugs suspected of causing nightmares include heart drugs, antibiotics such as ciprofloxacin, antihistamines, appetite suppressers and ulcer drugs. However, many drugs cannot be stopped abruptly without side effects, so it is necessary to consult your physician before altering the use of medications.

Childhood Development

The nightmares of early childhood likely reflect the struggle to learn to deal with normal childhood fears and problems. Emotional traumas that disturb the sleep of children can be overlooked easily by adults – such as the loss of a favorite toy or overhearing a loud argument between parents. Although nightmares and night terrors are considered normal developmental events in children which disappear by adolescence, frequent episodes at any age warrant professional evaluation. Crisis intervention techniques can be very effective in dealing with the trauma.


In both adults and children, nightmares and night terrors can be caused by unresolved psychological conflicts or traumatic events. They are a frequent feature of post-traumatic stress disorder. It is common for people to experience nightmares after they have suffered a traumatic event, such as surgery, death of a loved one, an assault or a severe accident.


Other people experience nightmares when they are undergoing stress in their waking lives. Some people experience frequent nightmares that seem unrelated to their waking lives. These people tend to be more creative, trusting and emotional than average and more sensitive to environmental and social factors.

Drug and Alcohol Abuse

Heavy drinking and drug abuse such as the use of cocaine are also strongly associated with nightmares.

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