Nightmare

A nightmare, also called a bad dream,[1] is an unpleasant dream that

Nightmare
can cause a strong emotional response from the mind, typically fear
but also despair, anxiety and great sadness. However, psychological
nomenclature differentiates between nightmares and bad dreams,
specifically, people remain asleep during bad dreams whereas
nightmares awaken individuals. Further, the process of psychological
homeostasis employs bad dreams to protect an individual's
Homeostatically Protected Mood (HPMood) from the impact of
elevated anxiety levels. During sleep, nightmares indicate the failure of
the homeostatic system employing bad dreams to extinguish anxiety
accumulated throughout the day.[2] The dream may contain situations
of discomfort, psychological or physical terror or panic. After a
nightmare, a person will often awaken in a state of distress and may be
unable to return to sleep for a short period of time.[3]

Nightmares can have physical causes such as sleeping in an

uncomfortable position or having afever, or psychological causes such
as stress or anxiety. Eating before going to sleep, which triggers an
increase in the body's metabolism and brain activity, is a potential
stimulus for nightmares.[4]

Recurrent nightmares may require medical help, as they can interfere

with sleeping patterns and causeinsomnia.

The Sleep of Reason Produces Monsters

(Francisco de Goya, c.1797)
Contents
Causes Stress or Anxiety
Signs and symptoms
Cause
Treatment
Post-traumatic stress disorder
Epidemiology
Etymology
See also
References
Further reading
External links

Signs and symptoms

Those with nightmares experience abnormal sleep architecture and that the results of having a nightmare during the night were very
similar to those of people who have insomnia. This is thought to be caused by frequent nocturnal awakenings and fear of falling
asleep.[5]
Cause
Scientific research shows that nightmares may have many causes. In a study focusing on children, researchers were able to conclude
that nightmares directly correlate with the stress in children’s lives. Children who experienced the death of a family member or a
close friend or know someone with a chronic illness have more frequent nightmares than those who are only faced with stress from
school or stress from social aspects of daily life.[6] A study researching the causes of nightmares focuses on patients who have sleep
apnea. The study was conducted to determine whether or not nightmares may be caused by sleep apnea, or being unable to breathe. In
the nineteenth century, authors believed that nightmares were caused by not having enough oxygen, therefore it was believed that
those with sleep apnea had more frequent nightmares than those without. The results actually showed that healthy people have more
nightmares than the sleep apnea patients.[7] Another study supports the hypothesis. In this study, 48 patients (aged 20–85 yrs) with
obstructive airways disease (OAD), including 21 with and 27 without asthma, were compared with 149 sex- and age-matched
controls without respiratory disease. OAD Ss with asthma reported approximately 3 times as many nightmares as controls or OAD Ss
without asthma.[8] The evolutionary purpose of nightmares then could be a mechanism to awaken a person who is in danger
.

In Stephen LaBerge's book entitled Exploring the World of Lucid Dreaming (1990) he outlines a possible reason for how dreams are
formulated and why nightmares occur with a high frequency. A dream starts with an individual thought or scene, in his example he
uses the scene of walking down a dimly lit street. Since dreams are not predetermined, your brain responds to the situation by either
thinking a good thought or a bad thought, and the dream framework follows from there. Since the prominence of bad thoughts in
[9]
dreams is higher than good, the dream will proceed to be a nightmare.

There is a popular view, featured in the story A Christmas Carol, that eating cheese before sleep can cause nightmares, but there is
little scientific evidence for this.[10]

Treatment
Sigmund Freud and Carl Jung seemed to have shared a belief that people frequently
distressed by nightmares could be re-experiencing some stressful event from the
past.[11] Both perspectives on dreams suggest that therapy can provide relief from
the dilemma of the nightmare experience.

Halliday (1987), grouped treatment techniques into four classes. Direct nightmare
interventions that combine compatible techniques from one or more of these classes
may enhance overall treatment effectiveness:[12]

Analytic and cathartic techniques

Story-line alteration procedures The Nightmare (Henry Fuseli, 1781)
Face-and-conquer approaches
Desensitization and related behavioral techniques.

Post-traumatic stress disorder

Reccurring post-traumatic stress disordernightmares in which traumas are re-experienced respond well to a technique called imagery
rehearsal. This involves dreamers coming up with alternative, mastery outcomes to the nightmares, mentally rehearsing those
outcomes awake, and then reminding themselves at bedtime that they wish these alternate outcomes should the nightmares reoccur.
Research has found that this technique not only reduces the occurrence of nightmares and insomnia,[13] but also improves other
daytime PTSD symptoms.[14] The most common variations of Imagery Rehearsal Therapy (IRT) "relate to the number of sessions,
duration of treatment, and the degree to which exposure therapy is included in the protocol".[15] The medication prazosin appears
[16]
useful in decreasing the number of nightmares and the distress caused by them in people with PTSD.

Epidemiology
Fearfulness in waking life is correlated with nightmares.[17] Studies of dreams have estimated that about 75% of the time, the
emotions evoked by dreams are negative.[17] However, it is worth noting that people are more likely to remember unpleasant dreams.

One definition of "nightmare" is a dream which causes one to wake up in the middle of the sleep cycle and experience a negative
emotion, such as fear. This type of event occurs on average once per month. They are not common in children under five, but they are
more common in young children (25% experiencing a nightmare at least once per week), most common in teenagers, and common in
[17]
adults (dropping in frequency about one third from age 25 to 55).

Etymology
The word "nightmare" is derived from the Old English "mare", a mythological demon or goblin who torments others with frightening
dreams.[18] Subsequently, the prefix "night-" was added to stress the dream aspect. The word "nightmare" is cognate with the older
Dutch term nachtmerrie and German Nachtmahr (dated).

See also
Succubus
False awakening
Hag in folklore
Lucid dream
Mare (folklore)
Mora (mythology)
Moroi (folklore)
Night terror
Nightmare disorder
Nocnitsa
Sleep disorder
Sleep paralysis
Horror and terror
A Christmas Carol

References
1. Harper, Douglas. "nightmare" (http://www.etymonline.com/?term=nightmare). Online Etymology Dictionary. Retrieved
July 11, 2016.
2. Tunbridge, Lindsay (2014), International Journal of Dream Research, Vol 7 Issue 1, http://nbn-
resolving.de/urn:nbn:de:bsz:16-ijodr-119592
3. American Psychiatric Association (2000),Diagnostic and Statistical Manual of Mental Disorders
, 4th ed, TR, p. 631
4. Stephen, Laura (2006)."Nightmares" (https://web.archive.org/web/20070831193305/http://www .psychologytoday.co
m/conditions/nightmare.html). Psychologytoday.com. Archived from the original (http://www.psychologytoday.com/co
nditions/nightmare.html)on 31 August 2007.
5. Simor, Pé, et al. "Disturbed Dreaming and Sleep Quality: Altered Sleep Architecture in Subjects with Frequent
Nightmares."European Archives of Psychiatry and Clinical Neuroscience 262.8 (2012): 687-96. ProQuest.eb. W 24
Apr. 2014.
6. Schredl, Michael, et al. "Nightmares and Stress in Children." Sleep and Hypnosis 10.1 (2008): 19-25. ProQuest.
Web. 29 Apr. 2014.
7. Schredl, Michael, et al. "Nightmares and Oxygen Desaturations: Is Sleep Apnea Related to Heightened Nightmare
Frequency?" Sleep and Breathing 10.4 (2006): 203-9. ProQuest. W eb. 24 Apr. 2014.
8. "Prevalence of nightmares among patients with asthma and chronic obstructive airways disease | Request PDF"
(htt
ps://www.researchgate.net/publication/232572123).
9. Stephen, LaBerge (1990).Exploring the World of Lucid Dreaming. New York: BALLANTINE BOOKS. pp. 65–66.
10. Hammond, Claudia (17 April 2012)."Does cheese give you nightmares?"(http://www.bbc.com/future/story/20120417
-does-cheese-give-you-nightmares). BBC. Retrieved 7 October 2018.
11. Coalson 1985, Web
12. Halliday 1987
13. Davis, J. L.; Wright, D. C. (2005). "Case Series Utilizing Exposure, Relaxation, and Rescripting Therapy: Impact on
Nightmares, Sleep Quality, and Psychological Distress". Behavioral Sleep Medicine. 3 (3): 151–157.
doi:10.1207/s15402010bsm0303_3(https://doi.org/10.1207%2Fs15402010bsm0303_3) . PMID 15984916 (https://w
ww.ncbi.nlm.nih.gov/pubmed/15984916).
14. Krakow, B.; Hollifield, M.; Johnston, L.; Koss,M.; Schrader, R.; Warner, T. D.; Tandberg, D.; Lauriello, J.; McBride, L.
(2001). "Imagery Rehearsal Therapy for Chronic Nightmares in Sexual Assault Survivors with Posttraumatic Stress
Disorder: A Randomized Controlled Trial". JAMA: The Journal of the American Medical Association . 286 (5): 537.
doi:10.1001/jama.286.5.537(https://doi.org/10.1001%2Fjama.286.5.537).
15. Lu, M.; Wagner, A.; Van Male, L.; Whitehead,A.; Boehnlein, J. (2009). "Imagery rehearsal therapy for posttraumatic
nightmares in U.S. Veterans". Journal of Traumatic Stress. 22 (3): 236–239. doi:10.1002/jts.20407 (https://doi.org/10.
1002%2Fjts.20407). PMID 19444882 (https://www.ncbi.nlm.nih.gov/pubmed/19444882)., p. 234
16. El-Solh, AA (2018). "Management of nightmares in patients with posttraumatic stress disorder: current perspectives"
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263296). Nature and Science of Sleep. 10: 409–420.
doi:10.2147/NSS.S166089(https://doi.org/10.2147%2FNSS.S166089). PMC 6263296 (https://www.ncbi.nlm.nih.gov/
pmc/articles/PMC6263296). PMID 30538593 (https://www.ncbi.nlm.nih.gov/pubmed/30538593).
17. The Science Behind Dreams and Nightmares(https://www.npr.org/templates/story/story.php?storyId=15778923),
Talk of the Nation, National Public Radio. 30 October 2007.
18. Liberman, Anatoly (2005). Word Origins And How We Know Them (https://books.google.com/books?id=sMiRc-JFIfM
C&pg=PA87#v=onepage&q&f=false). Oxford: Oxford University Press. p. 87.ISBN 978-0-19-538707-0. Retrieved
29 March 2012.

Further reading
Anch, A. M.; Browman, C. P.; Mitler, M. M.; Walsh, J. K. (1988). Sleep: A Scientific Perspective. New Jersey:
Prentice-Hall.
Harris, J. C. (2004). "The Nightmare".Archives of General Psychiatry. 61 (5): 439–40.
doi:10.1001/archpsyc.61.5.439. PMID 15123487.
Husser, J.-M.; Mouton, A., eds. (2010).Le Cauchemar dans les sociétés antiques. Actes des journées d'étude de
l'UMR 7044 (15–16 Novembre 2007, Strasbourg) . Paris: De Boccard. (in French)
Jones, Ernest (1951). On the Nightmare. ISBN 978-0-87140-912-6.
Forbes, D.; et al. (2001). "Brief Report: Treatment of Combat-Related Nightmares Using Imagery Rehearsal: A Pilot
Study". Journal of Traumatic Stress. 14 (2): 433–442. doi:10.1023/A:1011133422340. PMID 11469167.
Siegel, A. (2003). "A mini-course for clinicians and trauma workers on posttraumatic nightmares" .
Burns, Sarah (2004). Painting the Dark Side : Art and the Gothic Imagination in Nineteenth-Century America .
Ahmanson-Murphy Fine Are Imprint. University of California Press.ISBN 978-0-520-23821-3.
Davenport-Hines, Richard (1999).Gothic: Four Hundred Years of Excess, Horror, Evil and Ruin. North Point Press.
pp. 160–61.
Hill, Anne (2009). What To Do When Dreams Go Bad: A Practical Guide to Nightmares. Serpentine Media.
ISBN 978-1-887590-04-4.
Simons, Ronald C.; Hughes, Charles C., eds. (1985).Culture-Bound Syndromes. Springer.
Sagan, Carl (1997). The Demon-Haunted World: Science as a Candle in the Dark .
Coalson, Bob (1995). "Nightmare help: Treatment of trauma survivors with PTSD".Psychotherapy: Theory,
Research, Practice, Training. 32 (3): 381–388. doi:10.1037/0033-3204.32.3.381.
"Nightmares? Bad Dreams, or Recurring Dreams? Lucky oYu!". Archived from the original on 19 March 2012.
Retrieved 8 December 2015.
Halliday, G. (1987). "Direct psychological therapies for nightmares: A review".Clinical Psychology Review. 7 (5):
501–523. doi:10.1016/0272-7358(87)90041-9.
Doctor, Ronald M.; Shiromoto, Frank N., eds.(2010). "Imagery Rehearsal Therapy (IRT)". The Encyclopedia of
Trauma and Traumatic Stress Disorders. New York: Facts on File. p. 148.
Mayer, Mercer (1976). There's a Nightmare in My Closet. [New York]: Puffin Pied Piper.
Moore, Bret A.; Kraków, Barry (2010). "Imagery rehearsal therapy: An emerging treatment for posttraumatic
nightmares in veterans".Psychological Trauma: Theory, Research, Practice, and Policy. 2 (3): 232–238.
 doi:10.1037/a0019895.

External links
Media related to Nightmares at Wikimedia Commons Classification ICD-10: F51.5 · D
ICD-9-CM: xxx

Night-Mares: Demons that Cause Nightmares

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