Nightmares are dreams that cause a person to feel anxious or afraid. Nightmares can wake the sufferer from sleep. Nightmares can be experienced by all age groups, including children and adults. However, this condition is most often experienced by children.
During sleep, a person will experience 2 phases, namely the non-REM phase (non-rapid eye movement) and the REM phase (rapid eye movement). The sleep cycle begins with a non-REM phase and is followed by a REM phase, each of which lasts 90–100 minutes. Nightmares usually occur in the REM phase, which is between midnight and early morning.
Nightmares are often also referred to as nightmares or parasomnia is a common condition and experienced by almost everyone. But in some cases, nightmares can be disturbing, especially if they occur too often or cause sleep disturbances and stress.
Causes of Nightmares
Until now, it is not known exactly what causes nightmares. However, there are allegations that nightmares are related to genetic factors, psychological factors, physical abnormalities, disorders in the process of growth and development, and disorders of the central nervous system.
Although the cause is unknown, there are several conditions that are known to trigger nightmares, including:
- Stress and anxiety, for example due to activities at school or work, sadness due to the death of a close person, or fear of being left by someone
- Trauma, for example from injury, accident, bullying, and physical or sexual abuse
- Sleep disorders, such as narcolepsy, insomnia (insomnia), sleep apnea, and restless legs syndrome (restless leg syndrome)
- Side effects of medications, such as antidepressants, beta blockers, hypertension medications, Parkinson's medications, or sleeping pills
- The habit of snacking, reading a book, or watching a horror movie before going to bed
- Other illnesses, such as depression, post-traumatic stress disorder (PTSD), cancer, and heart disease
- Consumption of alcoholic beverages and drug abuse
Nightmares risk factors
Nightmares can be experienced by anyone, but are more common in children aged 3-6 years. At that age, the child's imagination is very active. In addition, nightmares are also more common in people with a family history of having frequent nightmares.
Nightmare Symptoms
Nightmares usually occur in the middle of the night before morning. These nightmares can have very varied themes, ranging from meeting strange creatures, falling, being kidnapped, to being chased. The frequency of nightmares varies, they can be rare, frequent, even several times a night.
Nightmares can cause the person experiencing them to feel angry, afraid, sad, anxious, or guilty. This feeling can continue to be experienced even though the person who has a bad dream has woken up from his sleep.
Dreams can be categorized as nightmares if there are the following characteristics:
- It seems clear, real, and causes the person experiencing it to be disturbed, anxious, sad or angry when remembering it
- Associated with threats to personal safety or survival, or other disturbing themes
- Causes people who experience it to sweat and palpitate during sleep
- Until it causes people who experience it to wake up and be able to recall their dreams in detail
- Makes people who experience it difficult to go back to sleep
Although including things that are experienced by everyone, nightmares can be categorized as a nuisance if:
- Often occurs
- Causes drowsiness, tiredness, and lethargy during the day
- Causes difficulty concentrating and remembering
- Causes sufferers to keep thinking about bad dreams
- Causes anxiety and fear when going to sleep
- Causes behavioral disturbances, such as fear of dark rooms
- Affects daily activities, for example causing a decrease in quality while studying or working
When to go to the doctor
Occasional nightmares are normal, so there's no need to worry. Consult a doctor if nightmares are accompanied by characteristics that can be categorized as a disorder, as described above.
Nightmare Diagnosis
The doctor will ask questions about the nightmares experienced, the drugs being consumed, the patient's medical history, and the patient's family history of nightmares. Doctors may also perform follow-up examinations, such as:
- Mental examination, to find out if the nightmares experienced are related to mental disorders, such as anxiety disorders
- Polysomnigraphy or recording of sleep activity, to determine if nightmares are related to another sleep disorder
The polysomnigraphy procedure is performed by measuring the patient's heart rate, brain waves, respiratory rate, blood oxygen levels, and the movement of the patient's hands and feet during sleep.
Nightmare Treatment
Occasional nightmares are nothing to worry about. However, if the nightmares are frequent, and cause you or your child to be depressed and affect daily activities, treatment is necessary.
Treatment of nightmares is done by addressing the cause. If the nightmare is caused by a side effect of medication, the doctor will prescribe another type of medication as a substitute.
If the nightmares are caused by a mental disorder or sleep disorder, treatment methods include:
- Medications, such as prazosin and selective serotonin reuptake inhibitors (SSRI)
- Psychotherapy, such as cognitive behavioral therapy, image rehearsal therapy, and visual-kinesthetic dissociation
- Relaxation techniques, such as meditation, yoga, and deep breathing (deep breath therapy)
Nightmare Complications
Nightmares can result in the following complications:
- Mood disorders, anxiety disorders, or depression
- Excessive sleepiness during the day, thus interfering with activities
- Restless when going to sleep, for fear of repeating bad dreams
- Suicide or attempted suicide
Nightmare Prevention
There are several ways that can be done to help with treatment while reducing the risk of nightmares, namely:
- Exercise at least 3 times a week
- Set the same time to sleep and wake up every day
- Set a comfortable atmosphere in the bedroom
- Avoid taking sedatives
- Limiting consumption of alcoholic and caffeinated beverages
- Listening to music that can make yourself more relaxed
- Avoid using smartphone or other electronic devices before bed
- Read a book or write a plan for tomorrow to distract your mind from nightmares
- Discuss nightmares with family or friends to reduce anxiety