Nightmares: Something to Frightened

The word nightmare has less to do with wild horses than many artistic interpretations would have us believe. The term is in fact derived from "night" plus the Old English meaning evil spirit.

Nightmares most commonly affect children, but about half of all adults have occasional nightmares and about one in a hundred adults suffers from nightmares once a week. Nightmares are really just bad dreams. Like ordinary dreams, they occur during REM sleep, late in the period of sleep, during which the body muscles are paralysed. On waking up, the sufferer is immediately aware of his or her surroundings and can often recall the nightmare in detail.

Night terrors are rather different. They affect fewer than one in thirty children, most commonly those aged two to six, and fewer than one in a hundred adults. They usually occur within the first two hours of going to sleep. Sufferers normally scream and appear to be terror-stricken. They may thrash about in bed or sit bolt upright, and they do not respond to touch or speech during the night terror.
After a night terror, sufferers will normally have little recall of the event, except possibly for a feeling of falling or choking, for example. Parental concern for a child who suffers from night terrors may cause the child more anxiety than the night terrors themselves. Doctors recommend seeking medical advice if they persist for longer than about three months.

Sleepwalking is closely related to night terrors in that it occurs during the deepest stage of non-REM sleep when the muscles are not paralysed. A sleepwalker gets up and walks about, eyes open, and may utter meaningless phrases. Sleepwalkers are hard to waken - the best strategy is to guide them gently back to bed without waking them up. People who go straight from stage four sleep to wakefulness have a propensity to sleepwalk.

Sleepwalking should not be dismissed lightly. Sleepwalkers have been known to injure themselves severely. Anyone who sleepwalks, or whose children sleepwalk, should take measures to reduce the risk of accidents by, for example, fitting bars on upstairs windows, stair gates and locks on doors.

Causes of Nightmare disorder

Personality disorders

Relationship difficulties

Other stressors

Drugs, for example, levodopa, beta-adrenergic drugs, and withdrawal of REM-suppressing medications Sleep terror disorder

Fever

Sleep deprivation (lack of sleep)

CNS depressant medications

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Nightmares: Something to Frightened

Causes of Nightmare disorder