Racing heart, sweaty palms and being jolted awake with an acute sense of stress and fear — it sounds like a scary movie scene, but it’s actually what often occurs when someone experiences a nightmare.
“Nightmares are unsettling dreams usually associated with feelings of anxiety or fear that awakens you from sleep and sometimes include abnormal movements, behaviors, emotions or perceptions,” says Raj Dasgupta, M.D., sleep expert and assistant professor of clinical medicine at Keck School of Medicine of USC and host of The Dr. Raj Podcast. “They’re a type of parasomnia, so it goes beyond just a bad dream; nightmares are very vivid and can be easily rememberable even after waking, and they may also cause you to develop other sleep issues, such as insomnia.”
So what’s the difference between a bad dream and a nightmare? It crosses the threshold into nightmare disorder when these nighttime episodes occur frequently and disrupt your daytime functioning, either due to lingering feelings of angst from what occurred in dreamland, or from lack of sleep due to awakenings or insomnia developed over a fear of falling asleep.
“After a bad dream, you realize it wasn’t real and have a sort of positive reaction to that realization. Whereas with nightmares there’s a residual reaction that usually involves negative feelings or emotions,” says Christopher Winter, M.D., sleep specialist and neurologist and host of Sleep Unplugged with Dr. Chris Winter.
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What causes nightmares?
There are a few things that can hike the likelihood of experiencing nightmares or trigger one. “Stress and sleep deprivation are two common ones that tend to go hand-in-hand. If you’re stressed you may be sleep-deprived, and if you’re sleep-deprived, that can contribute to you feeling stressed out — and both of those can increase the chances of having a nightmare,” explains Alicia Roth, Ph.D., clinical health psychologist who specializes in behavioral sleep medicine at Cleveland Clinic.
Nightmares can be exhausting and may feel like a hopeless situation when peaceful sleep is always under threat — but there are steps you can take to help tame the dream beast. Try these tips to stop nightmares, so you can snooze sounder at night.
How to get rid of nightmares
Get a full-body workup.
Sometimes there’s an underlying condition that may be causing your nightmare issues, so uncovering and treating it may be the fix you need. “For instance, something like sleep apnea may be lowering the quality of your sleep (which is a nightmare trigger), but there are ways to treat that. And people who have mental health disorders such as anxiety, depression, post-traumatic stress disorder and more tend to have a higher rate of nightmares than people without these conditions,” Dr. Dasgupta adds.
Try positive imagery therapy.
It’s a tactic that many sleep experts recommend for patients experiencing nightmare-related insomnia, and you can do it right from the comfort of your home before bed. “Insomnia in people with nightmares can be unique because it’s the result of the nightmare, you dread going to sleep so it becomes an aversive experience versus a nice and comfy one that most people enjoy,” Roth says. “I work with them on working out their positive imagination muscle.”
One of the basic techniques is to walk yourself through an imaginary nature scene that brings you peace and comfort — perhaps the beach or a majestic mountainscape. Focus on the visuals, sounds you’d hear and even scents you’d smell if you were really there. “It’s not always about getting rid of the bad stuff that appears in your nightmares, it’s about adding in good, positive images for your brain to consume,” adds Roth.
The much sought-after sleepytime hormone, melatonin, may help put you to sleep but end up causing nightmares, especially in people prone to them. Science tells us that melatonin can increase the amount of time we spend in REM (rapid eye movement) sleep stage, so sleep experts say it makes sense that the likelihood of experiencing nightmares would also go up. “REM sleep is almost like being awake, and that plays a role in why the dreams (or nightmares) that we have during that time are so much more vivid,” explains Dr. Dasgupta.
Explore lucid dreaming.
It sounds trippy, but it’s actually possible to be dreaming … and realize that you’re dreaming in the moment. “Some people can learn the technique of lucid dreaming, where you start to develop an awareness during the dream that may allow you to modify it,” Dr. Winter says. “I taught myself how to do in just a couple of weeks, but a sleep specialist can also help you; this helps you exert dream control and gives you more of a sense of stability in terms of dreaming.”
Find ways to wind down.
Since one of the biggest nightmare triggers is stress, finding ways to keep a handle on it during the day may help you out at night. “Nightmares sometimes result from us trying to solve problems in our sleep — this is the brain’s rehearsal system at work in the night, so too much daytime stress can lead to nightmares when you go to bed,” says Alex Dimitriu, M.D., founder of Menlo Park Psychiatry & Sleep Medicine in California. Find activities that keep you calm and make them a regular part of your daily routine. Try things like meditation, yoga, walking or other exercise, a hot bath before bed or scheduling a few minutes of quiet “me time” where you wind down from the day. “You need some sort of buffer zone between your day and when it’s time to sleep,” Roth adds. “A wind down routine helps your body understand that it’s nearing bedtime, just like when we were kids.
Have a bedtime snack.
If your blood sugar drops too low while you’re sleeping, that can cause a nightmare, says Jacob Teitelbaum, M.D., an integrative medical expert. How can you tell if nighttime “hanger” is to blame for your bad dreams? One good clue is if you feel “hangry” during the day. Dig into a small bedtime snack that includes protein and carbs but is low in fat, sodium and sugar.
Stick to a sleep schedule.
Maintaining a regular sleep schedule seven days a week (yes, weekends, too!) is key to getting enough shuteye, and in turn, staving off nightmares. “Having a haphazard sleep schedule or traveling, two things that mess with your circadian rhythm, can cause nightmares to occur,” says Dr. Winter. Go to bed and wake up at the same time each day and aim to get seven to eight hours of sleep each night. Finding a routine that works —putting away electronic devices 30 minutes before bed or reading a few chapters of your book — can help make drifting off to sleep easier.
Nix the nightcap.
Alcohol might make you sleepy, but it (and other substances like drugs) can actually lead to nightmares, says Dr. Dasgupta. Avoid sipping wine, beer, liquor and other spirits close to bedtime and instead rely on other tricks, like a soothing cup of hot tea or 10-minute meditation, to quiet your mind.
Examine your medicine cabinet.
Depression and anxiety can be a nightmare trigger, but so can some of the drugs often prescribed to treat those conditions, such as SSRI (selective serotonin response inhibitors)— in fact, SSRI may actually intensify dreams, says Michael Breus, Ph.D., clinical psychologist, diplomat of the American Board of Sleep Medicine, and Fellow of the American Academy of Sleep Medicine. Other drugs to treat blood pressure or help you sleep may also cause nighttime distress. Talk to your doctor about alternative medications or adjusting your dose to see if that helps.
And never stop taking a medication without consulting with your doctor first; the withdrawal your body’s pushed into when certain meds aren’t tapered properly may end up triggering nightmares, Dr. Dasgupta says.
Try rewriting your nightmares.
We can’t always remember our bad dreams, even if we emotionally or physically react to them — but if you can recall what you dreamt about, image-rehearsal therapy may help reduce nightmares the next time you sleep. The idea is to recast your nightmare into a happier, more peaceful script, says Dr. Dasgupta. For example, if you were running down a dark path as a threat got closer and closer, perhaps your new scenario features you walking down a quiet wooded path with your loyal dog trotting along behind you.
Schedule “worry time.”
By now you know that stress, anxiety, and depression can trigger nightmares. One trick that may help you keep a handle on them is to carve out time to feel and experience those negative thoughts and emotions — that way you don’t bring them with you into bed. “Journal or problem solve for 20-30 minutes hours before bedtime to get it all out ahead of time so it doesn’t happen at night,” says Dr. Dimitriu.
Avoid scary things.
This might seem obvious, but watching a frightening movie or reading a scary book can lead to nightmares, so consider taking a break or hitting pause to see if they stop. “This sounds silly but it’s not! I’ve watched a scary movie and then definitely had a nightmare that night!” says Dr. Dasgupta.
Alyssa is a senior editor for the Hearst Health Newsroom, where she has written research-backed health content for Prevention, Good Housekeeping and Woman’s Day since 2017. She has more than 13 years of reporting and editing experience and previously worked as research chief at Reader’s Digest, where she was responsible for the website’s health vertical as well as editing health content for the print magazine. She has also written for Chowhound, HealthiNation.com, Huffington Post and more.