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Nightmares
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Nightmares can be a chronic mental health problem for some individuals, but it is not yet clear why they plague some people and not others. One thing that is clear is that nightmares are common in the early phases after a traumatic experience. However, research suggests that most people who have PTSD symptoms (including nightmares) just after a trauma will recover without treatment. This typically occurs by about the third month after a trauma. However, if PTSD symptoms (including nightmares) have not decreased substantially by about the third month, these symptoms can become chronic. If you have been suffering from nightmares for more than 3 months, you are encouraged to contact a mental health professional and discuss with him or her the behavioral treatments described above.
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Nightmares are a type of sleep disruption, or parasomnia, characterized by frightening psychological content. Nightmares provoke a feeling of imminent physical danger with a sensation of being trapped or suffocated. These frightening dreams occur during rapid eye movement sleep (REM), or dream-time sleep, and trigger a partial or full awakening. Nightmares are a universal human experience occurring throughout the lifespan. They are especially common in early childhood and involve activation of the limbic brain, particularly the area that mediates negative emotion.
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Nightmares that occur after the patient has experienced trauma or stress may lead to an interpersonal integration of the event. On the other hand, long-term persistence (the habitual pattern of recurrent nightmares not associated with recent trauma) can cause a decline in daytime functioning without apparent benefit.
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Nightmares refer to complex dreams that cause high levels of anxiety or terror. In general, the content of nightmares revolves around imminent harm being caused to the individual (e.g., being chased, threatened, injured, etc.). When nightmares occur as a part of PTSD, they tend to involve the original threatening or horrifying set of circumstances that was involved during the traumatic event. For example, someone who was in the Twin Towers on September 11 th, 2001, might experience frightening dreams about terrorists, airplane crashes, collapsing buildings, fires, people jumping from buildings, etc. A rape survivor might experience disturbing dreams about the rape itself or some aspect of the experience that was particularly frightening (e.g., being held at knifepoint).
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Nightmares are greatly influenced by the particular stressors and anxieties present in the child's waking life. Typical childhood nightmares include dreams of abandonment; of being lost; of falling; or being chased, bitten, or eaten by a monster or hostile animal. Dream researchers have observed a developmental progression in the content and frequency of children's nightmares. A two-year-old dreamer may recall a fearful dream, but be unable to give form to the source of the threat. By the age of five, the frightened young dreamer may identify the attacker as a monster or wild animal. Older children who have developed more of an understanding of real-life dangers report dreams of pursuit by mean or bad people.
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Nightmares shouldn't be confused with night terrors, a less common sleep disturbance that normally strikes during the first third of the night. Children having a night-terror episode remain fast asleep throughout, in a deep, nondreaming state, yet they're extremely agitated and hard to console. Afterward, they go back to snoozing soundly and don't remember the incident in the morning.
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