Nightmares are often defined as “repeated occurrences of prolonged, extremely dysphoric, well-remembered dreams that typically involve threats to survival, safety, or bodily integrity” and can wake you up – according to a 2019 study by US researchers and French on lucid dreaming published in the Swiss journal Frontiers in Psychology.
“About 25 times a year, on average, a person will experience what is called a nightmare. These dreams cause fear and anxiety in the dreamer. They are not out of the ordinary and are experienced by almost everyone at one time or another,” says Tharaka Rani Sreekumar, a clinical psychologist at Abu-Dhabi-based NMC Specialty Healthcare.
According to a 2014 study by Canadian researchers from Sleep, the official journal of the World Society for Sleep Research, the most common types of nightmares are those that feature physical aggression, pursuit, interpersonal conflict, abnormality environment, an evil presence, accidents, disasters. / calamity, failure or helplessness, insects / vermin, health problems, apprehension or worry, and others.
Dr Mohamed Elshafei, a neurologist at Zulekha Hospital, Dubai, says: “There is a very important difference between nightmares or dreams that occurred during the REM phase where a person can remember most of the details, and night terrors – patients only know they’ve woken up. during sleep time with a scary story or scary experience.
When we dream
“Usually, our sleep goes through two major major stages – the non-rapid eye movement (NREM) stage, this is the first stage, and then the rapid eye movement (REM) stage. By definition, dreams occur during the REM phase,” says Dr. Mohamed Elshafei, a neurologist at Zulekha Hospital in Dubai.
REM stages occur on average three to five times per night.
9 reasons why we have nightmares
Although we often link our nightmares to events in our lives, the truth is that medications, illnesses, or actions that disrupt our REM sleep stage can all contribute to it. Here are some reasons that may increase your risk of nightmares:
1. Fear, stress and anxiety disorders
“If your brain is very active, thinking, worrying about a condition or apprehending something, your brain will turn that into images and stories in dreams,” says Dr. Elshafei.
A 2004 study by American researchers and published in Behavioral Sleep Medicine, the official journal of the Society of Behavioral Sleep Medicine in the United States, found that people with generalized anxiety disorder had significantly more bad dreams than those who didn’t. didn’t have any.
Indeed, visual images in dreams also include recent memories, images and experienced emotions – as explained by one of the main scientific theories behind our dreams. Pioneering dream researchers Allan Hobson and Robert McCarley had proposed a neuroscience-based activation synthesis explanation for dreaming, where dreams are electrical brain impulses randomly pulling images and thoughts from our brains.
2. Trauma and post-traumatic stress disorder
“Recurrent nightmares are a diagnostic symptom of post-traumatic stress disorder – memories in the form of flashbacks or nightmares,” says Dr. Tulika Shukla, a Dubai Health Authority-certified psychiatrist at Millennium Medical Center.
A 2009 study by American researchers and published in the journal “Sleep Medicine Clinics” found that 80% of people studied with PTSD had frequent nightmares, and another 2000 study published in Comprehensive Psychiatry showed that 60% of people studied who developed PTSD said they had nightmares before the trauma.
“Most of the time I’ve found that when there are issues in a person’s life – for example, PTSD, accidents, strokes, violence or childhood trauma – all of that can also lead to nightmares in the person’s life,” says Sreekumar.
3. Certain medications such as antidepressants, anti-anxiety medications and steroids
“Some antidepressants especially and anti-anxiety drugs, and some proton pump inhibitors that are overused now for gastritis, some blood pressure medications, it can affect stage two sleep, which is the main stage of sleep “So it can affect the dream history and you might have new dreams that weren’t present in the past. This should be analyzed,” says Dr. Elshafei.
A 2003 review study by American researchers and published in the journal Human Psychopharmacology: Clinical and Experimental, found that “pharmacological agents affecting the neurotransmitters norepinephrine, serotonin, and dopamine are clearly associated with patients’ reports of nightmares”.
• Beta-blockers : These are drugs that slow the heart rate and lower blood pressure.
• Some antidepressants – Selective serotonin reuptake inhibitors, which affect the neurotransmitter serotonin, including paroxetine, have been linked to increased nightmares.
• Certain medications for Alzheimer’s disease: Donepezil (Aricept) and rivastigmine (Exelon). A 2005 study published by German researchers in the journal Der Nervenarzt, a German journal for neurologists and psychologists, found a “clear” relationship between the occurrence of nightmares and an evening dose of donepezil in patients with type 1 dementia. Alzheimer’s (DAT), not a morning dose. They explain that this may be because activation of the visual association cortex during REM sleep is enhanced by the drug.
• Certain steroids: Prednisone, methylprednisone, according to GoodRx Health, a US-based healthcare information provider.
• Certain antihistamines – Diphenhydramine (Benadryl), Cetirizine, Loratadine, Fexofenadine, Chlorpheniramine, Doxylamine, according to GoodRx Health.
4. Suffering from migraines
A 2008 study by US researchers published in the Journal of Head and Face Pain showed that migraine patients had more persistent childhood nightmares than those without the disease, but a 2021 review of previous studies in the field for the International journal Behavioral Science concluded that nightmares sometimes accompany migraines.
5. Later in life, the onset of parkinsonism, Parkinson’s disease, a type of dementia
“Some dreams, especially recurring bad dreams, are linked to certain medical conditions like Parkinsonism,” says Dr. Elshafei.
According to a 2011 review article by University of Montreal researcher Tore Nielsen, titled “Disturbed Dreams as a Factor in Medical Conditions,” REM sleep behavior disorder (during which “vivid and often frightening dreams” are played by patients while they sleep) is known to show before the onset of Parkinson’s disease, and a type of dementia.
6. Sleep deprivation and insomnia
According to the Mayo Clinic, “schedule changes that cause irregular sleeping and waking times or that interrupt or reduce the amount of sleep you get may increase your risk of having nightmares.”
It may also include taking stimulants such as caffeine or a snack just before bed.
In fact, a survey of almost 14,000 people in Finland published in the journal Sleep in 2015 found that symptoms of depression and insomnia were the best predictors of frequent nightmares in the data set.
7. Horror movies and books
This one certainly isn’t surprising, especially if you watch the movie before bed and get an extreme reaction to it. The latest study on the effects of horror movies – a 2021 study published in the Global Mass Communication Review that studied teenagers in a town in Punjab, India, found that on average, 52% of teenagers studied did always have nightmares after a horror movie and 20 percent more have experienced it sometimes.
In a 1999 study by American researchers and published in the journal Media Psychology, 90% of university students studied showed a “lasting fear effect”.
8. Presence of sleep apnea
“Nightmares may be associated with the presence of apneas and hypopneas during REM sleep,” according to a 2019 study by Saudi researchers and published in the Swiss journal Frontiers in Neurology.
9. Nightmarish Disorder
“If there is continuous night terror or continuous nightmares, especially if it affects sleep – when the patient is afraid to sleep, in this situation there may be intervention,” says Sreekumar.
Nightmare disorder occurs when your dreams cause you intense distress and affect your adequate sleep, according to the Mayo Clinic. If you experience this, you should consult a doctor.
Nightmares have been shown to decrease well-being, and if yours are seriously affecting you, seek professional help.