Nightmare Disorder Symptoms and Treatment

Nightmare disorder (दुःस्वप्न विकार) is a sleep disorder characterized by repeated intense nightmares that most often center on threats to physical safety and security. The nightmares usually occur during the REM stage of sleep, and the person who experiences the nightmares typically remembers them well upon waking. More specifically, nightmare disorder is a type of parasomnia, a subset of sleep disorders categorized by abnormal movement or behavior, or verbal actions during sleep or shortly before or after. Other parasomnias include sleepwalking, sleep terrors, bedwetting, and sleep paralysis. Nightmare disorders can be confused with sleep terror disorders. The difference is that after a sleep terror episode, the patient wakes up with more dramatic symptoms than with a nightmare disorder, such as screaming and crying. Furthermore, they don’t remember the reason for the fear, while a patient with a nightmare disorder remembers every detail of the dream. Finally, sleep terrors usually occur during NREM Sleep.

Nightmare disorder Meaning

It is a pattern of repeated frightening and vivid dreams that cause significant distress or impaired functioning. Nightmare disorder is one type of parasomnia, which are behavioral sleep abnormality.

Nightmare disorder Symptoms

Increased heart rate and anxiety

During the nightmare, the sleeper may scream and yell out things. The nightmare sufferer is often awakened by these threatening, frightening dreams and can often vividly remember their experience. Upon awakening, the sleeper is usually alert and oriented within their surroundings, but may have an increased heart rate and symptoms of anxiety, like sweating. They may have trouble falling back to sleep for fear they will experience another nightmare.

Trouble going through everyday tasks

A person experiencing nightmare disorder may have trouble going through everyday tasks; anxiety and lack of sleep caused by fearful dreams may hinder the individual from completing everyday tasks efficiently and correctly. Upon experiencing this, these nightmare sufferers may consult with a psychiatrist.

Recurring episodes of awakening

The sleeper may have recurring episodes of awakening while recalling the intensely disturbing dream manifestations which usually result from fear or anxiety, but can also be triggered by anger, sadness, disgust, and other dysphoric emotions. Additionally, the sleeper may experience at least one of the following two features: the delayed return of going back to sleep after episodes and having episodes in the latter half of the sleep period.

Consequences of Nightmare Disorder

Nightmare disorder is common: it affects about 4% of the adult population. Even if children have more nightmares than adults, only 1% of children meet the criteria for the disorder. Nightmare disorder can impair the quality of life for people who are affected by the condition. It can make the patient avoid sleep, which leads to sleep deprivation, which in turn may lead to even more intense nightmares. Some other consequences of the nightmare disorder are fatigue and insomnia.

Nightmare disorders have negative consequences on several aspects of the patient’s life, such as sleep, cognitive and emotional functioning, and well-being. Nightmares can also have a negative impact on the bed partner’s life.

Content of idiopathic nightmares

Physical aggression is the main theme of nightmares. Other fields, such as interpersonal conflict, failure, helplessness, apprehension, being chased, accidents, evil forces, disasters, insects and environmental abnormalities may also feature in nightmares. Fear is the most frequent emotion associated with nightmares, even if other emotions such as sadness, anger, and confusion can also be present.

Nightmare disorder Criteria

According to the International Classification of Sleep Disorders, the criteria needed to diagnose a nightmare disorder are the following: 

• First, the presence of frequent nightmares that imply danger for the person and impact mood in a negative way is needed.
• Second, when waking up from nightmares, the person behaves in an alert way.
• Finally, the disorder has to have a significant impact on the patient’s personal, social, or professional functioning, in areas like mood, sleep, cognition, behaviour, fatigue, family, and occupation.

Nightmare disorder Causes

Extreme pressure or irritation

Nightmares can be caused by extreme pressure or irritation if no other mental disorder is discovered. The death of a loved one or a stressful life event can be enough to cause a nightmare but conditions such as post-traumatic stress disorder and other psychiatric disorders have been known to cause nightmares as well. 

Medication

If the individual is on medication, the nightmares may be attributed to some side effects of the drug. Amphetamines, antidepressants, and stimulants like cocaine and caffeine can cause nightmares. Blood pressure medication, levodopa, and medications for Parkinson’s disease have also been known to cause nightmares.

Psychiatric disorders

The nightmares may be idiopathic or could be associated with psychiatric disorders like post-traumatic stress disorder, schizophrenia, and borderline personality disorder. Nightmares can also be triggered by:

• Stress and anxiety,
• Substance abuse, such as drugs that affect the neurotransmitters norepinephrine and dopamine, and serotonin.
• Nevertheless, the causality between drugs such as beta-blockers or alpha-agonists and nightmares is still unclear and further research needs to be done to investigate the biochemical mechanisms of nightmares.

Eighty percent of patients who have PTSD (Post-Traumatic Stress Disorder) report nightmares. Patients with PTSD have symptoms that are classified into three clusters: intrusive/re-experiencing, numbing, and hyperarousal. Nightmares are usually considered to be part of the intrusive/re-experiencing symptom.

Nightmare Disorder Risk Factors

In some cases, it may seem that there is no explanation for why some people are prone to nightmares and others are not. While nightmares may sometimes be related to mental health conditions, this is not always true. Nightmare disorder does not appear to have a genetic link and does not consistently run in families.

Some factors that may increase a person’s risk of nightmare disorder include:

Poor Sleep Habits

Factors that influence a person’s overall ability to sleep restfully may be related to the experience of nightmares. These nightmare disorder risk factors include excessive stress, experiencing a traumatic event, or frequent disruption of sleep. Other sleep disorders, such as restless leg syndrome or sleep apnea, may make nightmares more likely by causing sleep disruptions.

Substance Use and Medications

Some medications and substances may cause nightmares. For example, selective serotonin reuptake inhibitors (SSRIs) and alcohol impact REM sleep and trigger nightmares during the withdrawal period.

Thinking Style

A person who tends to work excessively may be more likely to experience nightmares. This is due to the repetitive negative thoughts associated with worrying, especially if it occurs near bedtime.

Dissociation

Someone who avoids consciously dealing with stressors through dissociation has an increased risk of experiencing nightmares.

Assessment of Nightmare Disorder

Polysomnography records physiological parameters, such as electroencephalography (EEG), electromyography (EMG), and electrooculography (EOG) in a sleep laboratory. However, the frequency of posttraumatic nightmares tends to decrease in an artificial lab setting, which would impact the content of nightmares. Consequently, the assessment of nightmare disorders using polysomnography has to last for a longer period, in order to let the patient get used to the artificial environment.

Self-report by a questionnaire or by a diary is another way to investigate nightmare disorders. However, these methods are questionable. Indeed, when filling out questionnaires with questions about a long period, people often tend to underestimate the frequency of their nightmares because of forgetting. On the contrary, filling out a diary every day may lead to an overestimation of the number of nightmares, because of the focus on this phenomenon.

Nightmare disorder Comorbidity

Studies have reported that nightmare disorders were present in 50- 70% of the cases for PTSD, in 17.5% for depression, in 18.3% for insomnia, in 16.7% for schizophrenia, and in 49% for borderline personality disorder. For all psychiatric disorders taken together, nightmare disorders are present in 29.9% of the cases, a much bigger rate than for the general population, which is 2-5%.

Nightmare disorders can also be associated with sleep disorders such as night terrors, chronic insomnia, and sleep-disordered breathing. The presence of nightmares before a trauma would influence the severity of PTSD symptoms. Furthermore, having nightmares is linked to a significantly higher risk of attempting suicide and of death by suicide.

Nightmare disorder Treatment

Stress reduction techniques such as yoga, meditation, and exercise may help to eliminate stress and create a more peaceful sleeping atmosphere.

Recurring nightmares

Diagnosis and medication can only be given to patients that report recurring nightmares to a psychiatrist or other physician. Medications like prazosin are sometimes used to treat nightmares in people with PTSD. Therapy usually helps to deal with the frightening themes of the nightmares and alleviate the recurrence of the dreams. The persistent nightmares will usually improve as the patient gets older.

Therapy is usually efficient to treat chronic nightmares in PTSD disorder or in other populations. Medication has shown efficacy to treat chronic nightmares among a PTSD population but the impact of pharmacological treatments on other populations, such as drug-related nightmares, is unknown. Furthermore, patients usually take more than one medication at a time, whatever the cause related to nightmares, leading to possible interactive effects.

Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing (EMDR) has been demonstrated a significant nightmares reduction, especially for the treatment of PTSD. Silver, Brooks, and Obenchain have found a decrease in the nightmares of Vietnam War veterans after 90 days of EMDR.

Jayatunge has found significant results with people who have survived a tsunami. Greenwald has successfully used the EMDR with children. There wasn’t any negative consequence due to the EMDR sessions.

Imagery rehearsal therapy

Imagery rehearsal therapy has been shown as efficient to treat nightmare disorder in PTSD as well as in non-PTSD populations. In this treatment, the person has to write a new scenario of the nightmare with positive images that will be rehearsed for 10 to 20 minutes per day, in order to change the negative content of the nightmare. 

Cognitive behavioral therapy for insomnia (CBT-I) is also efficient to treat nightmares in the PTSD population. This method aims to change sleep habits with a clinician’s help and the use of tools such as a sleep diary.

Exposure, relaxation, and rescripting therapy

Exposure, relaxation, and rescripting therapy are used to treat PTSD-related nightmares. This intervention combines Imagery Rehearsal Therapy with exposure and relaxation techniques. The main objective is to work on the trauma-related themes of nightmares.

Research has been undertaken to investigate if sufferers of nightmares could benefit from the ability to be aware that they are indeed dreaming, a process known as lucid dreaming. Lucid Dreaming Therapy is a specific method of Imagery Rehearsal Therapy. 

Systematic Desensitization

Systematic Desensitization, using graduated exposure, has been shown to be efficient to treat chronic nightmares. The person has to face the frightening elements of nightmares in a gradual way, from the less to the most stressful. When the person starts to feel insecure, she has to manage the stress by applying a relaxation technique.

Pharmacological Treatments for Nightmare Disorder

Pharmacological treatments could be also efficient to treat nightmare disorders. Most of the treatments were assessed for patients with PTSD. The most efficient is an alpha-blocker, Prazosin, which reduces tone during sleep by blocking noradrenergic receptors. Prazosin would significantly decrease the number of PTSD-related nightmares and would therefore improve sleep quality.

However, only a few studies considered the effect of Prazosin on idiopathic nightmares. Benzodiazepines are also often used to treat nightmare disorders, despite the lack of efficacy demonstrated in empirical studies. Some patients were also treated with atypical antipsychotic medications. Olanzapine has quickly decreased nightmares. Two studies have shown the positive effects of Risperidone. Aripiprazole is more tolerated than olanzapine and has demonstrated substantial improvement in the nightmare frequency. 

Nightmare disorder Epidemiology

About 4% of American adults are affected by nightmare disorders. Women seem to be more affected than men, the ratio being 2-4: 1. This inequality decreases with aging because of a less high prevalence in elderly women. However, it is still unclear if the difference in prevalence between men and women is real or if it reflects a higher dream recall capacity of women.

According to studies, children at the age of 6–10 years are 41% more likely to experience nightmares and 22% at the age of 11. Children with persistent nightmares range from 10% to 50%. However, only 1% of children meet the criteria of a nightmare disorder. Some factors tend to predict the development of a disorder from the presence of nightmares during childhood, such as a fear of going to sleep or going back to bed after a nightmare, an irregular sleep life, and an avoidance of thinking about the nightmare.

Nightmare disorder Research

• People with Dissociative Disorder and Nightmare disorder are more likely to self-mutilate, attempt suicide, and have Borderline Personality Disorder.
• Borderline personality disorder with Nightmare Disorder is very common since the stages of sleep vary from that of a normal person (i.e. increased stage one sleep, and less stage four sleep). People with Borderline Personality Disorder and Nightmare Disorder are usually the severest of those who have Borderline Personality Disorder; therefore, treating those with Nightmare Disorder may also help some with Borderline Personality Disorder.
• Hypnosis seems to be a new and effective treatment for those with Nightmare Disorder since it increases relaxation.
• This connection is unclear; however, cholesterol may affect other hormones in the body (such as serotonin) which may affect one’s sleep.

Siddha remedies for Nightmare disorder

1. Siddha Preventive Measures

Everybody must practice Siddha preventive measures, whether affected by Nightmare disorder or not, but they are the primary steps for switching on to any other Siddha energy remedies, and hence they are important. It helps in one’s capability, effectiveness, productivity, decision-making power, intellectualism, and removing minor health problems.

Earthing, Field Cleaning, and Siddha Brain Exercise/Energizing are three types of preventive measures. Everybody’s tendency is to get attracted toward the word ‘free‘, however, don’t neglect even these Siddha preventive measures are free. Avail of the benefits by practicing them regularly. For ease of understanding of Siddha preventive measures, please watch a video for a live demonstration.

2. Siddha Shaktidata Yoga

This unique Siddha Shaktidata Yoga can solve problems related to Nightmare disorder with free Siddha energy remedies. Training in ‘Swami Hardas Life System’ methods is not a compulsion, but it would help achieve faster results. This not only gives benefits to self but also can be used for other affected persons, whether a person is in the same house, distantly available in the same city, same nation, or maybe in the corner of the world, however, both procedures have been explained here.

3. Siddha Kalyan Sadhana

Recite this Sadhana with a Sankalp “My Nightmare disorder problems are solved as early as possible and I should gain health”, which should be repeated in mind 3 – 3 times after each stanza. Any person irrespective of caste, creed, religion, faith, sex, and age can recite this Sadhana for free, which should be repeated at least twice a day. To know more about it, please click on this link.

4. CCPE products for Nightmare disorder

These products work on the concepts of ‘Conceptual Creative Positive Energy’ (CCPE) within the provisions of ‘CCPE Life System’ and the theory of Quantum Technology to a certain extent. However, the products get activated only whenever touched by a human and then they become capable of solving the problem and achieving health.

The use of CCPE products, being Energy Therapy, is one of the most effective free Siddha energy remedies for persons, who could not undergo training in Siddha Spirituality of Swami Hardas Life System.  However, please use these products for Nightmare disorder problems as mentioned below:

CCPE Extractor

The CCPE Extractor should be gently moved over the Agya Chakra in a circular motion for at least 30 to 60 seconds, thereafter, follow the same process on the head for another 30 to 60 seconds, which will convert negativity into positivity. This is how the process of using extractor finishes within almost 2 – 3 minutes. It is so simple.

CCPE Booster

Keep one Booster over the Agya Chakra and another over the head for 3 to 5 minutes. You may need to have 2 Boosters and the process would finish within almost 3 – 5 minutes, which establishes positivity. This is how the process of using CCPE Booster finishes within almost 3 – 5 minutes. It is so simple.

Wrapping boosters in a thin cloth and tying them around the head overnight to achieve faster results is permissible but after the use of the CCPE Extractor as explained above.

5. UAM

UAM (Understanding, Awakening & Movement): It is an energy-based process that can be applied by persons who have undergone training for touch therapy. One should have attended a minimum age of 18 years to avail of this golden opportunity. A desirous person can undergo training-process irrespective of caste, creed, religion, faith, and sex. Trained persons can follow the tips explained below for how to apply these free Siddha energy remedies:

• Touch therapy – UAM/leveling as per the symptoms of the disease
• Distant therapy – Siddha Shaktidata Yog, Sight healing
• Sankalp therapy – Siddha Kalyan Sadhana, Vishwa Kalyan Sadhana
• Energy therapy – Use of CCPE products e.g. CCPE Extractor, Booster, and Booster powder
• There are various reasons behind health, peace, and progress-related problems, but effective free Siddha energy remedies would help solve all of them.

Training of Swami Hardas Life System

Any problem with regard to health, peace, and progress can be solved independently without money and medicines by undergoing training in Swami Hardas Life System. Any person irrespective of religion, caste, creed, faith, sex, and age can undergo this unique training.

A daily routine for Nightmare disorder

In general, a daily routine to manage the problem may look like this:

• Perform Siddha Preventive Measures in the morning soon after you wake up
• After taking a bath, do brain exercise (energizing), and Siddha Kalyan Sadhana
• Do regular breathing exercises
• With the help of CCPE Extractor, Boosters apply the remedy as explained above
• Do light exercises routinely
• Adopt the Sattvik diet in your daily life
• Practice guided imagery
• Follow healthy lifestyle
• Before going to bed, repeat Siddha Kalyan Sadhana and remedies as suggested

And be sure to sprinkle in some fun during the day: Don’t forget to relax and laugh in between. Laughing is a great way to boost your immune system.

Along with all the above activities, apply free Siddha energy remedies minimum 3 times a day, the more is good. Just try methods of Siddha Spirituality of Swami Hardas Life System, and I am confident that you will surely find improvements within 15 days.

Conclusion 

In view of the above, I am confident that you have learned the basics of what is Nightmare disorder, its symptoms, consequences, criteria, causes, assessment, treatment, and Siddha remedies without money and medicines. As a bonus, you also learned free Siddha energy remedies. Now is the right time to use acquired knowledge for solving related problems for free. Hence, please undergo training, learn Siddha energy remedies, and apply them instantly to get or give instant relief to the needy.

Frequently asked questions

Before posting your query, kindly go through the:

What is Nightmare Disorder?   It is a pattern of repeated frightening and vivid dreams that cause significant distress or impaired functioning. Nightmare disorder is one type of parasomnia, which are behavioral sleep abnormality.

Which are the criteria for Nightmare Disorder? According to the International Classification of Sleep Disorders, the criteria needed to diagnose a nightmare disorder include: First, the presence of frequent nightmares that imply danger for the person and impact mood in a negative way is needed. Second, when waking up from nightmares, the person behaves in an alert way. Finally, the disorder has to have a significant impact on the patient’s personal, social, or professional functioning, in areas like mood, sleep, cognition, behaviour, fatigue, family, and occupation.

How to Treat Nightmare Disorder? Stress reduction techniques such as yoga, meditation, and exercise may help to eliminate stress and create a more peaceful sleeping atmosphere.

Reference: https://en.wikipedia.org/wiki/Nightmare_disorder