Understanding Nightmares and Dealing With Them Successfully | Dr. Michael Schredl

Nightmare Overview - Nightmares are dysphoric dreams that cause awakenings, typically occurring in the second part of the night with good recall, differentiating them from night terrors which occur in the first part of the night and are less recallable [2][3][4] - Studies indicate almost everyone experiences nightmares at some point, with 2-5% experiencing them frequently enough (once a week or more) to be diagnosed with nightmare disorder [5][6] - Nightmare disorder is characterized by frequent, distressing nightmares that cause anxiety, sleep disruption, and impaired daily routines [6] Causes and Maintenance of Nightmares - Disposition, particularly "thin boundaries" (sensitivity, creativity), stress (including trauma), and maladaptive coping strategies contribute to nightmare frequency [8][9][10][11][12] - Avoiding or pushing away nightmares is counterproductive, as it tends to increase their intensity and frequency [12][13] - Individuals with nightmares often share them with others for immediate relief, but this strategy does not change the nightmares in the long run [14] Treatment and Intervention - People with nightmares rarely seek professional help due to avoidance, stigma, and lack of awareness about effective treatments [15][16][17] - Health professionals often lack knowledge about nightmare treatment strategies, with only 30% of contacts being helpful [17][18] - Imagery Rehearsal Therapy (IRT), a cognitive therapy developed in the mid-1990s, is a simple and effective psychological approach consisting of writing/telling the dream, changing the dream scenario while awake, and rehearsing the new scenario [18][19][20][21][22][23] - IRT has been tested in 12-15 randomized controlled trials and has shown to decrease nightmare frequency, even with brief telephone counseling [25][26][27]