Scary dreams can be nerve-wracking no matter how many candles you’ve had on your birthday cake.  Even though we know they aren’t real, nightmares can still leave you feeling shaken and restless, making it difficult to fall back asleep. 

These aren’t your garden-variety bad dreams like forgetting to study for an important exam. “A nightmare is a physically and emotionally distressing dream that has the potential to disrupt your day and sleep,” says Michelle Leno, PhD, LP.

“It’s different from a bad dream in its intensity, clarity, and ability to affect you physically. You are unlikely to forget the details of a nightmare. Bad dreams, while emotionally disturbing, may be less memorable and disturbing to your sleep,” says Dr. Leno. 

A nightmare is a physically and emotionally distressing dream that has the potential to disrupt your day and sleep.


MICHELLE LENO, PHD, LP

Like all dreams, nightmares often occur in the REM (rapid eye movement) stage of sleep, when your brain is highly active while the body remains at rest.

While it’s common to have an occasional nightmare or two, sometimes they can be more frequent and disruptive, which can take a toll on your health and well-being. 

Understanding Nightmares

In order to figure out how to stop nightmares, it’s important to first look at what causes them in the first place. 

Nightmares are complex and can be caused by a number of factors such as stress, trauma, anxiety, irregular sleep schedule, and PTSD, says Jenny Flora Wells, MSW, LSW, ACSW

In some cases, it can be a symptom of underlying conditions like sleep disorders, mood disorders, borderline personality disorder, or schizophrenia. Certain medications like sedatives, amphetamines, and beta-blockers can also trigger nightmares.

Similarly, “substance use, especially withdrawal from alcohol and drugs, can cause nightmares,” says Dr. Chelsea Perry, a Massachusetts-based dentist specializing in sleep medicine and a member of the American Academy of Dental Sleep Medicine.

Occasional nightmares are usually less disruptive. Frequent nightmares, however, can cause high anxiety, poor sleep, daytime fatigue, impaired concentration, and hopelessness, says Dr. Leno. 

In the short term, “nightmares can trigger your fight-or-flight response, leading to symptoms like a racing heart, sweating, and rapid breathing,” says Gabrielle Morse, LMHC.

Identifying Personal Triggers

The good news is there are several tools and strategies that you can use to prevent nightmares and get restful sleep.

For example, a dream journal can help you identify triggers and recurring patterns or themes in your nightmares. These insights may shine a light on real-life issues (e.g., unresolved emotions or lifestyle habits) that need to be addressed. 

“It can be helpful to journal about your dream experiences to visualize on paper what themes and situations are coming up for you,” says Wells. If it’s difficult to think of your dreams in words, Wells suggests documenting them as drawings or paintings.

Because dreams tend to fade quickly after you wake up, it’s best to jot down the details of your dream and how it made you feel right after you wake up. 

It can be helpful to journal about your dream experiences to visualize on paper what themes and situations are coming up for you.


JENNY FLORA WELLS, MSW, LSW, ACSW

Secondly, reflect on any past traumas, as these might be contributing to your nightmares. If you find it difficult or overwhelming, consider seeking trauma-focused therapy, suggests Dr. Perry. 

Other than that, review any medications you may be taking to see if nightmares are listed as a known side effect. Consult your doctor if needed, Dr. Perry advises. 

In addition, watch your alcohol and caffeine intake, as they can also impact your sleep quality. 

Establishing a Relaxing Bedtime Routine

Creating a calming bedtime routine can also help reduce nightmares and improve sleep quality, says Dr. Perry. Here are some tips from the experts:

  • Turn the lights down low: Dr. Perry recommends keeping the bedroom dark, quiet, and comfortable to promote sleep. “Consider using a white noise machine or blackout curtains to enhance the environment,” she says.
  • Try breathing exercises or relaxation techniques: If you’re still finding it difficult to unwind, Morse suggests progressive muscle relaxation and diaphragmatic breathing. She also encourages engaging your senses through soothing sounds and calming scents. 
  • Avoid watching TV or using your phone at bedtime. “This can stimulate the brain rather than help you move into a relaxed state,” says Morse.
  • Mind your meals: According to Dr. Perry, what you eat can also influence your sleep. “Heavy or spicy foods consumed close to bedtime can disrupt digestion and affect our sleep cycles,” she says. 
  • Relax your mind: Similarly, what’s on your mind before going to bed may also impact your sleep quality. “Working on mentally demanding assignments right before bed may cause you to feel too preoccupied and unable to relax, and this unrest can trigger a nightmare,” Dr. Leno explains. 
  • Create a consistent sleep-wake schedule: Another important thing to keep in mind is that you’ll sleep better if you go to bed and wake up around the same time every day, even on weekends, says Dr. Perry.
  • Avoid working from bed when possible. “When people work in bed, it’s harder to sleep and clear the mind,” says Morse. This is because your brain starts associating your bedroom with work instead of rest. 

Managing Stress and Anxiety

Controlling your stress and anxiety levels is also crucial for preventing recurring nightmares

“Anything you can do to help promote relaxation and emotional regulation during the day and right before bed is useful,” says Madeline McKeon, PhD, a NYC-based clinical psychologist. Think breathwork, yoga, nature walks, journaling, guided meditation, gratitude lists, etc. 

If you’re going through a particularly stressful period, consider reaching out to a loved one or talking to a therapist.

One thing that is unlikely to help is thought suppression or avoiding negative and distressing thoughts, says Dr. McKeon. “Suppressed thoughts are actually more likely to manifest during dreams,” she points out. 

Promoting Healthy Sleep Habits

While there’s no one-size-fits-all solution, adopting better sleep habits can be helpful all around, both physically and mentally. Below, founder and CEO of End No Sleep, Nancy Bosnoian, shares three best practices for a good night’s sleep:

  • Stay away from blue light: Blue light from your electronic devices interferes with melatonin production, decreasing sleep quality and duration. Consider avoiding bright blue light at least 30 minutes before bedtime. If keeping your phone out of the bedroom is too hard initially, try easing into the habit by slowly cutting down your daily screen time.
  • Avoid stimulants like caffeine and alcohol: Try to avoid caffeine after 2 p.m. and any alcohol before bedtime. “Many people say it helps them fall asleep, or they don’t see any changes in how fast they fall asleep. However, even if you don’t see immediate changes, it can affect your sleep quality,” says Bosnoian. Instead, engage in relaxing activities such as reading, taking a warm bath, or practicing breathing exercises to unwind, suggests Dr. Perry.
  • Get moving: Research shows regular exercise may improve sleep quality and symptoms of sleep disorders. Even walking for just 30 minutes is a good place to start.

Remember that change takes time. For building long-term habits and achieving sustainable results, Bosnoian suggests incorporating one strategy at a time rather than trying to overhaul everything at once. 

Coping Techniques During Nightmares

“The best response to nightmares is regulating your nervous system back to a sense of safety,” says Wells. Here are five coping techniques to help you regain calm and control when you’re jolted awake by a nightmare:

  • Somatic awareness: Wells recommends practicing somatic awareness every day, even for just two minutes. Somatic awareness is a mindfulness activity that helps calm the nervous system by directing your attention to what your body is experiencing. All the sensations, signals, movements, thoughts, and emotions coming to the surface—without judgment and suppression.
  • Reality testing: This technique helps you determine whether what you perceive or fear is based on objective reality or influenced by what you saw or experienced in the dream. 
  • Havening touch: It’s a gentle, psycho-sensory technique that involves self-soothing touch (e.g., touching your face or hugging your shoulders) to calm stress and anxiety, Wells explains.
  • 4-7-8 method: Breath in for four seconds, hold the breath for seven seconds, and exhale for eight seconds. Breathing exercises like the 4-7-8 method activate the parasympathetic nervous system, which promotes rest, counteracting the stress response triggered by the nightmare.
  • Grab something cold: You can use ice cubes, an ice pack, or even take a cold shower, suggests Wells. This grounding exercise helps take your mind off of the distressing experience, bringing it to the present moment instead.

Seeking Professional Help

It’s time to speak with a healthcare provider or a mental health professional when:

  • the nightmares are persistent
  • they are causing a fear of going to sleep
  • they are disrupting your mood and ability to function
  • your coping techniques don’t seem to be helping

While treatment approaches vary from person to person, standard treatment options for recurring or severe nightmares include medication such as antidepressants and antipsychotics and psychotherapy, particularly CBT-based techniques like exposure therapy and desensitization.

Psychotherapy offers opportunities to develop better coping skills and emotional regulation. It can also alleviate nightmares by helping you understand and work through emotions and conflicts that are contributing to those nightmares, says Dr. McKeon. 

Another psychotherapy technique that’s used for treating nightmares is imagery rehearsal therapy (IRT). It involves rewriting the script of a typical nightmare to make the dream more neutral or even triumphant. 

For example, if you dream of being chased by a giant spider, you might rewrite the dream so that you become a giant and easily squash the spider. “You rehearse this new dream script several times a day while also practicing relaxation exercises to manage any related distress. The idea is that over time, you can actually change the dream and make it less distressing,” Dr. McKeon explains. 

Conclusion

While an occasional nightmare isn’t typically a cause for concern, recurring or frequent nightmares can significantly impact one’s quality of sleep and, consequently, quality of life. Stress, anxiety, and trauma are among the key factors that can contribute to nightmares. The good news is there’s help available. Improving sleep hygiene, maintaining a consistent sleep schedule, and practicing relaxation techniques like somatic awareness can make a big difference. For persistent nightmares, treatment options like exposure therapy and imagery rehearsal therapy have shown promising results.




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