Treatment
Treatment of nightmares, as cataloged by the DSM-5:
Support from friends and relatives can help if you are suffering stress. Witnessing or experiencing trauma may affect you in other areas of functioning. Consulting a mental health professional is recommended. Sharing your feelings whether with family, friends, or a therapist may help you better cope with the events that may be disturbing you. In addition, your physical health may need attention, regular exercise and consistent sleep hygiene are helpful. With physical activity, you may fall asleep faster, and enjoy a deeper sleep. Other helpful tips include relaxation therapy to reduce muscle tension and lessen anxiety.
A new medication may also be a culprit. Discussing prescription drugs with you physician or health practitioner may be required. Discontinuing medication and trying alternatives may be needed.
Substances to limit or avoid altogether may include: tranquilizers, alcohol, caffeine, other stimulants, especially at bedtime.
However, substance or alcohol abuse must be addressed. Seeking help through regular therapy or support groups such as Alcoholics Anonymous may help.
If you suffer nightmares more than weekly, contact your physician or health professional. Call your health-care provider if they occur more often than weekly, or if they prevent you from getting a good night’s rest and persist for a prolonged period. Your medical history and a physical exam may be needed.
Here are some medical history questions that may be included:
- Is there a time pattern to the nightmares?
- Are nightmares recurrent?
- Do they occur in the first or second half of the night?
- Are you suddenly fully awake from sleep?
- Do you feel intense fear and anxiety after the nightmare?
- Do you remember the imagery, the plot?
- Have you been recently ill?
- Did you have a fever?
- Did you experience a stressful incident?
- What is, if any, your alcohol intake?
- Do you take medications?
- Do you use street drugs? If so, what do you use?
- Do you take natural supplements or alternative medicine remedies?
- Do you suffer other symptoms?
The physical exam may include neurological and psychological assessments, blood tests, an EEG, as well as tests for liver and thyroid function.
If all possible above causes are ruled out, assessment by a sleep specialist may be required. The specialist may need to give a polysomnography, a test used to diagnose sleep disorders.
Here are some tips to regain sleep:
- Adhere to a routine and schedule every night and morning
- Sleeping at the same time each night can help
- Avoid sleeping in
- Limit caffeine and alcohol
- Do not smoke
- Relax before bed
- Exercise daily
- Wake with the sun
- Avoid lying in bed while awake
- Sleep in a cooler temperature
Call your health-care provider if the problem persists. Sleep disorders can be treated with the right help.
