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Nightmares and PTSD
Nightmares are dreams that are threatening and scary. Nearly everyone has had a nightmare from time to time. For trauma survivors, though, nightmares are a common problem. Along with flashbacks and unwanted memories, nightmares are one of the ways in which a trauma survivor may relive the trauma for months or years after the event.
How common are nightmares after trauma?
Among the general public, about 5% of people complain of nightmares. Those who have gone through a trauma, though, are more likely to have distressing nightmares after the event. This is true no matter what type of trauma it is.
Those trauma survivors who get PTSD are even more likely to complain of nightmares. Nightmares are one of the 17 symptoms of PTSD. For example, a study comparing Vietnam Veterans to civilians showed that 52% of combat Veterans with PTSD had nightmares fairly often. Only 3% of the civilians in the study reported that same level of nightmares.
Other research has found even higher rates of nightmares. Of those with PTSD, 71-96% may have nightmares. People who have other mental health problems, such as panic disorder, as well as PTSD are more likely to have nightmares than those with PTSD alone.
Not only are trauma survivors more likely to have nightmares, those who do may have them quite often. Some survivors may have nightmares several times a week.
What do nightmares that follow trauma look like?
Nightmares that follow trauma often involve the same scary elements that were in the trauma. For example, someone who went through Hurricane Katrina may have dreams about high winds or floods. They may dream about trying to escape the waters or being in a shelter that does not feel safe. A survivor of a hold-up might have nightmares about the robber or about being held at gunpoint.
Not all nightmares that occur after trauma are a direct replay of the event. About half of those who have nightmares after trauma have dreams that replay the trauma. People with PTSD are more likely to have dreams that are exact replays of the event than are survivors without PTSD.
Lab research has shown that nightmares after trauma are different in some ways from nightmares in general. Nightmares after trauma may occur earlier in the night and during different stages of sleep. They are more likely to have body movements along with them.
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Nightmares and cultural differences
Nightmares may be viewed differently in different cultures. For example, in some cultures nightmares are thought to mean that the dreamer is open to physical or spiritual harm. In other cultures, it is believed that the dreams may contain messages from spirits or may forecast the future. These beliefs may lead those with nightmares to use certain practices in an effort to protect themselves.
Are there any effective treatments for posttraumatic nightmares?
Nightmare symptoms often get better with standard PTSD treatment. If nightmares persist, there are treatments that can reduce how often they occur.
One treatment is Imagery Rehearsal Therapy (IRT). In IRT, the person who is having nightmares, while awake, changes how the nightmare ends so that it no longer upsets them. Then the person replays over and over in their minds the new dream with the non-scary ending. Research shows that this type of treatment can reduce how often nightmares occur.
Also, treatment for breathing problems that occur during sleep may reduce the nightmares that follow trauma. High levels of sleep-disordered breathing have been seen in trauma survivors. In one study, patients given a treatment to improve their breathing during sleep no longer had violent, scary dreams.
Little research exists on the use of medicines to treat nightmares from trauma. The medicine with the most promise is prazosin. Two studies have found that prazosin reduces nightmare symptoms. More research on prazosin is under way.
"Nightmares and PTSD." National Center for PTSD. 20 Dec. 2011.
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Adenoids and Tonsils
Tonsillitis is a contagious infection with symptoms of bad breath, snoring, congestion, headache, hoarseness, laryngitis, and coughing up blood.
Tonsillitis can be caused acute infection of the tonsils, and several types of bacteria or viruses (for example, strep throat or mononucleosis). There are two types of tonsillitis, acute and chronic. Acute tonsillitis lasts from one to two weeks while chronic tonsillitis can last from months to years.
Treatment of tonsillitis and adenoids include antibiotics, over-the-counter medications, and home remedies to relieve pain and inflammation, for example, salt water gargle, slippery elm throat lozenges, sipping warm beverages and eating frozen foods (ice cream, popsicles), serrapeptase, papain, and andrographism Some people with chronic tonsillitis may need surgery (tonsillectomy or adenoidectomy ).
AnxietyAnxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
InsomniaInsomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Loss, Grief, and BereavementGrief is the feeling one experiences after a loss (of a friendship, death of loved one, job). Complicated grief refers to grief that lasts for more than a year. Mourning describes the customs and rituals that help a bereaved individual make sense of their loss.
Mental Illness in ChildrenAbout 5 million children and adolescents in the U.S. suffer from a serious mental illness such as eating disorders, anxiety disorders, disruptive behavior disorders, pervasive development disorders, elimination disorders, learning disorders, schizophrenia, tic disorders, and mood disorders. Symptoms of mental illness include frequent outbursts of anger, hyperactivity, fear of gaining weight, excessive worrying, frequent temper tantrums, and hearing voices that aren't there. Treatment may involve medication, psychotherapy, and creative therapies.
Panic DisorderPanic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizziness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Posttraumatic Stress Disorder
Post-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include nightmares, flashbacks, sweating, rapid heart rate, detachment, amnesia, sleep problems, irritability, and exaggerated startle response. Treatment may involve psychotherapy, group support, and medication.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. The National Institutes of Health recommend about 7-9 hours of sleep each night for older, school-aged children, teens, and most average adults; 10-12 for preschool-aged children; and 16-18 hours for newborns. There are two stages of sleep; 1) REM sleep (rapid-eye movement), and 2) NREM sleep (non-rapid-eye movement). The side effects of lack of sleep or insomnia include:
- Feeling sleepy during the day
- Concentration or memory problems
Lack of sleep and insomnia can be caused by medical conditions or diseases, medications, stress, or pain. The treatment for lack of sleep and insomnia depends upon the cause.
Sleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. OSA is caused by the collapse of the airway during sleep. OSA is diagnosed and evaluated through patient history, physical examination and polysomnography. There are many complications related to obstructive sleep apnea. Treatments are surgical and non-surgical.
Take the Sleep QuizTake our Sleeping Quiz to learn which sleep disorders, causes, and symptoms rule the night. Trouble falling or staying asleep? Find out which medical treatments fight sleep deprivation, apnea, insomnia, and more!
SleepwalkingSleepwalking is a condition in which an individual walks or does other activities while asleep. Factors associated with sleepwalking include genetic, environmental, and physiological. Episodes of sleepwalking may include quiet walking to agitated running. Conditions that may have similar symptoms of sleepwalking, but are not include night terrors, confusional arousals, and nocturnal seizures. Treatment of sleepwalking generally include preventative measures. Medication may be prescribed if necessary.