Nightmares

Alternative names:

bad dreams

Home care:

For nightmares resulting from the effects of drugs or alcohol, discontinue use. For persistent alcohol problems, join an Alcoholics Anonymous group and attend regularly (see alcoholism - support group). Also, reassess lifestyle--friends, work, family--to identify and alter factors that encourage substance abuse.

For nightmares resulting from anxiety or stress, follow a regular energetic fitness routine, using aerobic exercises if possible. Learn techniques to reduce muscle tension (relaxation therapy).

Avoid long-term use of tranquilizers, and avoid caffeine and other stimulants.

Call your health care provider if:

• nightmares persists longer that 6 weeks or remain unexplained.

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination performed.

Medical history questions documenting nightmares in detail may include:

• time pattern
  • Do the nightmares occur repeatedly (recurrent)?
  • Do they occur in the second half of the night?

• quality
  • Is there a sudden full awakening from sleep?

• associated complaints
  • Does the nightmare cause intense fear and anxiety?
  • Is there memory of a frightening dream (one with vivid visual imagery and story-like plot)?

• aggravating factors
  • Has there been a recent illness?
  • Has there been a fever?
  • Has an emotionally stressful situation occurred recently?

• other
  • Is alcohol used? How much?
  • What medications are used?
  • Are "street drugs" being taken? Which?
  • What other symptoms are also present?

Physical examination may included a physical, neurological, and psychological examination.

Diagnostic tests that may be performed include:

• blood tests (such as CBC or blood differential)
• liver function tests
• EEG

After seeing your health care provider:
You may want to add a diagnosis related to recurrent nightmares to your personal medical record.