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Sleep Disorders

Frequent Nightmares

03/20/2009

Question:

I am a survivor of many occasions of sexual abuse. Since I have accepted that I was sexually abused at younger ages, rather than bottling it up and pushing it away, I have started having frequent nightmares. They are always very vivid, almost "flashback" like sequences of the abuse, and I wake up in the middle of the night, crying and shaking, and it normally leads to an anxiety attack. Sometimes these nightmares are worse some nights than others. I have these nightmares a few times a week.

My boyfriend has told me that before my episodes, I twitch in my sleep, toss and turn, and make a "muffled sound that almost sounds like crying".

When I wake up from these nightmares, I normally feel extremely panicked. These nightmares are really starting to take a toll on me. What is wrong, and what can I do to fix these things?

Answer:

The answer to your question contains parts that have been posted previously at our web site. However, your question in particular needs further elaboration on nightmares.

Parasomnias are undesirable events that take place during sleep or during the transition between wake and sleep. Stressful vivid dreams are considered nightmares and qualify as parasomnias.

Many conditions that disrupt sleep may lead to us remembering our dreams. A sleep disrupter can be an environmental or a physiological factor. Environmental factors can be an uncomfortable bed, loud noises, excessive lights, a warm room, a disrupting bed partner, or sharing the bed with pets or children. Physiological factors include periodic limb movement disorders, nocturnal seizures, sleep disordered breathing, or taking substances that affect sleep like tobacco, caffeine and over the counter sleep aids.

Usually, there is no clinical abnormality in people who have vivid dreams or nightmares. Also, no specific treatment is indicated since these parasomnias are usually situational and self limited. Cognitive therapy, hypnosis, relaxation therapy, and sleep medications have shown no benefit in treating these conditions. But your history of physiological trauma seems to be contributing to the content, the severity, and the frequency of your nightmares and such treatment options may prove beneficial. In particular, psychological counseling and cognitive therapy with a technique known as guided imagery may be helpful for you.

An evaluation by a Sleep Specialist is indicated. This will uncover any underlying sleep problems that may be contributing or worsening your nightmares. If such conditions are discovered, then treatment oriented to those problems will have significant benefit for you.

Until then, some general methods that may help you with your dreams include:

Additional information regarding sleep, and a listing of sleep centers near you, is available on the web at the American Academy of Sleep Medicine. I wish you happy dreams.

For more information:

Go to the Sleep Disorders health topic, where you can:

Response by:

Ziad  Shaman, MD Ziad Shaman, MD
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University