Ask an Expert: Nightmares of Family Dying, Out of Nowhere?

Sleep Disorders

Nightmares of Family Dying, Out of Nowhere?
10/29/2009

Question:

For the last couple of weeks I have been having nightmares. They mostly are with-in the first 3hrs I`m asleep. Nothing has changed in my life, I eat the same, been taking the same meds. They scare me so bad, that I get up crying. My dreams are always of death of myself or my family. One of my dreams I was trying everything I could to kill myself(Which is weird because Im not that kind of person.) another one, our car broke down and my son push the stroller (with my daughter in it) Into the middle of the freeway.. another one.. My husband, myself, and my kids were in the mountains, so one was hiding in the bushes, jumped out and started killing us. These dreams come out of no where.. I wake up cold, shaking, and scared.. I dont even want to fall asleep any more.. Im out of ideas on what it could be.

Answer:

It sounds like this is quite troubling to you and you are right to seek help. Without further information, I can’t give you an exact diagnosis, but based on the information you have provided, it sounds as though you have developed a nightmare disorder in the last few weeks. It’s also possible that these could be the result of anxiety or panic attacks, or the manifestation of another primary sleep disorder, such as obstructive sleep apnea or narcolepsy. OSA and narcolepsy are usually associated with excessive sleepiness during the daytime.
It would be a good idea to discuss your problems with your physician and possibly consider a referral to a sleep specialist if needed. I’ll address some issues about nightmares in general, and then talk about some simple conservative measures that may improve your sleep and, in some cases, can help to reduce the nightmares.
The onset of nightmares can be the result of a number of different factors, though most commonly they are associated with a traumatic event. Nightmares can also result from increased stress or conflict in life. Even if medications haven't changed, changes in doses may lead to changes in your sleep and could precipitate nightmares. Of course the use or withdrawal from certain substances, such as alcohol or illicit drugs, can bring on nightmares.
It’s a good idea to ensure one has good sleep habits to decrease the tendency to have fragmented sleep as this may contribute to the nightmares. Good sleep hygiene includes,
1. Caffeine

This is a stimulant and is present in coffee, tea, soda, and chocolate.

It can delay falling asleep and interfere with the ability to stay asleep.

Avoid several hours before bedtime.

2. Nicotine (tobacco)

This is a stimulant- Smokers have more sleep problems than non-smokers.

Avoid smoking several hours before bedtime.

3. Alcohol

It may help you fall asleep initially but you will have more restless sleep and awakenings the second half of the night.

Chronic daily alcohol use can decrease the quality of sleep over time.

No alcohol 4 hours before bedtime

4. Diet

Hunger can cause wakefulness- Eat a light snack before bed.

Being too full can cause wakefulness.

5. Exercise

Being active during the day can help improve sleep.

Exercise three times a week for 20-30 min

Late afternoon/ early evening is the best time to facilitate sleep.

6. Bedroom Environment

The bedroom should be dark, quiet, and comfortable

Avoid watching TV, reading, using the computer or doing other activities other than sleep in the bedroom as these can actually prolong your ability to fall asleep. Do these activities in a different room and only use the bedroom for sleep. This way you can train your brain to associate your bedroom with rapid sleep only.

7. Bedtime Routine

The bedtime routine actually starts before you get into bed. If you are running around and active right before you get into bed, you may be too stimulated to sleep.

You need to decrease your mental activity before sleep. Those with insomnia tend to have ruminating thoughts as they are trying to fall asleep and have trouble shutting their mind off for sleep.

In the early evening, take 20 min to write down the events of day and how you feel. Make a to do list for the next day.

When it is bedtime remind yourself you already have dealt with the things you need to do or think about

If new thoughts come- write them down on a paper by your bed and deal with it the next day

Give your self an hour to hour and half to relax before sleep. Stop all activity and do something relaxing.

For more information:

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Response by:

Meena S Khan, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
Clinical Assistant Professor of Neurology
College of Medicine
The Ohio State University