If you suffer from nightmares, you no doubt wonder how to diagnose their cause -- and what nightmare treatments may be available. Nightmares are not considered a disorder needing treatment unless they are recurrent and cause significant difficulty getting back to sleep, resulting in insomnia. Fortunately, there are effective treatment options available, including medications and therapy.
Potential Causes of Nightmares
If nightmares do become problematic, the first step is to identify and eliminate any of the potential causes, including:
- Non-REM parasomnias
- Sleep-disordered breathing (i.e., sleep apnea)
- Post-traumatic stress disorder (PTSD)
- Sleep terrors
- REM behavior disorder
- Sleep paralysis
By addressing these underlying causes, it is possible that no further evaluation or treatment will be necessary.
How to Diagnose Nightmares
In some cases, it may be necessary to undergo a standard sleep study called a polysomnogram. This study is slightly modified to include additional brain wave measurements. This expanded electroencephalogram (EEG) identifies possible seizure activity as a contributor to the nightmares.
Nightmare treatment may require the assistance of a sleep or mental health specialist. The medication prazosin has been used in adults with PTSD who have nightmares, but it has not been studied in children. In addition, it may be helpful to undergo therapy, such as:
Finally, the use of certain medications to suppress REM sleep can also be effective. These include medications for anxiety and depression, such as selective serotonin reuptake inhibitors and tricyclic antidepressants.
If you suffer from recurrent nightmares that are disruptive to your sleep and your life, you may wish to start by talking with your health care provider about some of the options available to you.
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Raskind, MA et al. "Reduction of nightmares and other PTSD symptoms in combat veterans by prazosin: a placebo-controlled study." Am J Psychiatry 2003;160(2):371-373.