What is the pathophysiology of nightmare disorder?

Updated: Aug 08, 2018
  • Author: Daniel R Neuspiel, MD, MPH, FAAP; Chief Editor: Caroly Pataki, MD  more...
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Sleep is divided into 2 distinct states: rapid eye movement (REM) and nonrapid eye movement (non-REM). REM and non-REM sleep alternate in 90- to 100-minute cycles. REM sleep is characterized by EEG activity similar to a wakeful pattern. In older children and adults, 75% of sleep is non-REM sleep, which consists of 4 stages.

Dreaming and nightmares occur during REM sleep, and they are more frequent in the second half of the night.

Nightmares are often confused with night terrors, which are episodes of extreme panic and confusion associated with vocalization, movement, and autonomic discharge. Night terrors occur during non-REM sleep. Children with night terrors are difficult to arouse and console and do not recall a dream or nightmare.

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