What causes nightmare disorder?

Updated: Aug 08, 2018
  • Author: Daniel R Neuspiel, MD, MPH, FAAP; Chief Editor: Caroly Pataki, MD  more...
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Developmental, genetic, psychological, and organic factors can contribute to occurrence. A high prevalence of parasomnias in early childhood has been associated with separation anxiety. [5]

Multiple studies have demonstrated that a child’s general level of anxiety is related to nightmare severity and frequency. [3]

Approximately 7% of individuals who have frequent nightmares have family history of nightmares.

Nightmares are more common in children with mental retardation, depression, and CNS diseases; an association has also been reported with febrile illnesses.

Medications may induce frightening dreams, either during treatment or following withdrawal. Withdrawal of medications that suppress REM sleep, including tricyclic antidepressants and selective serotonin reuptake inhibitors, can lead to an REM rebound effect that is accompanied by nightmares.

Nightmares are associated with anxiety disorders, particularly in adolescents. [11]

Daytime emotional conflicts and psychological stress often contaminate sleep and predispose the child to nightmares.

Nightmares may result from a severe traumatic event and may indicate posttraumatic stress disorder.

In a mainly female adult sample from the United Kingdom, nightmare occurence was associated with higher levels of worry, depersonalization, hallucinatory experiences, paranoia, and sleep duration. Nightmare severity was associated with higher levels of worry, depersonalization, hallucinatory experiences, and paranoia. [12]

In a Finnish adult population, depression and insomnia were the strongest risk factors for nightmare frequency. [13]

Nightmares may be more frequent during pregnancy. [14]

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