Recurring Nightmares: Causes, Treatments, & How to Cope

What Are Recurring Nightmares?

Experiencing an occasional nightmare is common. However, when these disturbing, vivid dreams occur repeatedly over a long period of time, they become recurring nightmares. Recurring nightmares impact children more often than adults and can leave the dreamer feeling anxious, upset, and angry. In these nightmares, the dreamer also has a clear vision of things that are anxiety-provoking and distressing to see or think about.

A recurring nightmare doesn’t have to be the exact same dream every night. Often, they carry a similar theme but with varying content. However, a recurring nightmare will leave the sleeper feeling the same emotions upon waking, such as guilt, anger, or anxiety. The impact of these sleep disruptions can be hard to manage, as it can be challenging to get back to sleep. Left untreated, recurring nightmares can lead to other physical and mental health issues.¹

Nightmares Vs. Night Terrors

Unlike nightmares, which are a normal part of sleeping and dreaming, night terrors are a parasomnia or a sleep disorder where people can talk, scream, or move around while still asleep. Additionally, the two sleep experiences happen at different stages of the sleep cycle. While nightmares tend to occur during sleep’s rapid eye movement (REM) phase, later in the night, night terrors occur during the deepest stage of non-rapid eye movement (NREM) sleep, known as N3. Recurrent nightmares may also be a symptom of parasomnia and may need an in-depth evaluation to determine treatment options.²

• Nightmare disorder: A mental health condition, nightmare disorder is marked by recurrent nightmares that are vivid and memorable upon waking, feeling stressed upon waking, and leading to ongoing daytime distress.
• Night terrors: This is a sleep-related issue, not a diagnosis, in which one may experience physical and verbal reactions due to the distressing dream in the night terror. These happen in non-REM sleep stages and can be very difficult to wake up from.

What Causes Recurring Nightmares?

Nightmares are still not well understood. Although scientists and experts have examined why we dream for many years, there isn’t a consensus on their cause or purpose. However, recurring nightmares are believed to result from an existing mental health condition, like post-traumatic stress disorder (PTSD), or as a way for the brain to process stressful events that occurred while awake. A family history of parasomnia can also increase the dreamer’s risk of having recurring nightmares.

Some potential causes of recurring nightmares and nightmare triggers include:

• Traumatic experiences in childhood: Nightmares are a symptom of PTSD as a trauma response. PTSD is one of many mental health conditions linked to nightmares. Other mental health issues include depression, anxiety, and bipolar disorder. Enduring childhood trauma can also be the culprit of recurring nightmares.
• Negative thoughts and emotions: Disorders such as PTSD, depression, and bipolar disorder can lead to recurring nightmares as these can stir up negative emotions and past trauma or fear that can play out in your sleep.
• Chronic stress and anxiety: Chronic stress in your waking hours can increase your likelihood of experiencing a nightmare while asleep.
• Sleep deprivation: REM rebound, which happens when a person temporarily has a higher percentage of their sleep in REM stage due to sleep deprivation, can be linked to nightmares as many nightmares tend to happen in REM sleep.
• Medications: Nightmares can be a side effect of some medications, including selective serotonin reuptake inhibitors (SSRIs).
• Substance misuse: Use of substances can lead to recurring nightmares as drugs and alcohol can disrupt the normal sleep cycle and lead to changes that can trigger recurring nightmares.
• Medical conditions: Medical conditions such as narcolepsy or sleep apnea can disrupt sleep cycles.
• Family history of recurring nightmares: A family history of recurring nightmares is also linked to a predisposition to nightmares.
• Sleep disorders: Sleep disorders like insomnia or restless legs syndrome can cause irregular sleeping times, or interrupted sleep, increasing your risk of experiencing nightmares.³

What Are the Most Common Recurring Nightmare Themes?

It can be hard to understand why recurring nightmares occur. Nightmares can be triggered by numerous things and they emerge during times of rest. Recurring nightmares follow several themes, sometimes revolving around some type of threat or lack of safety and security.

Common themes of recurring nightmares include:

• Death
• Being chased
• Falling endlessly
• Flying uncontrollably
• Trapped in embarrassing or shameful situations with no escape
• Missing a critical life event
• Losing control of a vehicle
• Losing teeth
• Health problems
• Threats
• Uncomfortable situations in school (long after being out of school)
• Loss of a loved one
• Natural disasters ⁴

Impacts of Recurring Nightmares

While nightmares can happen to anyone, having recurring nightmares can really negatively impact your quality of life. Having these can be related to an untreated mental health condition such as depression, PTSD, and anxiety, especially if they are happening multiple times a week. It can leave you struggling throughout the day and leave you unable to show up in your relationships and commitments.

Negative effects of recurring nightmares include:

• Sleep deprivation: Excessive time spent in REM sleep can lead to recurring nightmares.
• Worsening PTSD symptoms: Trauma response can be exacerbated by a lack of sleep due to an inability to process complex memories.
• Worsening depression symptoms: Low mood can be profound when there is lack of sleep or healthy sleep due to recurring nightmares.
• Relationship issues: Recurring nightmares can lead to issues during the day with friends and family, as the nightmare can be so disturbing it can stay with you all day. To add, given that there is often a struggle to get back to sleep after a recurring nightmare, it can leave you feeling exhausted and impatient.
• Worsening anxiety symptoms: Lack of sleep can trigger anxiety as the part of the brain that processes problems wasn’t well rested due to the nightmare.⁵

How to Stop Recurring Nightmares: 9 Tips

Unfortunately, there is no cure or solution to control or stop recurring nightmares. This lack of control can be especially distressing since recurring nightmares are disruptive to sleep and daytime functioning. But there are some helpful tips to improve sleep and potentially reduce the frequency of nightmares.

Here are 9 tips for coping with recurring nightmares:

1. Keep a regular sleep schedule: A consistent sleep schedule helps your body fall asleep faster and achieve higher quality sleep.
2. Avoid caffeine and alcohol: Alcohol and caffeine can affect the nervous system, disrupting sleep. Eliminating these substances can reduce the chance of disruption and improve sleep quality.
3. Practice relaxation techniques: Trying breathwork or progressive muscle relaxation before bedtime can really help you stay grounded in the present and allow you to drift into sleep more easily.
4. Evaluation and treatment of other disorders: Consider evaluation and treatment for medical or mental health disorders such as depression, as it can be linked to recurring nightmares.
5. Keep your bedroom comfortable: A cool, quiet bedroom promotes better sleep. Having comfortable sheets and adequate window coverings can make a big difference in your sleep quality.
6. Reduce screen time before bed: Many screens emit a blue light that disrupts your sleep, so limit screens before bed.
7. Exercise and yoga: Exercise and yoga are beneficial for the body and the mind and help your body to fall and stay asleep.
8. Practice mindfulness: Mindfulness and meditation can help you calm your mind to reduce stress before falling asleep.
9. Check Medications: Make sure you are logging side effects to medications and speaking with your doctor if it is impacting your sleep.

Treatments for Recurring Nightmares

If you’ve home remedies to improve sleep and still experience recurring nightmares, you may be dealing with an untreated medical or mental health condition such as anxiety, depression, and PTSD. The type of treatment best suited for someone may depend on the underlying condition.

If your sleep is impacting your health, you should discuss the situation with your physician or with a therapist. Searching an online therapist directory is an excellent way find a therapist specializing in sleep disorders and recurring nightmares. There are many online therapy options to make your therapy time convenient and accessible.

Therapy

There is no one-size-fits-all for treating recurring nightmares. Each person’s experiences and stressors have a unique impact on how often recurring nightmares occur and their content. But there are a variety of therapies to consider when looking for treatment.

Here are therapies that address recurring nightmares:

• Image rehearsal therapy: This helps individuals reframe their story so that when they wake up after a nightmare, they learn to replace negative images with positive ones.
• Eye Movement Desensitization and Reprocessing (EMDR) Therapy: EMDR helps with processing trauma using eye movements. If these nightmares are related to PTSD, it can be especially effective, as it is with veterans and those who have complex trauma.
• Hypnotherapy: It can be helpful to try hypnotherapy as this practice will help you change your thoughts about your experiences.
• Exposure Therapy: Another therapy to try is exposure therapy which also helps people reframe their experiences and improves their body’s reaction to the distressing memory.
• Systematic desensitization therapy: Another therapy to try is systematic desensitization therapy which gives people a safe level of exposure over time to their fear which is the subject of their recurring nightmares.
• Interpersonal therapy (IPT): IPT is effective for depression-related nightmares as it helps to work through interpersonal issues in a safe place to be able to improve overall functioning with others.
• Cognitive behavioral therapy (CBT): CBT is an effective treatment for depression-related nightmares and sleep issues as it helps to reframe thoughts and behaviors. ⁶

Medication

Where there are no medications to treat nightmares, there are medications that can treat other mental health issues. Medication may reduce recurring nightmares due to an underlying condition, such as PTSD or a sleep disorder. PTSD treatments are linked to improved sleep quality, and depending on your specific concerns, other medications can also be recommended. You may need to speak with both your therapist/psychiatrist as well as your primary care doctor or another specialist to obtain the appropriate medication. ⁶

Final Thoughts

Recurring nightmares are distressing and can quickly affect all aspects of your life. However, they typically have an underlying cause. Implementing at-home strategies to improve your sleep and working with a qualified therapist can allow you to reduce or even eliminate your recurring nightmares, restore your sleep, and improve your overall health.