Why Do I Have Nightmares Every Night?

GinaMarie Guarino, LMHC

Published on January 19th, 2022

Updated on March 11th, 2022

Nightmare disorder is a disorder in which a person suffers from distressing nightmares. These nightmares happen often and have an impact on a person’s sense of wellness. They will also affect a person’s functioning and comfort when falling asleep.

A person who is suffering from nightmare disorder will have recurring dreams of threat or distress. These nightmares will recur at varying severities depending on the affected person.

Nightmare disorder will affect each person differently. Some will suffer from short-term recurrences, and others will have chronic nightmares. Some will have more severe nightmares than others. The frequency of nightmares will also be different between cases. The method of determining the intensity of a case of nightmare disorder is as follows:

Duration

The duration refers to how long a person has been struggling with nightmares. There are three levels of duration for nightmare disorder:

• Acute (nightmares recurring for less than one month)
• Subacute (nightmares recurring for one to six months)
• Persistent (nightmares recurring for more than six months)

Severity

The severity of nightmares refers to the frequency of recurring nightmares. The three levels of severity for nightmare disorder include:

• Mild (Nightmares recur regularly but less than once a week)
• Moderate (Nightmares recur at least once a week but not every night)
• Severe (Nightmares recur nightly or most nights)

Symptoms Of Nightmare Disorder

Nightmare disorder can have a significant impact on a person’s quality of sleep. The nightmares tend to wake an affected person during the night and make it hard to fall back asleep. More severe cases of nightmare disorder can also cause a fear of falling asleep.

Everyone has nightmares sometimes. It is not unusual for a person to have the occasional nightmare or bad dream. For most, a nightmare will be unpleasant, but may not affect a person for more than a few minutes. Many do not even wake following a nightmare.

Having nightmares is not the same as suffering from nightmare disorder. There are criteria needed for a diagnosis of the condition. The criteria separate nightmare disorder from a normal experience of nightmares.

Having nightmares alone does not mean that a person is suffering from nightmare disorder. An affected person will also struggle with other symptoms because of their nightmares. Symptoms of nightmare disorder include:

• Being suddenly awoken by the intensity of a nightmare
• Racing heartbeat or sweating in reaction to a nightmare
• Clearly remembering the content of a nightmare
• Trouble with falling back asleep after a nightmare
• Themes in a nightmare relating to a threat to safety or personal integrity
• The content of the nightmare causes fear, anxiety, shame, or distress
• Nightmares fit into categories for duration and severity
• Impairment of daily functioning
• Feeling afraid to fall asleep
• Disturbing content of a nightmare that causes difficulty focusing on other things

Causes Of Nightmare Disorder

A person can develop nightmare disorder for different reasons. Research supports that daytime mood affects the recurrence of nightmares. If a person has a bad day or has unpleasant feelings, they are at risk of suffering from nightmares.

There are factors that contribute to having nightmares. These factors alone may not cause the condition. They do put a person at risk of suffering from recurring nightmares. Such factors that may cause a case of nightmare disorder include:

• Stress
• History of trauma
• History of abuse
• Traumatic injury
• Sleep issues
• Substance use

Nightmare disorder can run in families. A person is at risk of suffering from nightmares if they have a family member who also has nightmares. A person is also at increased risk if they suffer from other mental health issues, including:

• Insomnia
• Anxiety
• Depression
• Post-Traumatic Stress Disorder
• Specific phobia
• Addiction or substance use
• Alcoholism

Treatment Of Nightmare Disorder

It is important to get proper treatment when suffering from nightmare disorder. Without treatment, the nightmares are likely to persist and will continue to have an impact on the affected person’s quality of life.

It is important to consult with a doctor or mental health professional when struggling with nightmare disorder. They will be able to prescribe proper and effective treatment. Proper treatment for nightmare disorder may include a combination of psychiatric medication and therapy.

Therapy helps a person with nightmare disorder by teaching them coping skills to make the experience of the nightmare less intense. Specific forms of therapy can be helpful for managing nightmares. The following are some recommended forms of treatment for nightmare disorder:

• Image Rehearsal Therapy (IRT). Involves rewriting and memorizing a more positive scenario for the nightmare.
• Systematic Desensitization. Uses gradual exposure to stressors in a nightmare. This is done to build coping methods and tolerance for feared situations.
• Hypnosis. Helps by opening the affected person up to changing thoughts or behaviors in response to feared themes in nightmares.
• Self-Exposure Therapy. Allows the affected person to create a hierarchy of fears and confront each fear at their own pace.

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