Nightmares can really screw up a goodnight's sleep, especially when we grapple with their content. If you ever woke up and stared at the ceiling like, "What the hell was that!" you know what I'm talking about! So what can we do with these dreadful mental manifestations?
What is it about dreams that we find so captivating!? They can be so bizarre and directionless. Some can be amusing, while others desert us in the middle of the night, leaving us bewildered and anxious. A majority of us have at least once experienced the impending doom of a nightmare (e.g., falling from a great height, running away, etc.) only to be thurst awake right before imminent death encompasses us (e.g., crashing into the ground, being captured).
Through befriending the body and taking active steps (outlined later in this article) after waking up, you can limit nightmares' impact on your quality of sleep.
What Are Dreams?
Freud posited that dreams contained content the mind found unacceptable. Additional research has since expanded on Freud's theory, but he did spark a lot of curiosity. What exactly comprises a dream? Why is dream content so jumbled and kooky? Is there a hidden message in dreams?
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Sleep plays a pivotal role in how our brain processes memories. Dreams occur during the REM ( Rapid Eye Movement) stage of sleep, noted in research by an increase in brain activity. A brain in the REM and deep sleep filters relevant and irrelevant information we absorb in our daily lives. It then blends it into the more extensive brain system. In other words, dreaming occurs as an outlet for mood regulation by helping us make sense of our experiences, thus decreasing susceptibility to anxiety and depression.
Common sleep problems include:
Difficulty Falling/ Staying Asleep
Not Feeling Rested & Revived
What's a Nightmare?
First, nightmares are not bad dreams! Bad dreams are uncomfortable, but they do not wake you up. Nightmares are an unconscious expression of an unresolved conflict, pulling you out of REM and startling you awake. Nightmares occur more frequently in children and tend to reduce in frequency into adulthood. According to the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA], 2013), a nightmare is defined as
" An extended, extremely dysphoric" dream that "usually involves efforts to avoid threats to survival, security, or physical integrity."
Nightmares are also categorized as an intrusive symptom under the diagnostic criteria for PTSD ( Post Traumatic Stress Disorder). Nightmares and nightmares associated with trauma have distinct qualities. Post-traumatic nightmares are symptoms of unresolved traumatic experiences and evoke emotions and content related to the original trauma.
A nervous system functioning free of trauma typically ebbs and flows between arousal (stress) and calm (threat has passed). Ebb and flow is significantly slowed for traumatized individuals, taking longer for their nervous system to return to a level of calm following stress. The persistent sense of threat accompanied by the constant discharge of stress hormones (e.g., Cortisol, Adrenaline, norepinephrine, acetylcholine) puts the mind and body in a continually activated state, disturbing an individual's sleep on multiple levels.
What's the Difference Between A Nightmare and A Night Terror?
Nightmares are dreams. Night terrors are a type of parasomnias
Nightmares occur during REM (i.e., Stage 4) sleep. On the other hand, night terrors occur during the transition from Stage 3 to Stage 4 of sleep ( Refer to the previous image in this article for a more precise depiction).
Nightmares are a terrifying awakening from sleep, absent of an external cause. Details of a nightmare can typically be recalled upon waking up. Whereas when waking from a night terror, individuals can't recall information about it.
Night terrors are associated with moments of intense panic and terror and the accompanying bodily stress responses (e.g., increased heart rate, sweating, wide eyes, flushing of the skin). Nightmares do not evoke the same intense feelings and physiological reactions.
Night terrors typically present with more vocalizations and body movements ( e.g., screaming, thrashing, kicking). They are similar to body movements that appear in Nightmare Disorder. Physical movements can range from simple twitches to more violent movements. At times individuals may even walk around or perform other forms of enactment. These physical movements are potentially dangerous to the individual and their sleeping partner.
Side Note: Nightmare Disorder is a REM sleep-related parasomnia in which a person will physically enact their dream into wakefulness and is distinct of night terrors.
Negative effects of nightmares typically present themselves the next day as
Increased stress throughout the day, especially when recalling the nightmare.
To make sense of these repercussions, we may draw the simple conclusion, "I'm just a bad sleeper." But sleep routine, life stressors, environment, medication, and/or trauma can all play a part in the quality of sleep you get and the frequency of nightmares and night terrors you have.
It can be hard to sleep when holding unresolved trauma. The silence of night provides fewer distractions, making it harder to avoid traumatic feelings and memories. Fewer distractions can compel the mind to start overworking, making you more vulnerable to adopting strategies to compensate, such as;
Fear of things associated with sleep
Fearing the bed
Keeping lights on or watching tv
Fear of going to sleep
Sporadic sleep schedules
Using drugs or alcohol to induce sleep. Withdrawal from drugs and alcohol can intensify nightmares and interfere with REM sleep!
To "save oneself" from distress caused by nightmares, it's not uncommon to adopt the latter strategies, but the goal of healing is to release habits that don't serve you and bring in ones that do. I encourage you to begin to use these strategies to improve your sleep and work through traumatic reminders. However, these suggestions do not replace professional help, and if you continue to struggle, it's not a bad idea to seek a trained therapist to support you in your journey. The below strategies can be applied to night terrors too.
What to Do When Waking
Waking up from a nightmare is terrifying and disorienting. When you wake up, the first thing you do is begin to orient to your surroundings. Orienting, in short, means you get a feel for where you are and assess for the possible threat. Although this process kicks off instinctually, you may notice thoughts like "Where am I?", "What happened?" "Was that real?". You may look over to ensure your partner is there or scan the room for something familiar. Nightmares are not an immediate external threat, but the body can react like it is.
Get Your Footing In the Present
Getting present and reassuring your safety is priority number one! Waking from a nightmare and experiencing paralysis can be extremely frightening. Sleep-related paralysis is a temporary state of immobility induced by fear. If you find that you cannot move after waking from a nightmare, having visual anchors (i.e., to your left or right, on the ceiling, diagonal) around your room will help you reorient, ground, and feel safe.
Resources can be anything like:
A night light
A digital clock
An object to feel on the nightstand
Water next to the bed
A fish tank light
Stars on the ceiling
Turn on your light and get out of bed. You may think laying there and trying to force yourself back to sleep is the better option but research shows getting up and doing a low-level activity is more effective ( try to avoid blue light, don't start cleaning the house or exercising! ). Smelling essential oils such as the nice blends Aurelia offers, is a great way to bring your senses online.
Once Your Up and Moving,
Use a cloth or splash cold or cool water on your face and back of your neck. Cold water is an excellent grounding technique to help feel sensations produced in the present and not the past. Use dialogue clarifying your presence in the moment, "I'm safe in the now," "Whatever the nightmare was, it's over," "This is my bedroom/ bathroom" "These are my legs, eye, nose, etc."
You'll Probably Need a Drink,
Because of our beautiful multi-branched vagus nerve, you get a dry mouth and a tense voice when you're upset. A nightmare can literally leave a bad taste in your mouth! Have a decaffeinated drink, a mint, or brush your teeth. Do not consume a meal; keep it light.
Then Follow Up With Activity,
Low-level activity options are:
Light stretching to engage the body. You don't have to do a whole yoga class. The goal is to feel the body and allow it to move. Sit on the floor doing toe touches or reach your arms for the ceiling; nice and easy does it.
Rest With Your Pet,
Another option Snuggle up next to your beloved buddy. While you stroke your pet, feel the texture of their coat, connect with the natural rise and fall of their calm breath. Animals are all instinct, meaning they have an innate ability to take life as it comes.
If you've ever startled a resting dog, you know their head instantly perks up (i.e., orienting) only to realize it's just you and quickly returns to resting (i.e., no threat, parasympathetic nervous system). Your dog was not lying there pondering all the possibilities of being startled and how to cope; your dog innately " trust" its system to handle threat as it comes, not before it comes.
What an inspiring reminder to trust ourselves to address stress when it comes so that we can be alive in our world in the now!
Weighted blankets are a great non-interactive strategy to increase parasympathetic nervous system activity. Weighted blankets provide deep pressure stimulation which helps to promote relaxation. Take a moment and wrap yourself in a blanket and feel your body release and sink into relaxation.
What To Do With Persistent Nightmares
Reminder: There is often an inability to recall content following a night terror; these suggestions may not apply to night terrors.
Transform the Story
This exercise focuses on changing aspects of the nightmare to either make it less distressing or to reach a safe and successful resolution. Rescripting can be done through writing or imagery. With imagery, you mentally rehearse the new story. Examples of storyline changes can include; creating a successful way out of the threatening situation, bringing in people or animals that can support you and give you strength, or a special power you acquire. Creativity makes the options limitless! Changing the story should not eliminate facts about the situation ( i.e., removing the threat or experience altogether). Alternatively, it should change aspects of the experience (i.e., defending yourself, successfully running away).
Other Forms of Resolution
Write down the nightmare and then tear it up and throw it away. If you work with a therapist, you can bring it to a session to process with them. Sound machines from Yogasleep have proven to help improve sleep quality.
Overall, working with the manifestations of the mind and improving sleep quality is imperative for an engaged and healthy life. Additional suggestions to improve your sleep hygiene can be found on my site. Although these exercises are very useful, they do not supplement professional mental health services. I believe everyone could use support from time to time and therapy can be very helpful, but therapy is your individual choice. I do encourage you to find support if these exercises become overwhelming or you decide therapy may complement your healing process.