Nightmare disorder

Diagnosis

Nightmare disorder is typically not diagnosed through routine tests; instead, it is identified when distressing dreams significantly impact your well-being or disrupt your sleep. To diagnose this disorder, your doctor will conduct a thorough evaluation, which may involve:

• Physical exam: A comprehensive physical examination will be conducted to identify any underlying conditions contributing to the nightmares. If anxiety is suspected as a factor, a referral to a mental health professional may be recommended.
• Symptoms discussion: Diagnosis relies on your detailed description of your experiences. Your doctor may inquire about your family’s history of sleep problems, discuss sleep behaviors with you or your partner, and explore the possibility of other sleep disorders if necessary.
• Nocturnal sleep study (polysomnography): In cases of severe sleep disturbance, an overnight sleep study may be suggested to determine if nightmares are linked to another sleep disorder. This study involves placing sensors on your body to monitor various parameters such as brain waves, blood oxygen levels, heart rate, breathing, eye and leg movements, and may include video recording to document your behavior during sleep cycles.

 Treatment

In most cases, treating nightmares is unnecessary. However, treatment may become essential if your dreams start to disrupt your daily life, causing you anxiety or sleep disturbances.

Treatment for nightmare condition is influenced by its underlying cause. Possible course of treatment options include:

• Medication. It is rare to treat nightmares using medication. For severe dreams linked to Post Traumatic Stress Disorder (PTSD), medication could be advised.
• Stress or anxiety treatment. If your doctor concludes that a mental health condition, such as anxiety or stress, is the underlying cause of your nightmares, they might suggest counseling, therapy, or stress-reduction techniques as potential treatment options.
• Medical treatment. If the nightmares are associated with a medical condition, treatment primarily targets addressing the underlying health issue.
• Imagery rehearsal therapy. Imagery rehearsal therapy, commonly used for individuals with PTSD who suffer from nightmares, involves the process of reimagining and altering the outcome of a remembered nightmare while you are awake, making it appear less threatening. Subsequently, you engage in mental rehearsal of the modified ending. This approach has the potential to reduce the frequency of nightmares.