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We don't know why nightmares occur. Possible causative factors include normal development, dealing with daytime stresses, or exposure to frightening situations. Febrile illness and various medications may trigger nightmares in some children, as can being overtired or eating too close to bedtime. Additionally, significant life changes (starting class at a new school, parental divorce) may lead to nightmares. Between 5 and 10 percent of children with frequent nightmares have a strong family history of nightmares.
Anxiety disorders, intellectual disability, and depression can also lead to nightmares. Nightmares that follow a particularly traumatic event may be a sign of posttraumatic stress disorder.
Although nightmares are often considered a problem of childhood, adults may experience nightmares as well. Pregnancy can trigger bizarre dreams and nightmares; workers who change shifts routinely may experience shift-work sleep disturbance as well as nightmares. Adults are more likely to be exposed to certain medications that can trigger nightmares either during treatment (such as statins) or as an effect of discontinuing the medication (as with certain antidepressants). Consumption or withdrawal of alcohol or illicit drugs can also lead to nightmares. Paradoxically, medications used to treat insomnia (zolpidem/Ambien® and zalepon/Sonata®) have also been implicated in causing nightmares.
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