- No specific medical treatment is indicated for nightmares.
- If a nightmare occurs, reassurance and comfort are appropriate.
- If nightmares occur frequently, an evaluation of daytime routines is needed. This includes assessing exposure to daytime stressors, television, or video games and bedtime practices.
Research suggests that dreams can be impacted by conscious thought before bed; remembering fun events or funny stories can
sometimes help derail a nightmare before it begins.
- Lucid dreaming, or being aware during a dream, can help redirect a nightmare into a pleasant dream.
Practicing good sleep hygiene is important for everyone who has experienced nightmares. This includes:
- establishing a bedtime routine that starts at the same time every evening
- making bedtime a safe and comfortable time.
- using a nightlight can decrease fear or anxiety;
- discussing “monsters” -- either under the bed or in the closet -- and showing the child that nothing harmful is present can be reassuring; and
- imagining alternate endings to nightmares can provide a child with a sense of empowerment prior to going to sleep.
For adults, improvement in sleep/wake cycles can be seen with:
- eliminating television or computer exposure an hour or more before bedtime;
- maintaining consistent sleep and wake times;
- eliminating working in bed;
- cutting back on caffeine after 1PM (for those who work daytime hours); and
- practicing lucid dreaming.
If nightmares occur frequently (more than two nights per week over many months), then psychological evaluation is suggested. Different types of psychotherapy, including cognitive-behavioral therapy and hypnosis, can be of benefit in decreasing the frequency of nightmares.
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