Fighting Freddy Krueger, “Nightmare on Elm Street” and nightmare disorder

In the newly released remake of “Nightmare on Elm Street” the protagonists try to stay awake to avoid dreaming of the demonic Freddy Krueger. As evident by the high kill-counts in each of the horror film in the series, it turns out they were doing it all wrong.

In real life, people who have recurring nightmares about a menacing figure like Freddy should instead see a psychologist or behavioral sleep specialist. They likely have nightmare disorder, a type of parasomnia.

Nightmares can occur at any age. Children most frequently get nightmares. Only a small fraction of people who get nightmares have the disorder.

Nightmare disorder happens when the horrifying dreams are so frequent it causes you to fear going to sleep. Those who manage to fall asleep end up waking up in the middle of the night terrified. And the nightmares only get more intense as the sleep deprivation adds up.

The problems the teenagers in “Nightmare on Elm Street” face fit this description. Only in their dreams they can die.

Nightmare disorder tends to run in families. In other cases the nightmares are a side-effect of medications.

There are several treatment options available. Counseling is most often recommended. A therapist helps look and confront the thoughts and feelings that are the root cause of the nightmares. Relaxing training may be part of the therapy.

Image rehearsal therapy is another option. It’s a form of cognitive behavioral therapy. Patients record their dreams in a journal, and relive them during the daytime. Through practice, the aim is to confront and disarm the unpleasant elements of the nightmare.

Coincidently, this is how the protagonists of “Nightmare on Elm Street 3: Dream Warriors” defeated Freddy Krueger. They used lucid dreaming to give themselves magic powers to do battle with the ghoul.

Medications are not normally used to treat nightmares. Some researchers believe the drug prazosin can effectively reduce nightmares. The drug treatment would have to be ongoing; nightmares may return after drug withdrawal.

If you think you have nightmare disorder avoid watching scary movies, especially any of the “Nightmare on Elm Street” films. Instead find help at an AASM-accredited sleep center or behavioral sleep specialist near you.

The real Freddy Krueger, “Nightmare on Elm Street” and sudden unexplained deaths

He visits us in our nightmares. The ghoul wearing a striped shirt and fedora slowly taps his razor-sharp finger knives as he approaches. Anyone who grew up in the 80’s knows his sneering burnt face. Freddy Krueger is a horror movie icon, representing everything we fear in our sleep.

Today a new generation meets the boogeyman for the first time. The remake of “Nightmare on Elm Street” is now open in theaters nationwide.

The movie is getting panned by most major critics. This blogger recommends instead checking out the 1984 original, or the self-aware follow-up "Wes Craven’s New Nightmare," where Freddy haunts the actors and crew behind the first film.

The franchise is about a child murderer who was burned alive by a mob of angry parents and returns to haunt their teenage children in their dreams.

Director Wes Craven reportedly came up with the premise after reading in the news about a group of young Cambodian refugees who, haunted by terrifying nightmares, refused to sleep. The group had escaped the countries genocidal Khmer Rouge regime, only to face those same fears in their dreams while safe in America. This is where it gets chilling -when they gave in and returned to sleep, they died.

Craven described his reaction to the article he read in the Los Angeles Times:

In the middle of the night they heard these horrendous screams and crashings and they ran in and he’s thrashing on the bed. They ran to him and by the time they got to him he was dead. They did an autopsy on him and there was nothing physically wrong with him. And I just thought: “My God.”

Researchers believe the deaths were caused by a mysterious disorder called sudden unexplained death nocturnal syndrome. Otherwise healthy men from Southeast Asian countries ages 20 to 45 years old suddenly die in their sleep.

Some in Thailand and the Philippines believe the incidents are supernatural. A spirit comes to kill them by sitting on their chests while they sleep. This belief is not unlike the “Nightmare on Elm Street” antagonist. To avoid the spectral threat, some Thai men would disguise themselves as women.

Though researchers have offered a variety of hypothesis over the last few decades, none have held up. Many have not been disproven either. Relatives of some of the victims describe hearing a sudden gasp for air, before they died.

In “Nightmare on Elm Street,” the victims tried to stay awake to avoid Freddy Krueger’s nightmare assaults. Coming up Sunday morning on the blog, find out what doctors say they should have done instead.

Image courtesy New Line Cinema

New PTSD Sleep Clinic Opens in New Mexico

A new PTSD Sleep Clinic is opening today in Albuquerque, N.M. The clinic will target the sleep problems that plague people who have post-traumatic stress disorder.

The clinic is directed by AASM member Dr. Barry Krakow. He is the founder of the Maimonides International Nightmare Treatment Center.

Krakow notes that antidepressant medications may not be the best option for people who have PTSD. And many people with PTSD also have obstructive sleep apnea. This can make their PTSD symptoms even worse.



The AASM reports that recurring nightmares tend to be most disturbing aspect of PTSD. In these dreams the event may be relived in a way that seems shockingly real.

Krakow says that treating sleep problems can greatly reduce PTSD symptoms. Daytime fatigue and sleepiness decrease, and energy levels increase. This provides a boost for the coping skills and motivation needed to tackle the problems related to PTSD.

His clinic uses a variety of techniques to treat PTSD. These include cognitive behavioral therapy, imagery rehearsal therapy and sleep-related emotion-focused therapy.

Last year the Sleep Education Blog reported that imagery rehearsal therapy is helping some people change their nightmares. Yoga also is being used to help soldiers who have PTSD. And a recent study showed that old fear memories can be “updated” to prevent the return of fear.

Read more about PTSD and nightmares.

Sleep Apnea & Nightmare Recall

A new study examined nightmare recall in people with obstructive sleep apnea. The results were published yesterday in the Journal of Clinical Sleep Medicine.

The study involved 393 consecutive patients at an AASM-accredited sleep center. They were evaluated by an overnight sleep study. Their mean age was 50.5 years with a range of 13 to 82 years. Sixty-seven percent of participants were male.

Severe OSA was common. They had a mean apnea-hypopnea index of 34.9 breathing pauses per hour of sleep. An AHI of more than 30 is considered “severe” OSA.

They were asked about dream and nightmare recall frequency. Recall was considered to be “infrequent” when it was reported once a month or less. Recall was “frequent” when it was reported at least weekly.

Results show that about 52 percent of people reported frequent dream recall. Thirty-four percent reported frequent nightmare recall.

The percent of people with frequent nightmare recall decreased as sleep apnea severity increased. Frequent nightmare recall was reported by 71.4 percent of people who did not have OSA and 43.2 percent of people with mild OSA.

The rate of frequent nightmare recall dropped to 29.9 percent in people with moderate OSA. Only 20.6 percent of people with severe OSA frequently recalled nightmares.

Average sleep apnea severity was much higher in people who reported infrequent nightmare recall. They had a mean AHI of 40.3. People who reported frequent nightmare recall had a mean AHI of 24.6.

“The results were somewhat surprising, since nightmares are frequently reported by patients with sleep apnea,” lead author Dr. Jim Pagel told the AASM.

Pagel suspects that the decline in nightmare recall may be attributed to the sleep fragmentation that is caused by OSA. This leads to a reduction in the nightly amount of rapid eye movement (REM) sleep. REM sleep is the sleep stage when nightmares generally occur.

Treating OSA with CPAP therapy leads to increases in the amount of REM sleep per night. This may cause the frequency of nightmare recall to rise when OSA is treated.

Are you at risk for sleep apnea? STOP and find out. You also can answer these questions on SleepEducation.com to learn more about your risk. Get help for sleep apnea at an AASM-accredited sleep center near you.

Read more about nightmares and about obstructive sleep apnea.

Image by Franco Marconi

Updating Memories to Prevent the Return of Fear

A new study shows that old fear memories can be “updated” to prevent the return of fear. The discovery is promising for the treatment of post-traumatic stress disorder.

"Our results suggest a non-pharmacological, naturalistic approach to more effectively manage emotional memories," study co-author Elizabeth Phelps, PhD, said in a press release.

The researchers used mild wrist shocks to condition participants to fear colored squares. A day later, the memory was reactivated.

Participants were re-exposed to the feared squares. This was followed by extinction training. They were repeatedly exposed to the colored squares without shocks.

The fear response was banished only if extinction training followed soon after the fear reactivation. This “reconsolidation window” appears to last for about six hours after the fear is reactivated.

During this time an old memory can be “rewritten.” It can be updated with non-fearful information.

"Timing may have a more important role in the control of fear than previously appreciated," said Phelps. "Our memory reflects our last retrieval of it rather than an exact account of the original event."

The study also found that the technique had a long-lasting effect. Fear responses were no longer expressed when tested one year later.

The AASM reports that recurring nightmares tend to be most disturbing aspect of PTSD. In these dreams the event may be relived in a way that seems shockingly real.

Earlier this year the Sleep Education Blog reported that playing the computer game Tetris can reduce unwanted “flashbacks.” Last month the blog noted that imagery rehearsal therapy is helping some people change their nightmares.

Learn more about sleep and memory.

Image by Stu Mayhew

Changing Nightmares: Imagery Rehearsal Therapy

“Your Health” columnist Kim Painter reports in USA Today that imagery rehearsal therapy is helping some people change their nightmares.

This method is just one form of cognitive behavioral therapy. A variety of CBT techniques have been used to reduce nightmare frequency.

One method is to record your nightmares in a diary. Relaxation exercises also may be helpful. Exposure techniques involve “reliving” a nightmare in your imagination during the daytime.

Cognitive-restructuring techniques involve changing a nightmare. One technique is lucid dreaming treatment; you change the nightmare as it occurs during sleep.

Imagery rehearsal therapy involves changing the nightmare while awake; you “rehearse” the new version in your mind during the day.

The first step is to write down a recent nightmare. Then you change the nightmare. Usually you change it to a more positive version.

You write down this new version. Then you rehearse it in your mind daily; you imagine the imagery of the changed nightmare.

In 2008 a review in the Journal of Clinical Sleep Medicine noted that CBT has become the treatment of choice for nightmares. It reported that imagery rehearsal therapy and exposure are effective at reducing nightmares; the methods also reduce other sleep complaints and mental distress.

The authors noted that the drug prazosin also may be effective at reducing nightmares. But it appears that treatment requires ongoing use of the drug; nightmares may return after drug withdrawal.

One of the review’s co-authors was sleep specialist Dr. Barry Krakow. He is founder of the Maimonides International Nightmare Treatment Center in Albuquerque, N.M.

In 1992 Krakow and colleagues at the University of New Mexico published a study of imagery rehearsal therapy in the journal Sleep. They found that the therapy reduced nightmare frequency by 72 percent.

Nightmare rehearsal was first reported as an effective treatment option in a 1978 case study. The method was adapted into an imagery rehearsal technique at the University of New Mexico; the first case studies were reported in 1991.

In June the Sleep Education Blog reported that imagery rehearsal therapy also can be helpful for children with nightmares. Learn more about dreams and nightmares on SleepEducation.com. Get help for nightmare disorder at an AASM-accredited sleep center near you.

Image by Cornelia Kopp

Children, Media Violence & Nightmares

Just in time for Halloween, the thriller Paranormal Activity and horror flick Saw VI topped the box office charts last weekend. The House of the Devil opened on Friday.

They’re the kind of movies that the American Academy of Pediatrics wants parents to help their children avoid. The AAP has just released a revised policy statement on media violence.

It reports that the average young person will have viewed an estimated 200,000 acts of violence on TV by the age of 18 years. That doesn’t include exposure to violence in movies, music and video games.

Does this exposure to violence have an effect? The statement reports that it has been linked to a variety of physical and mental health problems in children and teens. This includes fear, depression, nightmares and sleep disturbances.

The AAP recommends that parents make thoughtful media choices that limit violent content. Parents should view and discuss programs together with their children.

Parents also are encouraged to limit their children’s screen time to one or two hours per day. This includes time watching TV and videos, playing video games and surfing the Internet.

The AAP also advises parents to keep the TV, computer and video games out of children’s bedrooms. It reports that children with a TV in their bedroom watch an additional hour of TV per day.

Children also are likely to sleep better in a media-free room. In March the Sleep Education Blog reported that sleep problems often occur when children have a TV in their bedroom.

When nightmares do occur, parents can provide comfort and reassurance. Learn more about nightmares and children.

Dreams, Nightmares and 9/11

Today marks the eighth anniversary of the terrorist attacks against the U.S. on Sept. 11, 2001.

“Nearly 3,000 days have passed -- almost one for each of those taken from us,” President Obama said at a wreath-laying ceremony at the Pentagon. “But no turning of the seasons can diminish the pain and the loss of that day.”

Did that pain and loss affect our dreams in the days and weeks after 9/11? A study published in the journal Sleep in 2008 offers some answers.

The study involved 11 men and 33 women. For years they had been keeping a written record of all their dreams. Each participant submitted written accounts of 20 dreams for the study. These were the last 10 dreams they recorded before 9/11 and the first 10 dreams recorded after the attacks.

The 880 dreams were analyzed for features such as central image, intensity, emotion and vividness. They also were scored for content involving attacks, tall buildings and airplanes.

Results show a significant increase in the presence and intensity of a central image in dreams after 9/11. The researchers conclude that this change springs from an increased emotional arousal after 9/11.

Surprisingly, there was no increase in dream content involving airplanes or tall towers. There also were no “replay dreams.” None of the 440 post-9/11 dreams portrayed the events that were replayed time and again on television.

But there was a trend in these dreams to more content involving attacks. The dreamer was almost always the victim or potential victim. Attacks involved animals or monsters, violent criminals or battle scenes.

In these results the authors find support for the Contemporary Theory of Dreaming. The theory states that dreams are guided by the emotion of the dreamer. The central imagery of the dream depicts the dreamer’s emotion.

Earlier this week the Sleep Education Blog reported that smells can affect the emotional content of dreams. In May the blog reported on treatments for recurring nightmares.

Read more about the study of dreams and 9/11 on SleepEducation.com. Learn about dreams and nightmares and nightmare disorder.

Image by Brian Boyd

Civilian Life is Interrupted by PTSD and Sleep Disorders for Many Soldiers Returning from Iraq

A new study finds high rates of disturbed sleep among current and former military personnel who served in Afghanistan during Operation Enduring Freedom or Iraq during Operation Iraqi Freedom.

Sleep problems were considerably more common and severe among those with post-traumatic stress disorder (PTSD), reports Military.com. PTSD is an anxiety syndrome that occurs after a traumatic event, such as combat or military exposure. Symptoms typically improve after three months of treatment, but for some people the problem continues for the rest of their lives.

Data from the Pentagon suggests that up to 20 percent of returning Iraq war veterans suffer from PTSD. Records from the Department of Veterans Affairs show that nearly 76,000 veterans of the current wars were diagnosed with PTSD between 2002 and mid-2008.

According to the AASM, most people with PTSD report having disturbed sleep, and suffer from severe nightmares in which they relive the traumatic event. Severe cases of PTSD may be treated with cognitive behavioral therapy and medications to improve sleep.

Learn more about PTSD on SleepEducation.com.

Image courtesy of the U.S. Army.

Treating Nightmares in Children with Imagery Rehearsal Therapy

Imagery rehearsal therapy is an effective way to treat adults with nightmare disorder. A new study from Canada shows that it also can be helpful for children.

The small study involved 11 boys and nine girls between 9 and 11 years of age. Each child had a moderate or severe nightmare problem; they had one nightmare or more per week for at least six months. None of the children had post-traumatic stress disorder.

Eleven children were put on a waiting list; nine of the children were treated with imagery rehearsal therapy. This is a way to train your brain to change your nightmares into a new set of images.

Results show that imagery rehearsal therapy reduced the frequency of nightmares. This effect lasted during a nine-month follow-up period. Nightmares became so rare that the researchers were unable to measure post-nightmare distress.

The AASM reports that children tend to begin having nightmares between the ages of three and six. The frequency of these disturbing dreams usually peaks between the ages of six and 10.

Learn more about nightmares and children.

Treating Nightmares with Imagery Rehearsal Therapy

It’s bad enough to have your sleep disrupted by a nightmare. It’s even worse when recurring episodes of disturbing dreams turn into a nightmare disorder.

This is a common problem for soldiers and other people who have post-traumatic stress disorder. Their dreams often replay a disturbing event in a way that seems shockingly real.

But the Pittsburgh Post-Gazette reports that treatment can help break the cycle of recurring nightmares. This can help your sleep, and your daytime life, return to normal.

One of the most effective treatments for nightmares is “imagery rehearsal therapy.” According to the article, it is effective in more than 90 percent of people who try it.

“You train your brain to have a new set of images,” sleep researcher Anne Germain told the Post-Gazette.

Germain also said that the high blood pressure medication prazosin is another treatment option. The drug is effective at eliminating nightmares.

Get help for nightmare disorder at an AASM-accredited sleep center near you.

Learn more about dreams and nightmares on SleepEducation.com.

Image by Vanessa C

Violent Sleep: Acting Out Dreams & Nightmares

CBS 2 News in Los Angeles reports on REM sleep behavior disorder, or RBD. Note: Parents should be aware that the video on the CBS Web site may not be appropriate for children.

People who have RBD act out vivid dreams and nightmares as they sleep. The dreams tend to be action-packed. The dreamer may punch, kick, jump or get out of bed and run. All of this occurs while he or she is still asleep.

Injuries are common. Cuts, bruises or broken bones may occur to the dreamer or to a bedpartner.

"It is violent, moving nightmares,” Dr. Carlos Schenck told CBS. “It is what happens during sleep, and they end up hurting themselves or bed partners."

Schenck and colleague Dr. Mark Mahowald first identified RBD, reporting on it in the journal Sleep in 1986. Sixteen years later they filed a follow-up report.

Schenck also is executive producer of the documentary Sleep Runners. It tells the true stories of people who suffer from RBD and other parasomnias.

Contact an AASM-accredited sleep center if you or someone you know acts out dreams during sleep.

Survivor: Reinterpreting Dreams with the Threat Simulation Theory

In 2000 Finnish researcher Antti Revonsuo proposed a new theory for interpreting dreams. It has become known as the “Threat Simulation Theory.”

The theory proposes that dreaming is a defense mechanism. It serves a biological function by simulating threatening events. The theory suggests that the brain selects waking events that pose a threat to your safety.

Then during the majority of dreams your brain simulates these events over and over again. The threats are replayed in various combinations.

In this way the brain is able to practice how it perceives threats. It also “rehearses” threat avoidance.

A 2006 study tested this theory using a sample of 212 recurrent dreams. It provided some support for the theory. Sixty-six percent of the dream reports contained one or more threats.

These threats tended to put the dreamer in danger. Dreamers tended to take reasonable defensive or evasive actions.

But less than 15 percent of the dreams depicted realistic situations that would be critical for survival when awake. Also, dreamers rarely succeeded in fleeing the threat.

The theory also suggests that your “threat simulation system” would be highly active if you live in a dangerous environment. It would be less active if you live in relative safety.

A 2005 study supported this proposal. It analyzed the dream reports of Kurdish and Finnish children. Results show that severely traumatized children had more dreams. These dreams included a higher number of threatening events.

But a 2008 study contradicted these findings. It tested the theory using 208 people who live in a high-crime area of South Africa. Their dreams were compared with those of people who live in a low-crime area in Wales.

The people in South Africa had more exposure to a recent life-threatening event. But they reported fewer threat dreams. Overall less than 20 percent of dreams featured realistic survival threats. Less than two percent of dreams included an escape from a threat.

A new review analyzed the results of these and other studies. It concludes that there is strong support for the theory.

Learn more about dreams and nightmares on SleepEducation.com.

Sleep Through the Centuries

Sleep has been around for…well, for centuries. So have sleep disorders. And remedies for sleep problems.

An exhibit at the Folger Shakespeare Library in Washington, D.C., explores 17th-century beliefs and ideas about sleep. “To Sleep, Perchance to Dream” pulls back the covers on sleep in Renaissance England.

Topics include preparing for sleep. (Use a bed and bedding that are less likely to attract “vermin.”) How to sleep. (Sleep was divided into “first” and “second” sleeps.) Theories about sleep. (It may be the product of digestion.) Sleep aids. (There were numerous recipes to treat insomnia.)

And dreams. The exhibit shows that – like today – people in the 17th century were fascinated by dreams and nightmares. What they are. Why we have them. What they mean. How to control them.

A New York Times review calls it an “entrancing exhibition.” The Times also has a slideshow of images from the exhibit.

The exhibition continues through May 30. Visit the Folger Web site for an online tour.

Study Links Insomnia with Suicide Risk

Both Reuters and BBC News report that a new study links insomnia symptoms with an increased risk of suicide.

The one-year study involved 5,692 adults in the U.S. They had no history of mental health problems.

Results show that suicidal thoughts or attempts were more likely in people with symptoms of insomnia. The study controlled for other factors such as depression and substance abuse.

The study measured these three symptoms of insomnia: trouble falling asleep or staying asleep, and waking at least two hours earlier than desired. About 35 percent of people reported having at least one of these sleep problems in the last 12 months.

Results link “waking early” to an increased suicide risk. People who reported this problem were more likely to have had suicidal thoughts. They also were three times more likely to have attempted suicide.

People with more than one insomnia symptom also had a higher suicide risk. They were 2.6 times more likely to try to kill themselves.

A study in the journal Sleep in 2007 reported that sleep problems and nightmares are common in people who have attempted suicide. A 2008 study in the journal Sleep linked suicide risk with a short sleep duration of five hours or less.

A 2005 study in the journal Sleep linked insomnia and nightmares with suicide risk. But after controlling for depression, insomnia was no longer a significant factor.

The CDC reports that suicide is the eleventh-leading cause of death in the U.S. It resulted in 32,637 deaths in 2005. In contrast, there were 18,124 deaths caused by homicide.

Grey's Anatomy Dissects PTSD

Post Traumatic Stress Disorder (PTSD) is common among returning military personnel, though it is not often discussed. That may change after last week’s episode of Grey’s Anatomy entitled “Elevator love Letter.”

Owen Hunt became head of trauma at Seattle Grey’s Hospital after receiving an honorable discharge from the army. Although Owen returned physically intact, his co-workers are beginning to see that he did not escape the war unscathed.

In the episode, Dr. Hunt has a nightmare that is triggered by the rotating blades of the ceiling fan in his girlfriend Cristina’s bedroom. Cristina is awakened by Owen choking her aggressively. Owen awakens, feeling confused, disturbed and ashamed.

His co-worker believes that he is suffering from PTSD. Common symptoms include memory loss, depression and anger. People suffering from PTSD continue to experience disturbing effects caused by the event, which often occur in the form of recurrent dreams or nightmares.

According to the American Academy of Sleep Medicine, nightmares tend to be the most disturbing for people with PTSD. In these dreams they may relive the event in a way that seems shockingly real.

Most people with PTSD report having disturbed sleep. It can be very hard to fall asleep or stay asleep. This is known as “adjustment insomnia.” The lack of restful sleep can make feelings of anxiety, anger and depression even worse.

A severe case of PTSD may need to be treated with intensive counseling by a trained therapist. Some forms of cognitive behavioral therapy may also improve sleep. The short-term use of medications also may give PTSD suffers temporary relief.

Understanding Child Parasomnias

Child parasomnias are sleep disorders that can put a scare into parents. Episodes can involve unusual and undesirable actions.

Nightmares may be the most familiar parasomnia. Others include sleepwalking and sleep terrors.

The good news is that these disorders tend to be common and harmless in children. In many cases the child will have no memory of the event.

But some children may have a more severe problem with a parasomnia. You should contact an AASM-accredited sleep center if a sleep problem greatly disturbs your child.

It may be hard to distinguish some parasomnias from one another. They can have similar features.

This chart will help you compare four common child parasomnias. Get tips for parents from the AASM.

Sarah Connor is Right: A Sleep Study Can Help You Terminate Your Sleep Problem

Sarah Connor has the right idea. If she is going to save the world, she has to get some sleep first. If only she could get rid of these pesky nightmares.

So in tonight’s episode of the Terminator TV series she checks into a sleep clinic for a sleep study. Of course, things don’t quite go as expected. Or as the show’s promo says, “Suspicious things begin happening.”

You can check out the episode “Some Must Watch While Some Must Sleep” at 8 p.m. EST on FOX.

For your own sleep problems, you can check in at one of nearly 1,700 AASM-accredited sleep centers across the country. It sounds like Sarah should have made sure that her sleep center was accredited before she spent the night.

AASM accreditation is the “gold standard” for the profession. It shows that a sleep center or lab maintains the highest standards in all it does.

It also ensures that you receive expert care. AASM-accredited sleep centers are required to have a board-certified sleep specialist as the medical director.

A sleep study gathers the information that will help your doctor solve the riddle of your sleep problem. This provides the foundation for an effective treatment plan.

Treating a sleep disorder promotes your health and well-being. In the long run it also can save you money.

Want to learn more? Find out how A Sleep Study May be Your Best Investment for Long-Term Health.

Sleeping Scared: Nightmares & Children

As a parent it is natural to be concerned when your child has a nightmare. But should these disturbing dreams cause you to worry about your child?

In most cases nightmares are a normal and common part of a child’s development. They occur in equal rates among boys and girls.

Children tend to begin having nightmares between the ages of three and six. The frequency of these disturbing dreams usually peaks between the ages of six and 10. Most children then begin to have nightmares less often.

Some children may continue to have nightmares as teens and adults. For them it may be a lifelong problem.

A nightmare disorder may develop if a child has frequent nightmares that wake him or her from sleep. This disorder can cause anxiety, sleep loss and daytime problems. It is one of the childhood parasomnias.

In some children nightmares may be a sign of post-traumatic stress disorder. This problem occurs when the child experiences a traumatic or stressful event. In his or her dreams the child may re-enact the event.

Parents can provide comfort and reassurance to a child who has nightmares. Cognitive behavioral therapy may help in the case of an ongoing problem.

Parents also can follow these tips to help a child who has nightmares:

• Let your child sleep with a special blanket or stuffed animal for security.


• Use a dim nightlight in your child’s room to help him or her feel safe.


• Respond quickly to comfort your child when he or she wakes up from a nightmare.


• Discuss nightmares openly with your child during the day.


• Assure your child that it is normal for children and even adults to have nightmares.


• Talk to your child’s doctor if recurring nightmares greatly disturb your child.

Are you unsure if your child is having nightmares or another type of parasomnia? Compare the common features of childhood parasomnias.

Get more tips for parents of a child who has a parasomnia.

When Dreams Come Alive: REM Sleep Behavior Disorder

Dreams that come to life are the stuff of fantasy novels and horror movies. But it’s also a reality for people who suffer from REM sleep behavior disorder.

People who have RBD act out vivid dreams as they sleep. The dreams tend to be action-packed. The dreamer may punch, kick, jump or get out of bed and run. All of this occurs while he or she is still asleep.

The disorder may sound funny. But injuries are common. Cuts, bruises or broken bones may occur to the dreamer or to a bedpartner.

Why does RBD occur? Normally your brain paralyzes most muscles during the stage of rapid eye movement (REM) sleep. This is the stage of sleep when you have most dreams and nightmares. RBD occurs when the brain fails to tell the muscles to remain still.

RBD is similar to sleepwalking. But a sleepwalker tends to be confused upon waking up. Once awake, a person with RBD usually has clear recall of a vivid dream.

Sleepwalkers also are more likely to get up calmly, have their eyes open and walk out of the room. RBD actions tend to be more intense and dramatic.

RBD was identified and reported in the journal Sleep in 1986. Sixteen years later a follow-up report was published by the same research team. People with RBD are at risk for developing Parkinson’s disease.

RBD appears to be rare, affecting less than one percent of people. It is more common in older men. A new study followed 93 people with RBD. Participants had an average age of 65.4 years; 80 percent were men.

But stand-up comedian Mike Birbiglia is evidence that RBD can strike when you are younger. During his routines he often shares true stories of his RBD episodes. He is even starring in an off-Broadway show called Sleepwalk with Me.

Laughter is good medicine; but people with RBD should seek medical help. Contact an AASM-accredited sleep disorders center if you act out your dreams while you sleep.