Symptoms

You're more likely to have a nightmare in the second half of your night. Nightmares may occur rarely or more frequently, even several times a night. Episodes are generally brief, but they cause you to awaken, and returning to sleep can be difficult.

A nightmare may involve these features:

• Your dream seems vivid and real and is very upsetting, often becoming more disturbing as the dream unfolds.
• Your dream storyline is usually related to threats to safety or survival, but it can have other disturbing themes.
• Your dream awakens you.
• You feel scared, anxious, angry, sad or disgusted as a result of your dream.
• You feel sweaty or have a pounding heartbeat while in bed.
• You can think clearly upon awakening and can recall details of your dream.
• Your dream causes distress that keeps you from falling back to sleep easily.

Nightmares are only considered a disorder if you experience:

• Frequent occurrences
• Major distress or impairment during the day, such as anxiety or persistent fear, or bedtime anxiety about having another nightmare
• Problems with concentration or memory, or you can't stop thinking about images from your dreams
• Daytime sleepiness, fatigue or low energy
• Problems functioning at work or school or in social situations
• Behavior problems related to bedtime or fear of the dark

Having a child with nightmare disorder can cause significant sleep disturbance and distress for parents or caregivers.

When to see a doctor

Occasional nightmares aren't usually a cause for concern. If your child has nightmares, you can simply mention them at a routine well-child exam. However, consult your doctor if nightmares:

• Occur frequently and persist over time
• Routinely disrupt sleep
• Cause fear of going to sleep
• Cause daytime behavior problems or difficulty functioning