Posttraumatic nightmares are generally defined as threatening or frightening dreams that awaken a dreamer and may be marked by any intense negative emotion, such as fear, anger, or even sadness. These nightmares cause significant distress (both during the dream and after awakening) and may occur several times a week.
Dreams often reflect what we see and feel while we're awake, so after a traumatic experience it's common to have nightmares and anxiety dreams. The content of these disturbed dreams often incorporates similar feelings and sensations to those experienced during the trauma.
When someone experiences nightmares from PTSD, they can seem very real to them. They might feel like they are back in a situation that is not safe, the traumatic experience that caused the disruption in the first place. Symptoms can keep them awake or unable to fall asleep for long periods of time.
Nightmares, dreams and other sleep disturbances are a common symptom of complex trauma with nightmares recognised as a principal feature of post-traumatic stress disorder (PTSD). The treatment of nightmares not only alleviates those symptoms but is shown to help reduce PTSD symptoms in general.
Trauma and nightmares
Nightmares can arise for a number of reasons—stress, anxiety, irregular sleep, medications, mental health disorders—but perhaps the most studied cause is post-traumatic stress disorder (PTSD).
Nightmares are primarily a REM sleep phenomenon, but they may also occur during NREM sleep in patients with PTSD (12). These dysphoric dreams often depict themes, images, and emotions that can be related to traumatic events. Nightmares may trigger short or prolonged awakenings from sleep.
What Helps With PTSD Nightmares? You can make sure your bedroom is not too cold or too hot; start a nightly relaxation routine to prepare for sleep; ensure there isn't light in your room keeping you from sleeping deeply; exercise daily; talk about your dreams; and engage in Image Rehearsal Therapy (IRT).
Sleep terrors differ from nightmares. The dreamer of a nightmare wakes up from the dream and may remember details, but a person who has a sleep terror episode remains asleep. Children usually don't remember anything about their sleep terrors in the morning.
Trying to wake them up can be dangerous but also futile. Many people in night terrors never wake up during the episode. What you can do is speak to them in a calm and soothing voice to offer comfort. If they get up but are not too agitated, gently guide them back to bed.
Can Nightmares Cause Trauma? Typically, it's trauma that causes nightmares, not the other way around. It is worth noting, though, that while nightmares may not lead to trauma, there's plenty of evidence to suggest that they're not without consequence.
Women with PTSD may be more likely than men with PTSD to: Be easily startled. Have more trouble feeling emotions or feel numb. Avoid things that remind them of the trauma.
In summary, PTSD nightmares differ from standard nightmares because the themes, or feelings are related to the traumatic experience. They have also started after the traumatic experience.
Not surprisingly, PTSD sufferers often wake from sleep with the covers torn off, or may even find themselves on the floor. Some remember in precise detail what they've dreamt; while others wake with no memory of a dream, but have intense emotions of fear, horror or anger, as though the trauma has just occurred.
Researchers at UC Berkeley have found that when dreams occur during the REM (rapid eye movement) stage of sleep, our stress responses shut down, and the neurochemicals responsible for stressful feelings stop being released. Not only this, but REM helps reduce the negative effects of difficult memories.
Moreover, having nightmares shortly following a traumatic event predicts more severe PTSD symptoms 6 weeks later. 11 Even with PTSD symptoms abating, nightmares can persist a lifetime.
PTSD and Night Terrors
Approximately 96% of people with PTSD experience terrifying nightmares that are so vivid that they seem real. Unlike bad dreams, night terrors have physical manifestations such as thrashing, flailing, screaming, and even sleepwalking.
Some experts believe nightmares in PTSD are the sleeping version of “re-experiencing,” or reliving a traumatic event. When you're awake, reexperiencing may occur in the form of a flashback. These intrusive symptoms have to do with how PTSD changes brain regions involved in fear response and memory recall.
After a trauma, people may talk more in their sleep. Talking during sleep can affect bed partners. Feeling "on alert." People with PTSD may feel the need to be on guard, to protect themselves from danger. It is difficult to have restful sleep when you feel the need to be always alert or are startled easily by noise.
Yes, in fact nightmares are a classic symptom of post traumatic stress disorder. Kids are more likely to experience frequent and intense nightmares if they have lived through traumatic events, such as abuse, domestic violence, natural disasters, or the death of a loved one (Secrist et al 2019).
We have dreams — including nightmares — during the rapid eye movement (REM) stage. Night terrors happen during deep non-REM sleep. A night terror is not technically a dream, but more like a sudden reaction of fear that happens during the transition from one sleep stage to another.
Since adult night terrors are so closely associated with life trauma and psychological disorders, many of those who endure this bedtime battle will often also exhibit signs of aggression, anxiety, memory loss, and inward pain that are often expressed in the form of self-mutilation.
The UK Trauma Council defines complex trauma as traumatic experiences involving multiple events with interpersonal threats during childhood or adolescence. Such events may include abuse, neglect, interpersonal violence, community violence, racism, discrimination, and war.