Nightmares: Meanings and Common Causes

I guess everybody has nightmares. But what if they happen almost every night? Here’s how typical causes of nightmares and what can help.

When nightmares make you afraid to sleep

Probably everyone has had one or two nightmares in their lives. Bad dreams often cause us to startle from sleep and to feel completely anxious in the first moment after waking up. Depending on how bad the nightmare was, we may find it difficult to get back to sleep afterwards – we may even develop a real fear of sleeping. Nightmares belong to the so-called parasomnias that interrupt sleep.

It is estimated that about five percent of all adults suffer from frequent nightmares, which they find stressful. Children also often have such anxiety dreams. If nightmares occur regularly and thus disturb the important sleep, one should look for the possible causes with professional help and eliminate them.

Why are we even dreaming?

Opinions about why we actually dream differ among researchers. Neuroscientists assume that we process sensory impressions and everyday information through every dream. Psychologists often suspect that a dream is something like a bodily therapy: In a dream, we are practically forced to deal with the emotions we were confronted with during the day – even if we would rather not do so. According to this, the nightmares can be traced back to unresolved conflicts, for example, and can disappear again when this conflict is resolved.

Still others assume that a dream or nightmare should prepare us for possible future scenarios full of horrors: The brain practically plays out different situations that we might encounter so that we instinctively react correctly. On the other hand, some sleep researchers consider the nightmare to be merely a side effect of sleep, while spiritual people often see a dream or nightmare as a sign of things to come.

And why do we have nightmares?

Nightmares are usually dreams that trigger strong negative feelings in us. These can be feelings of sadness, disgust, fear, sorrow or even panic. Depending on how disturbing the nightmares are, the person affected probably needs some time to shake them off and go back to sleep. There are different types of nightmares:

• Unpleasant dreams (dysphoric dreams)
• Bad dreams you can’t wake up from
• Nightmares that lead to awakening
• Post-traumatic nightmares and so-called flashbacks (re-experiencing the dream in the mind), which occur after a trauma, for example due to a war

What are the causes of nightmares?

The exact causes of nightmares are still not clear – but there are some risk factors that increase the probability of frequent nightmares. These include:

• Post Traumatic Stress Disorder (PTBSD)
• Certain drugs (e.g. antihypertensive drugs, ironically also some sleeping pills)
• Stimulants like alcohol
• Drugs
• Chronic stress
• Genetic factors
• Snoring
• Insomnia
• Sleep apnoea
• Mental illnesses, e.g. anxiety disorders or depression
• Physical diseases, e.g. cardiovascular diseases

When do nightmares occur?

Every night we go through various so-called sleep phases, which together form a sleep cycle. It is important for our health that we go through this sleep cycle about four to six times each night. Contrary to what is often assumed, we can have a dream during each sleep phase – but we dream particularly intensively during the so-called REM phase. There are the following sleep phases:

• Falling asleep phase: When falling asleep, pulse and breathing become calmer, the body relaxes. Slight disturbances, for example by light or noise, wake us up quickly.
• Light sleep phase: Now we are really asleep, with hardly any muscle or eye movements. We spend most of the nightly sleep time in the light sleep phase.
• Deep sleep phase: In the deep sleep phase, our brain begins to process what we have experienced and store it in our long-term memory. In addition, the body cells regenerate and the immune system is improved.
• REM phase: REM stands for Rapid-Eye-Movement and owes its name to the fact that our eyes move back and forth quickly under closed eyelids during this sleep phase. Certain areas of our brain now show similar activity to when we are awake. In addition, dreams or even nightmares are most common during the REM phase.

How should I interpret my nightmare?

There are some widespread nightmares for which the so-called dream interpretation defines different causes, which often have to do with fears. These include, among others:

• Traps: Falling from great heights is one of man’s primal fears and occurs in many nightmares. This can mean, for example, that one has actually reached a great goal and is now afraid of losing what one has achieved. Or you have general fears of loss, for example you fear separation or losing your job.
• Paralysis: If you are paralysed in your dreams or can only move slowly, you could be afraid of losing control in real life, for example, or feel a strong dependency on other people.
• Forgetfulness: If you forget something specific in your dream or are generally forgetful, this may indicate that you unconsciously want to separate or generally distance yourself from someone or something.
• Death or disappearance of important people: Surprisingly, the loss of loved ones in a dream could mean that feelings for that person are waning or that there are conflicts that should be resolved. But there may also be real fear of loss, for example because the person in question is ill or in danger.
• Persecution: If you are persecuted in your dreams by something or someone, this can often be explained by problems from the past that were badly handled or not handled at all.
• Coming too late: In psychology, nightmares in which one is late are suspected to be caused by deep-seated fears of not being able to complete tasks or not being able to complete certain tasks on time.
• Examination: A dream of an examination of anyone can mean that one does not feel prepared for an upcoming situation in life.

What helps against nightmares?

Anyone who has a nightmare more than once a week and suffers from it (e.g. in the form of fear of falling asleep or a general lack of sleep) should talk to the doctor about it and look for possible causes. If you know the cause of your nightmares, you can tackle them and at best severely limit or even prevent the occurrence of bad dreams. If illnesses are behind the nightmares, they must be treated. If drugs are the triggers, it may be possible to use a different preparation in consultation with the doctor.

If anxiety or even an anxiety disorder is present, psychotherapy should be used to try to find the causes. Then one can work on changing the perception of a dream to make it less threatening.

Help through a dream diary

Even nightmares can fade quickly after waking up, so that we cannot remember them after a short time. This is where a dream diary comes in handy, in which you write down all the details of the dream immediately after waking up, which you can then discuss later with the doctor or in therapy.