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October 28, 2022

Stop nightmares and get a better night's sleep with these strategies

Maintaining a consistent sleep-wake schedule, reducing alcohol intake and avoiding scary TV shows before bedtime are among the best ways to prevent bad dreams

Prevention nightmares
Nightmare prevention Shane/Unsplash

For about 2% to 5% of people, nightmares can occur frequently, even every night. Strategies for preventing nightmares include having a consistent sleep-wake schedule, reducing alcohol intake, avoiding snacks before bed, and waking up fully after experiencing a nightmare.

We all occasionally have nightmares when we are stressed or sick, but for some people, recurrent nightmares can wreck their sleep and affect their ability to function properly throughout the day.

For about 2% to 5% of people, nightmares can occur frequently, even every night. People with post-traumatic stress disorder, those who have experienced childhood abuse, and people who struggle with alcohol or drug misuse also are more likely to have them frequently. They're also more common among females than males.

Yet, some people have recurrent nightmares for no apparent reason, a condition called nightmare disorder. These people experience nightmares on a frequent basis, and the bad dreams are so intense that they cause impairment during the day. The disorder can cause anxiety, difficulties concentrating, fatigue and fear of falling asleep.

Nightmare disorder is often treated by imagery rehearsal therapy, which involves rewriting the ending to nightmares and rehearsing the new script for 5 to 20 minutes each day. Then right before bed, people set an intention for having a more positive dream that night. This practice helps retrain the brain, the Mayo Clinic says.

A new study, published in Current Biology, suggests that adding an extra element to imagery rehearsal therapy makes it more effective. Playing a sound the person associates with more positive outcomes during REM – the dream stage of sleep – may lead to a four times bigger reduction in nightmares than just using the therapy alone.

In the study, some people with nightmare disorder heard a piano chord play through an actimeter, a headband that monitors sleep stages and delivers sound through bone conduction. The chord struck every 10 seconds while they were reinventing their nightmares. A control group only practiced basic therapy. 

Both groups saw a reduction in their nightmares, but those who received the positive sound association had a more significant and faster reduction. This lessening of nightmares was still continuing at the three-month follow-up.

"While the results of the therapy coupling will need to be replicated before this method can be widely applied, there is every indication that it is a particularly effective new treatment for the nightmare disorder," said researcher Lampros Perogamvros, of the HUG'S Center for Sleep Medicine in Switzerland. "The next step for us will be to test this method on nightmares linked to post-traumatic stress."

How to avoid nightmares

There are other strategies to help curtail bad dreams, particularly for people who don't experience them frequently enough to be diagnosed with nightmare disorder. Here are some tips to curtail bad dreams, curated from Psychology Today, CNN, National Sleep Foundation and Kids' Health:

• Maintain a regular sleep-wake routine. Though you may want avoid sleep as much as possible when you are having recurrent nightmares, the lack of sleep will make the nightmares worse and affect your health in other ways.

• Review any medications you are taking with your doctor to make sure they are not the cause of your nightmares. Sometimes even the timing of your medication can affect your sleep.

• Reduce your alcohol intake. Like lack of sleep, alcohol can cut short your REM sleep, leading to a rebound of REM sleep later in night when you are likely to have more intense nightmares.

• When you are in the midst of a nightmare, wake yourself up fully by getting up and getting a glass of water. When you stay in the stage between wake and sleep, you are more likely to slip back into your nightmare.

• Don't watch or ready anything scary before bed.

• Don't snack before bed. Sleep experts say you should stop eating 2 to 3 hours before bedtime because food will boost your metabolism, causing your brain to be more active at night. That could lead to nightmares.

• Stress often can be a cause of distressing dreams, so make sure you are practicing stress-busters every day to help you feel more relaxed.

• If you are suffering from PTSD or another mental health condition, seek help as soon as possible.

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