Introduction
Nightmares are dreams that are scary or disturbing. The themes of nightmares vary widely from person-to-person, but common themes include being chased, falling, or feeling lost or trapped. In nightmares, the person will feel unreal emotions like anger, sadness, guilt, fear, anxiety etc. These emotions will be felt even after waking up.
People of all ages have nightmares. However, nightmares are more common in children, especially those under age 10. Girls are more likely to be troubled by their nightmares than boys. Nightmares seem to be a part of normal development, and except in the case of post-traumatic stress disorder, they usually aren’t symptoms of any underlying medical condition or mental disorder. However, nightmares can become a problem if they persist and interrupt the sleep pattern. This can lead to insomnia and difficulty functioning during the day.
Signs & symptoms
Bad dreams while sleeping
Interrupted sleep
Headache
Heaviness of head
Pain in the eyes
Causes
Nightmare disorder is a kind of sleep disorder that involves bad experiences that occur while falling asleep, during sleep or when waking up. Nightmares usually occur during the stage of sleep known as rapid eye movement (REM). The exact cause of nightmares is not known.
Nightmares can be triggered by many factors, including:
- Stress or anxiety
- Trauma (Physical or mental)
- Sleep deprivation
- Medications like some antidepressants, blood pressure medications, beta blockers can trigger nightmares.
- Substance abuse
- Mental disorders like Depression and physical disorders such as heart disease or cancer. Having other sleep disorders that interfere with adequate sleep also can cause nightmares.
- Post-Traumatic Stress Disorder (PTSD)
- Scary books and movies
Pathophysiology
Sleep is divided into 2 states: rapid eye movement (REM) and nonrapid eye movement (non-REM). REM and non-REM sleep alternate in 90- to 100-minute cycles. REM sleep is characterized by EEG activity similar to a wakeful pattern. In older children and adults, 75% of sleep is non-REM sleep, which consists of 4 stages.
Dreaming and nightmares occur during REM sleep, and they are more frequent in the second half of the night.
Nightmares are often confused with night terrors, which are episodes of extreme panic and confusion associated with vocalization, movement, and autonomic discharge. Night terrors occur during non-REM sleep. Children with night terrors are difficult to arouse and console and do not recall a dream or nightmare.
There are no specific tests for diagnosing nightmares.
But a sleep study can help in the diagnosis. During a sleep study, the patient spends the night in a laboratory. Sensors monitor various functions, including:
- heartbeat
- brain waves
- breathing
- blood oxygen levels
- eye movements
- leg movements
- muscle tension
Treatments
Treatment is not needed in most cases of nightmares. However, any underlying medical or mental health problems should be addressed.
Counselling or stress-reduction techniques will be beneficial if any of the following conditions is triggering the nightmares:
- anxiety
- depression
- stress
In rare cases, medication for sleep disturbances may be advised.
Prognosis
Nightmares have a long-term prognosis. Treatment will help improve the quality of sleep.
Complications
- Excessive daytime sleepiness, which can lead to difficulties at school or work, or problems with everyday tasks, such as driving and concentrating
- Problems with mood
- Resistance to going to bed or to sleep for fear of having another bad dream resulting in disturbed sleep
- Suicidal thoughts or suicide attempts
Disease & Ayurveda
Duswapna
Nidana
Vaatakopa in the body
Stress or emotional problems
Psychological trauma
Purvaaroopa
Not specifically mentioned
Samprapti
When the vitiated doshas are excess in quantity, they start to travel in the body. When they get lodged and affect the manovahasrotas and nidra, dusswapna happens.
Lakshana
Dusswapna – watching bad dreams on a regular basis
Divisions
Not mentioned
Prognosis
Yaapya
Chikithsa
Samana
Satvavajayachikithsa
Sodhana
Sneha-sweda
Vamana
Virechana
Nasya
Kashayavasti
Snehavasti
Commonly used medicines
Mridweekadi kashayam
Kallyanakaghrutam
Panchagavyaghrutam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
Lifestyle changes
- exercising at least three times per week
- limiting the amount of alcohol and caffeine
- avoiding tranquilizers
- engaging in relaxation techniques, such as yoga or meditation
- establishing a sleep pattern by going to bed at the same time every night and getting up at the same time every morning
- using a nightlight and leaving the bedroom door open at night
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, fresh fruits and vegetables
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from extreme climate changes.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active.
Yoga
Regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
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