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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Nightmare disorder

Introduction

Overview

Overview

Nightmare disorder is a sleep disorder characterized by frequent awakening from nightmares with a vivid remembrance of the dream. It is often caused by a major stressful event or from the use of SSRIs. Most cases reported begin at the age of 10 after a stressful life event. The frequency of the episodes is varied form person to person; generally one will suffer from three or four episodes every week.

Differential Diagnosis

Differential Diagnosis

  • Bereavement
  • Breathing-related sleep disorders
  • Medication or substance use
Epidemiology and Demographics

Epidemiology and Demographics

The prevalence of nightmare disorder is:

  • 6,000 per 100,000 (6%) monthly among adults
  • 1,000-2,000 per 100,000 (1%-2%) frequently among adults[1]
Risk Factors

Risk Factors

  • Genetic predisposition
  • Irregular sleep-wake schedules
  • Past adverse events
  • Sleep deprivation
  • Sleep fragmentation[1]
Diagnostic Criteria

Diagnostic Criteria

DSM-V Diagnostic Criteria for Nightmare disorder [1]

“
  • A. Repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that usually involve efforts to avoid threats to survival, security, or physical integrity

and that generally occur during the second half of the major sleep episode.

AND

  • B.On awakening from the dysphoric dreams, the individual rapidly becomes oriented and alert.

AND

  • C.The sleep disturbance causes clinically significant distress or impairment in social, occupational,or other important areas of functioning.

AND

  • D.The nightmare symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication).

AND

  • E.Coexisting mental and medical disorders do not adequately explain the predominant complaint of dysphoric dreams.

Specify if:

  • During sleep onset

Specify if:

  • With associated non-sleep disorder, including substance use disorders
  • With associated other medical condition
  • With associated other sleep disorder

Specify if:

  • Acute: Duration of period of nightmares is 1 month or less.
  • Subacute: Duration of period of nightmares is greater than 1 month but less than 6 months.
  • Persistent: Duration of period of nightmares is 6 months or greater.

Specify current severity:

Severity can be rated by the frequency with which the nightmares occur:

  • Mild: Less than one episode per week on average.
  • Moderate: One or more episodes per week but less than nightly.
  • Severe: Episodes nightly.
 ”
References

References

  1. ↑ 1.0 1.1 1.2 1.3 Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.

Template:WikiDoc Sources

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]