Nightmares in Adults

When you wake up terrified from a disturbing nightmare, you might think you're the only adult who has them. After all, aren't adults supposed to outgrow nightmares?

While it's true nightmares are more common among children, one out of every two adults has nightmares on occasion. And between 2% and 8% of the adult population is plagued by nightmares.

Are your nightmares causing you significant distress? Are they interrupting your sleep on a regular basis? If so, it's important to determine what's causing your adult nightmares. Then you can make changes to reduce their occurrence.

What Are Nightmares?

Nightmares are vividly realistic, disturbing dreams that rattle you awake from a deep sleep. They often set your heart pounding from fear. Nightmares tend to occur most often during rapid eye movement (REM) sleep, when most dreaming takes place. Because periods of REM sleep become progressively longer as the night progresses, you may find you experience nightmares most often in the early morning hours.

The subjects of nightmares vary from person to person. There are, though, some common nightmares that many people experience. For example, a lot of adults have nightmares about not being able to run fast enough to escape danger or about falling from a great height. If you've gone through a traumatic event, such as an attack or accident, you may have recurrent nightmares about your experience.

Although nightmares and night terrors both cause people to awake in great fear, they are different. Night terrors typically occur in the first few hours after falling asleep. They are experienced as feelings, not dreams, so people do not recall why they are terrified upon awakening.

What Causes Nightmares in Adults?

Nightmares in adults are often spontaneous. But they can also be caused by a variety of factors and underlying disorders.

Some people have nightmares after having a late-night snack, which can increase metabolism and signal the brain to be more active. A number of medications also are known to contribute to nightmare frequency. Drugs that act on chemicals in the brain, such as antidepressants and narcotics, are often associated with nightmares. Non-psychological medications, including some blood pressure medications, can also cause nightmares in adults.


Withdrawal from medications and substances, including alcohol and tranquilizers, may trigger nightmares. If you notice a difference in your nightmare frequency after a change in medication, talk with your doctor.

Sleep deprivation may contribute to adult nightmares, which themselves often cause people to lose additional sleep. Though it's possible, it has not been confirmed whether this cycle could lead to nightmare disorder.

There can be a number of psychological triggers that cause nightmares in adults. For example, anxiety and depression can cause adult nightmares. Post-traumatic stress disorder (PTSD) also commonly causes people to experience chronic, recurrent nightmares.

Nightmares in adults can be caused by certain sleep disorders. These include sleep apnea and restless legs syndrome. If no other cause can be determined, chronic nightmares may be a distinct sleep disorder. People who have relatives with nightmare disorder may be more likely to have the condition themselves.

What Are the Health Effects of Nightmares in Adults?

Nightmares become much more than bad dreams when they have a significant effect on your health and well-being. Among people who experience nightmares, those who are anxious or depressed are more likely to be distressed about the experience and suffer even more psychological ill effects. Although the relationship is not understood, nightmares have been associated with suicide. Because nightmares may have a significant impact on your quality of life, it's important to consult a medical professional if you experience them regularly.

Sleep deprivation, which can be caused by nightmares, can cause a host of medical conditions, including heart disease, depression, and obesity.

If nightmares in adults are a symptom of untreated sleep apnea or post-traumatic stress disorder, the underlying disorders can also have significant negative effects on physical and mental health.

Treatments for Nightmares in Adults

Fortunately, there are steps you and your doctor can take to lessen the frequency of your nightmares and the effect they are having on your life. First, if your nightmares are the result of a particular medication, you may be able to change your dosage or prescription to eliminate this unwanted side effect.


For people whose nightmares are caused by conditions such as sleep apnea or restless legs syndrome, treating the underlying disorder may help alleviate symptoms.

If your nightmares aren't illness- or medication-related, don't despair. Behavioral changes have proven effective for 70% of adults who suffer from nightmares, including those caused by anxiety, depression, and PTSD.

Imagery rehearsal treatment is a promising cognitive behavioral therapy for recurrent nightmares and nightmares caused by PTSD. The technique helps chronic sufferers change their nightmares by rehearsing how they would like them to transpire. In some cases, medications may be used in conjunction with therapy to treat PTSD-related nightmares, though their efficacy has not been demonstrated as clearly as that of imagery rehearsal treatment.

There are a number of other steps you can take on your own that may help reduce your nightmare frequency. Keeping a regular wake-sleep schedule is important. So is engaging in regular exercise, which will help alleviate nightmare-causing anxiety and stress. You may find that yoga and meditation are also helpful.

Remember to practice good sleep hygiene, which will help prevent the sleep deprivation that can bring on nightmares in adults. Make your bedroom a relaxing, tranquil place that is reserved for sleep and sex, so that you don't associate it with stressful activities. Also, be cautious about the use of alcohol, caffeine, and nicotine, which can remain in your system for more than 12 hours and often disrupt sleep patterns.

WebMD Medical Reference Reviewed by Varnada Karriem-Norwood, MD on August 28, 2014



American Sleep Association: "Nightmares."

Medline Plus Medical Encyclopedia: "Nightmares."

Medical College of Wisconsin: "Nightmares, Sleepwalking and Night Terrors Haunt Many."

American Academy of Sleep Medicine: "Nightmares."

National Center for Posttraumatic Stress Disorder: "Nightmares."

Levin, R., Sleep, March 2002.

American Academy of Family Physicians: "Nightmares and Disorders of Dreaming."

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