Nightmares

A nightmare is an unpleasant dream that can evoke strong negative emotional responses; typically fear and/or horror, but also despair, anxiety and great sadness. The dream may contain situations of danger, discomfort, psychological or physical terror. Sufferers usually awaken in a state of distress and may be unable to return to sleep for a prolonged period.

Causes

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, it may be important to talk with your doctor. Sleep deprivation may contribute to adult nightmares, which themselves often cause people to lose additional sleep.

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 cause people to experience chronic, recurrent nightmares. Nightmares in adults can be caused by certain sleep disorders. These include sleep apnea and restless leg syndrome.

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. Nightmares have been associated with suicide. Because nightmares may have a significant impact on your quality of life, it is important to consult a medical professional if you experience them regularly.

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. If your nightmares are not illness- or medication-related, do not despair. Behavioral changes have proven effective for 70% of adults who suffer from nightmares, including those caused by anxiety, depression, and PTSD. Imagery rehearsal treatments, such as proprioceptive imagery training, is a promising cognitive behavioral therapy for recurrent nightmares and nightmares caused by PTSD and other conditions. The technique helps chronic sufferers change their nightmares by rehearsing how they would like them to transpire while they are awake. 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. 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.

Nightmares usually happen in the second part of the night and wake up the sleeper, who is able to remember the content of the dream.

Cannabinoids May Eliminate Nightmares

There is quite a lot of anecdotal evidence that cannabis use, especially medicinal hemp, reduces the frequency and severity of nightmares, sometimes immediately eliminating them altogether. Published research into the effects of cannabis on nightmares, however, is almost non-existent. There is one interesting study published that relied on a patient-reported subjective assessment of nightmare severity and frequency. The study did not include a placebo control group. The study concluded that nabilone (a weak endocannabinoid receptor agonist), reduced the severity and frequency of treatment-resistant nightmares in patients with PTSD. The author concluded that given something as weak as nabilone appeared to help and that perhaps stronger, full spectrum cannabis products would have even more compelling effects.

Physiological Underpinnings

There are some important physiological underpinnings that would argue for cannabis being helpful in reducing or eliminating nightmares. For example, we know now that the endocannabinoid system (ECS) is critical in the regulation of memory extinction. Also, scientists have found that injection of cannabinoid agonists into the basolateral amygdala (BLA) which mediates frightening stressors also helps eliminate vivid, uncontrolled memory recall of stressor events and images.

This may be especially true for people with post-traumatic stress disorder who repeatedly relive their trauma in the form of nightmares and disturbing recollections during the day.   This is logical to assume as the main advances related to the potential therapeutic use of cannabinoid compounds in psychiatry have found CBD to have antipsychotic, anxiolytic, and antidepressant properties.