Nightmare Disorder

Posted byRatel Health
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Nightmare Disorder

Medically reviewed · Ratel Health editorial team · Sunday, 16 August 2026

A sleep disorder involving repeated occurrences of extended, extremely dysphoric, well-remembered dreams that cause significant distress or impairment.

Overview

Nightmare disorder involves repeated occurrences of extended, extremely dysphoric, and well-remembered dreams, usually involving threats to survival or safety, that cause clinically significant distress or impairment.

Signs and Symptoms

Symptoms can include waking fully alert from a disturbing dream, difficulty returning to sleep, and daytime fatigue or anxiety about sleeping. Experiencing one or more of these symptoms does not necessarily mean that a person has this condition. Diagnosis requires an appropriate clinical evaluation.

Causes and Risk Factors

Nightmares can be associated with stress, trauma, certain medications, or occur without a clearly identifiable trigger.

Diagnosis

A diagnosis should be made by a qualified healthcare professional following a comprehensive clinical assessment. Clinicians may use established diagnostic frameworks such as DSM-5-TR and/or ICD-11 as part of a comprehensive assessment.

Treatment

Treatment depends on the individual’s symptoms, clinical history, severity, age, co-occurring conditions, and other relevant factors.

Psychotherapy

Imagery rehearsal therapy, a form of cognitive behavioral therapy, has evidence supporting its use for recurrent nightmares.

Living With Nightmare Disorder

Maintaining a consistent sleep schedule and addressing underlying stress can help reduce nightmare frequency.

When to Seek Professional Help

Professional evaluation may be appropriate if symptoms persist, worsen, cause significant distress, or interfere with work, school, or relationships.

Emergency Situations

If a person may be in immediate danger, is experiencing a medical or psychiatric emergency, or may harm themselves or another person, seek immediate assistance through appropriate local emergency services.

Outlook

Many people experience meaningful improvement with targeted behavioral treatment.

Related Conditions

Insomnia Disorder

A condition involving persistent difficulty falling asleep, staying asleep, or achieving restful sleep, causing distress or impairment.

Post-Traumatic Stress Disorder

A condition that can develop after exposure to a traumatic event, involving intrusive memories, avoidance, negative mood changes, and heightened arousal.

Medical Information Disclaimer

Ratel Health provides general educational information and does not provide medical diagnosis, treatment, or individualized medical advice. Information on this page is not a substitute for evaluation or care from a qualified healthcare professional. Do not use this information to diagnose yourself or another person, or to start, stop, or change treatment or medication without consulting an appropriately qualified healthcare professional.

References

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
  • National Institute of Mental Health.
  • World Health Organization. International Classification of Diseases, 11th Revision.