Archive for the ‘Nightmares’ category

Waking up confused and panicked

August 6, 2013

Q:  I sometimes awaken in the middle of the night with a horrible feeling like I’ve done something terribly wrong or a loved one has been somehow hurt in an accident.  When this happens I feel panicked, my heart races, and it’s very difficult to fall back asleep.  What is going on?

A:  What you are experiencing could be just a bad dream, or it could be a night terror.  In either case these thoughts can be intensely disturbing or even frightening,  but they are generally harmless if you learn to just let them go.

To better understand what’s going on, consider the normal sleep cycles we typically experience each night.  It’s normal to briefly awaken between the 5 or 6 cycles of sleep each night.  Good sleepers usually fall right back asleep after these transitory awakenings, and typically forget about them by morning.

But if we are under an increased amount of stress, tension, or anxiety, these wake-ups, especially between the earlier cycles in the night, can sometimes be disturbing.  This may be what you are experiencing.

If you are under excessive anxiety or stress, managing these issues during your waking hours may help reduce these disturbing wake ups and help you sleep better.  Key among stress and anxiety management methods is getting good daily exercise, which helps support more robust sleep.

Some stress and anxiety is normal, we all experience them to some degree.  To sleep better, try to identify and address the recurring negative thought patterns that underlie anxiety.  You can also help manage stress by understanding the situations that typically result in a stress response, and modify your reaction to them.

If you are looking for a comprehensive and drug-free solution for better sleep that also helps you address anxiety and manage stress, consider CBT — cognitive behavioral therapy, specifically designed for insomnia.  CBT has been proven to help most people who try it, the improvements are usually permanent, and CBT has no side effects.

In your case, regardless of whether it’s a nightmare or a night terror, remember it’s still only a dream, and dreams cannot hurt you.  It’s OK to safely let them go.

Understanding night terrors and insomnia

June 6, 2013

Q:  I sleep walk and am prone to night terrors.  Sometimes I wake up in the night screaming, other times I find myself running out of my bedroom yelling.  I rarely remember any details about my dreams, but these terror episodes seem to be worse when I am stressed.  Do you have any suggestions?

A:  Night terrors can be absolutely frightening, but rest assured there are effective treatments

First, it’s important to understand the difference between nightmares and night terrors.

Nightmares are a form of REM dreaming.  While dreaming is thought to be a continuous process throughout the night, our most vivid dreams typically occur during REM.  When the emotional content of a REM dream is very negative, we might call it a nightmare.

Night terrors are qualitatively different than nightmares.  Night terrors typically occur during the deeper NREM sleep stages that normally precede REM sleep.  NREM is also known as deep or slow wave sleep.

Children are most prone to night terrors, but typically outgrow them during adolescence.  Adults can also experience night terrors, but most of us can usually just them go safely unless they become overly disruptive, dangerous, or they have lingering negative effects that overlap into daytime waking hours.

If you feel overwhelmed by the experience of night terrors, a visit to your doctor is in order.  A primary care doctor may refer you to a physician specializing in sleep medicine, or to a sleep clinic where you may have an overnight sleep study.  This will help you either treat or rule out any underlying medical issues.

Night terrors are often worsened by stress and anxiety.  So it stands to reason that reducing levels of stress and anxiety will also help manage night terrors.

Counseling is one way to learn effective methods to control stress and anxiety.  By understanding the recurring negative thought patterns that underlie stress and anxiety, it’s possible to manage them permanently, and without drugs.

If you are the self-help type, you can find many books and online resources about stress management and control of anxiety.  In particular cognitive behavioral therapy (CBT) is very useful, and there are CBT programs specifically designed to help train adults to sleep better.  These methods might help you better manage night terrors while improving your overall sleep.

In addition, you will help yourself by having a better understanding of what dreams really are, including night terrors, and what they are not.

What they are not is real.

By themselves, night terrors or nightmares cannot hurt you.  Even if they are terrifying or the content is disturbing, they are still only dreams.

Regardless of emotional content, what dreams and night terrors really are is a function of sleep.  A night terror by definition means you are experiencing deep sleep, which is normally the most refreshing stage.  A nightmare experienced during REM sleep means you are still benefiting from all the preceding deeper most refreshing stages of sleep.

While the psychological function of dreams is still not completely understood, they may be a way to purge yourself of excessive anxiety, fears, or prior trauma you may have experienced.   In that sense, dreams, including nightmares, are healthy.

So we suggest it’s OK for most of us to just let these negative dreams go.  Most of us can do so safely.

Resolve nightmares using Image Rehearsal Therapy

October 22, 2012

Recurring nightmares disrupt the sleep of a surprisingly large number of people, about 4% of adults on a regular basis, and higher percentages for children and adolescents.

We previously discussed ways to understand the potentially beneficial roles nightmares play, both as a form of dreaming, and as a way to cleanse or purge especially traumatic or painful memories and experiences.

Another proven method to help reduce the negative impact of nightmares is through Image Rehearsal Therapy (IRT).

In 2001, medical researchers at the University of New Mexico found IRT significantly improves sleep by cutting the incidence of disturbing nightmares in half.  The method also helps reduce the daytime symptoms of stress and trauma.

The IRT method involves deliberately recasting nightmares into a more favorable light.  The process goes something like this:  First identify a recurring nightmare that is bothering you.  Write down the imagery so you recognize and understand it.  Then imagine that nightmare in changed terms, whatever terms you want.  Change the nightmare in your mind intentionally.  Then write down the changed nightmare, which is now more of a dream with less negative connotations, so you understand it in detail.  Commit the new dream to memory.

Next, mentally practice or rehearse the changed dream in your mind for 5 to 20 minutes per day.  Continue this rehearsing every day until the nightmare is no longer a problem.  Basically, using this method, the nightmare over time loses its negative impact and fades away.

IRT is a variation of cognitive behavioral therapy (CBT) that has been proven effective and is recommended as a standard of treatment by the American Academy of  Sleep Medicine.

In broader terms, CBT specifically designed for sleep can benefit most everyone with sleep problems.  Like IRT, the methods contained in CBT are drug-free, natural, and designed to get to the real root of the problem.  By doing this, sleep tends to improve naturally.  As a result of better sleep, daytime performance and overall personal happiness is enhanced.

For more information on using CBT methods to improve sleep, or to ask a sleep question, please feel free to visit us at

Nightmares: try a new perspective for better sleep

September 17, 2012

Let’s be honest:  nightmares are disturbing.  While all of us experience them from time to time, nightmares may cause a significant loss of sleep to some people who find them particularly troubling.  Some are so fearful of a nightmare they dread just the idea of falling asleep.

Those who struggle with nightmares might be helped by taking a different and more realistic perspective.  We suggest trying to see nightmares for what they really are, and understand what they aren’t.

What they aren’t are real.  No matter how disturbing the images or negative the emotions may be, they’re still only dreams.

They cannot hurt you.

What dreams really are is a manifestation of REM sleep, and REM sleep is good.  It’s healthy.  To reach a REM stage of sleep, we normally go through all the preceding stages of NREM sleep, also known as deep or slow wave sleep.

The NREM stages are the most physically restorative stages of sleep, so if you have dreams, even nightmares, you can be assured of receiving the physical benefits of deep sleep.

You can choose to view REM dream sleep, regardless of content, as serving a beneficial purpose.  Through our dreams, we process experience.  We consolidate short term memories from each day, give meaning and perspective to them, and possibly convert the experiences into long term memory.  Using REM sleep, we in effect re-set our emotional balance, our mood, for a fresh new day.

Nightmares, in particular, may also represent a subconscious effort to cleanse or purge ourselves of painful memories or trauma.  It’s a form of a catharsis.  Think of it like this: getting cleansed of traumatic experiences in our dreams is far better and healthier than living it during our waking hours.

How we interpret dreams is a choice we make and can control.  While we cannot control the content of our dreams, we can consciously choose how we react to them.  By understanding nightmares in more realistic and accurate terms, it’s easier to just let them go by saying, “whew!  I’m glad that was only a dream!”  And it then may be easier to relax and fall back asleep.

Understanding nightmares for what they really are is a form of cognitive restructuring, one of the core components of cognitive behavioral therapy for insomnia (CBT).  If you have been experiencing sleep problems, CBT is one of the very best ways to permanently improve sleep.  The methods in CBT are completely drug-free and help most everyone.  Many who try CBT become normal sleepers again.

For more information on using CBT for insomnia, or to ask a sleep question, please feel free to contact us.

Resolving “Anxiety Dreams”

July 30, 2012

Q:  I have a hard time getting to sleep, and part of the problem is anxiety and worry.  Just before waking, I often have anxiety dreams, and then the residue stays with me after I awaken.  What’s going on?

When we spontaneously awaken after sleep, we typically are ending a REM dream phase.  So remembering a vivid dream after you awaken is in fact common and normal for this reason.

The emotional content of dreams is another question.  Dreaming is poorly understood and there is not strong consensus among sleep experts.

Are dreams simply random thoughts strung together?  Do we tend to dream about what we are thinking just prior to going to bed?  Do we use dreams to process the previous days events?  Do we, through our dreams, emotionally purge ourselves of traumatic experiences?

Any and all of the above could be happening.

You might benefit by taking a positive view of your dreams , including nightmares.

At the risk of stating the obvious, dreams are not real.  They cannot hurt you.  Rationally, there is no reason to let anxiety “residue” negatively affect your waking hours.

A better, more accurate view might be that in reality your sleeping mind is processing anxiety in a healthy way to help get rid of it — through your dreams.  From this perspective it may then be easier, upon awakening, to just let it go.  And once you are awake and more in conscious control, remember that letting it go is a choice you have and can make.

When it comes to dreams, this much we do know:  excessive levels of anxiety can and will disrupt sleep, and may contribute to dreams with disturbing images.  So learning how to reduce anxiety experienced during waking hours helps.  More specifically, learning how to reduce the impact of the recurring negative thought patterns that underlie and contribute to anxiety will often go a long way to help support better sleep.  And just maybe help contribute to sweet dreams.

You can learn how to sleep better and manage anxiety through a good CBT-based insomnia treatment like the Sleep Training System.  The STS includes components that help you naturally de-stress and control anxiety, in addition to providing you with potent ways to help sleep better permanently — and without the need for drugs of any kind.

Check out the Sleep Training System for more information, and feel free to contact us with your questions about better sleep naturally.

Put nightmares in proper perspective for better sleep

January 11, 2012

A surprising number of people are often disturbed by nightmares, disturbed to the point where it affects their ability to consistently get a good night’s sleep.  Here’s a few ideas to help put nightmares in proper perspective for better sleep.

First, rest assured if you are having a nightmare that you are in fact actually sleeping, and for those with trouble sleeping that’s a good thing right there.

Dreaming is a continuous process through sleep cycles, but typically the most vivid dreams occur during REM sleep. This suggests a nightmare is normally experienced during REM sleep, which means you can be assured of several more benefits beyond the fact that you are actually sleeping.

REM sleep normally occurs at the end of much deeper sleep phases.  So if you have a nightmare, you are in fact benefiting from the most restorative and physically refreshing stages of deep sleep that usually precede REM sleep.

Even if the nightmare is disturbing, in balance the physical benefits you receive from experiencing deep sleep are likely far more important to your overall well being.

Second, although the exact function of sleep and dreams is still not completely understood, many sleep experts believe dreaming and especially REM dreams help consolidate memory, process events, and help re-set one’s mood for a new day.   So even if you have a nightmare you can be assured that you are in fact processing events in your life as you should be through your dreams.

Some psychologists suggest that recurring nightmares are a symptom of trauma, stress, and anxiety experienced during waking hours.   If you are experiencing unusual stress or anxiety that affects your daytime functioning, counseling can help.  In this way professional counseling might also help reduce the frequency and intensity of bad dreams.

Finally, at the risk of stating the obvious, nightmares are in fact only dreams. They are not real. Reminding yourself of this might help you let them go, be less disturbed by them, and just accept them for what they really are — including the aforementioned significant benefits.

Putting nightmares in a realistic and accurate perspective might help you say what many of us say when we experience them: “Whew, I’m glad that’s only a dream!”

Nightmares are only dreams.  They can’t hurt you.

For more sleep tips and information on ways to sleep better naturally, or if you have a sleep-related question, feel free to contact us.