Nightmare disease: how to recognize it and how is it treated?

When bad dreams are so frequent that they deteriorate the quality of life, it is called the disease of nightmares. Who is concerned ? Can we treat it?

Waking up in a sweat in the middle of the night because we dreamed that we fell into a precipice or that a monster devoured us. Every one of us has had a nightmare. This “striking, unpleasant dream which often includes a form of threat to the safety, survival, esteem or physical integrity of the subject, then leading to awakening, (is distinguished) from “bad dreams”, rich in negative emotions but which do not wake the sleeper”, describes the Brain Institute. As unpleasant as they are, they are completely natural, in that they do not recur regularly.

On the other hand, if they are too frequent and “if they have an impact on sleep, quality of life, mood and mental health, this parasomnia becomes a disease, “the disease of nightmares””, perhaps we read in Congress News by Medscape about the Brain Congress 2022. This pathology affects about 4% of adults according to the American Academy of Sleep Medicine.

What are the causes ?

“The nightmare disease can be idiopathic (we don’t know what causes it, editor’s note) or associated with other pathologies such as psychiatric disorders”, indicates Dr Julia Maruani, doctor in the Psychiatry and Addiction department at Bichat Hospital. in Paris which reviewed this pathology at the 2022 Brain Congress. “It affects 70% of patients with post-traumatic disorders, 16.5% of patients with unipolar depression and 9 to 55% of patients with psychotic disorders.”

Can we treat it?

“It is very important to diagnose and treat the disease of nightmares because the complications are severe,” continues Dr. Maruani. “It is an independent risk factor for suicidal thoughts and attempts, depression, and substance use, among others.”

The management consists of setting up psychotherapeutic treatments, including the repetition of positive mental imagery (RIM). Reference treatment for idiopathic nightmares and related to post-traumatic stress disorder, it reduces the frequency and distress associated with nightmares over the long term without reported adverse effects.

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