Sleep Education

American Academy of Sleep Medicine 

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Nightmares - Risk Factors

Nightmares can happen to anyone, and in most cases the reasons why the nightmares occur are unclear. Stress, anxiety, an irregular sleep routine or being overtired can increase your risk for nightmares.

Some medications such antidepressants, and medications for hypertension or Parkinson’s disease may increase the frequency of nightmares. Nightmares that cause sleep problems may also be associated with factors such as:

  • Another sleep disorder
  • A medical condition
  • Medication use
  • A mental health disorder such as depression, anxiety or post-traumatic stress disorder
  • Substance abuse

Having the same nightmare repeatedly over time can also be common after severe stress or a traumatic event. These nightmares are often a way of “reliving” the traumatic event.

Nightmare Disorder Prevelance

Nightmares can happen to anyone, but nightmare disorder is relatively rare. The key difference for nightmare disorder is the inability to get sufficient sleep because of disturbing dreams. An estimated 2-8 percent of people have nightmares that cause sleep problems.


Nightmares are especially typical in children aged 3-6 years. Up to 50 percent of young children have severe nightmares that cause them to wake up their parents. Nightmares in children tend to peak by ten years of age. After that time, nightmares usually decrease. Some children continue to have nightmares as teens and adults. This may be a lifelong problem for these individuals.


An estimated 50-85 percent of adults report having the occasional nightmare. Nightmares tend to become less frequent and intense as you age. Women tend to report nightmares more often than men, but are also more open to discussing their dreams.

Parasomnias similar to nightmares

Other sleep disorders also classified as parasomnias are sometimes mistaken for nightmares:

Night terrors – These episodes cause you to wake up disoriented from slow-wave sleep in intense fear with your heart racing. Night terrors may cause you to scream, kick, thrash or bolt out of bed. It’s usually difficult to remember what happened, though you may be able to recall brief segments of a terrifying dream. Night terrors tend to occur in the first third of the night.

REM sleep behavior disorder - A potentially dangerous sleep disorder that causes you to act out vivid dreams as you sleep. The dreams are usually filled with action and may even be violent. Because these actions may result in injury to yourself or your partner, REM sleep behavior disorder is considered a dangerous condition that requires medical attention. This disorder is most common in middle-aged men.

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