Nightmares and nightmare disorder: causes, night terrors and what helps

The NHS describes nightmares as bad dreams that you wake up from and can remember, with strong feelings of fear. Nightmares happen later in the night, and can affect both children and adults. Most people have the occasional nightmare. When they are frequent and affect sleep and everyday life, this is sometimes called nightmare disorder, although the NHS refers simply to frequent nightmares.

The NHS stresses that night terrors and nightmares are different and happen at different stages of sleep, which affects how they should be handled.

The NHS sets out a clear comparison. During a night terror you may talk and move about but are asleep, and it is rare to remember it.

The NHS lists common causes of night terrors and nightmares: being very tired or unwell, sudden noises at night or needing to pee during the night, which can affect deep sleep, and something that has frightened you, such as a scary film, or made you stressed, anxious or worried. They can also be caused by taking certain medicines, such as antidepressants, conditions that affect sleep such as restless legs syndrome or sleep apnoea, mental health conditions such as generalised anxiety disorder, conditions that affect the brain such as Parkinson's disease, and severe injury, after which sleep may be disturbed for 4 to 6 weeks.

Night terrors are more common in people with family members who have had night terrors or who sleepwalk. The NHS sleepwalking page notes that sleepwalking, another disturbance of sleep, can be linked to not getting enough sleep, other sleep conditions, being unwell with a high temperature, certain medicines, stress and drinking alcohol.

The NHS says to see a GP if your child continues having nightmares after the age of 6, is having frequent nightmares or nightmares caused by an upsetting or frightening event, continues having night terrors after the age of 12 or starts having night terrors after the age of 5, or if you are having regular nightmares that are affecting your sleep and everyday life.

If nightmares began after a traumatic event, a GP may recommend psychological treatment such as counselling, according to the NHS. If you suspect a medicine is involved, do not stop it without talking to the prescriber.

The NHS says for most people nightmares get better on their own, and suggests a few things.

• Have a relaxing bedtime routine.

• Keep a sleep diary, including how long you or your child sleep for, how long it takes to fall asleep and how you feel the next day, to help identify any causes.

• Try to deal with things that might be causing stress or anxiety.

• For night terrors, stay calm and wait for the person to calm down, do not try to wake them, and do not talk to them or try to stop them moving unless there is a risk of injury.

• If night terrors happen at the same time every night, try waking the person up 15 minutes before for 2 weeks, which the NHS says may stop them.

The NHS says treatment depends on what may be causing the nightmares. Psychological therapies such as cognitive behavioural therapy (CBT) can help children and adults who have frequent nightmares, and CBT may also help with conditions such as anxiety or insomnia that can cause night terrors or nightmares. If you have a condition that affects your sleep, treatment will usually involve managing the condition better.

On the NHS the route is the GP, then talking therapies or sleep services where appropriate. Private psychologists and CBT therapists can provide sessions sooner, and it is reasonable to ask for someone with experience of sleep problems or trauma where relevant. A sleep diary helps whichever route you use.