What To Do If You Can't Stop Having Nightmares

Photographed by Alexandra Gavillet.
The worst thing about nightmares may be that the unpleasantness doesn't end when you wake up. Not only was the dream itself awful, but then it just stays with you. And who knows whether or not you'll be able to get to sleep the next night with the memory of those ghosts (or three-eyed monsters or giant rabid dogs or whatever they were) hiding in your subconscious. Luckily, if you're one of the unlucky who gets nightmares a lot, there are ways to banish them.
When it comes to nightmares (and dreams in general), it's the emotions you feel that matter more than the weird things that are happening in the dream, says Barry Krakow, MD, founder of the Maimonides International Nightmare Treatment Center. "Say you had a dream about being really angry at a dinosaur," he says. "Well, you probably don’t have too many dinosaurs in your life, but you probably have some anger and you might need to explore that."
Although everyone gets nightmares at some point, some of us experience them more often than others — especially those who are already dealing with mental health issues. And, if you have nightmares so often and so vividly that they're interfering with the rest of your life, you may have nightmare disorder, which can easily exacerbate other mental disorders. "In people who have chronic nightmares, it seems to be destructive and damaging to sleep," Dr. Krakow says, "and you end up with more anxiety or depression."
For some people, chronic nightmares develop after they've been through some sort of trauma. In those cases, Dr. Krakow says your nightmares may actually be a symptom of PTSD — especially if you have recurring nightmares in which you go through almost exactly the same scenario over and over again. Insomnia is also common among people with PTSD, possibly fueled by anxiety about having nightmares.
In other cases, though, you might get frequent nightmares because you process your emotions a bit differently from the way others do, Dr. Krakow says. Research shows that people who get nightmares frequently tend to be more anxious and neurotic but also more empathetic and creative than the average person. On top of that, experiencing more mild forms of stress (e.g. getting an angry email from your boss) can make you more susceptible to nightmares.
So what are you supposed to do about it? Well, there are a few science-backed options. First, there's imagery rehearsal therapy (IRT), a technique which Dr. Krakow and his colleagues pioneered. During IRT, you'll talk to a therapist about your nightmares and essentially re-write them to be more positive.
For instance, if you're plagued by dreams of hulking figures on the horizon, your therapist might help you turn them into a peaceful mountain range instead. And, crucially, you'll rehearse your improved version of the nightmare before you go to sleep. If you have nightmares along with a mental health or sleeping issue (e.g. severe insomnia or PTSD), it's probably best to do this with the guidance of a therapist. But if you're just dealing with the nightmares, Dr. Krakow says you can actually try this on your own (with the help of a workbook and audio guide). If you're still having trouble, though, definitely enlist some professional help.
There are other psychotherapy techniques, too, such as lucid dreaming, which can help you accomplish the same goal of re-writing the dream. And several medications have been shown to reduce nightmares, such as the high blood pressure drug prazosin, especially if you have severe insomnia.
Interestingly, there's also a mysterious connection between having frequent nightmares and having breathing disorders associated with sleep, such as sleep apnea. Researchers have even found that putting patients with PTSD-related chronic nightmares on a CPAP machine, which helps regulate breathing while a patient sleeps, actually reduces the amount of nightmares they have. The reasons behind this aren't totally understood at this point, but helping patients get good sleep without breathing issues may help alleviate other symptoms of their disorder and, therefore, their nightmares.
The bottom line is that, if you find yourself getting nightmares often, you aren't necessarily stuck with 'em. And, especially if you're also dealing with insomnia or a mental health issue, it's worth checking in with a professional counselor to figure out how to make peace with your dreams and get the rest you deserve.

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