Why Do I Have Recurring Nightmares?

When we think of nightmares, we often associate these bad dreams with kids who fear monsters under the bed or things that lurk in the dark. But adults often have nightmares too. And sometimes they are recurring.

A recurring nightmare is defined as an unpleasant dream that is repeated over and over again across a long period of time.

Perhaps you dream about being assaulted once a week. Or maybe your nightmare involves a loved one getting into an accident, and you experience it every time you fall asleep.

Whatever type of recurring nightmare you might have, waking up terrified is an awful feeling. And it can feel even scarier to fall asleep when you know you’re likely to have another nightmare.

Fortunately, understanding your recurring nightmares could be the first step in addressing them.

Potential Causes

While dreams have long fascinated people, little is still known about why we dream. And there’s little consensus about whether dreams have deeper meanings.

Even less is known about nightmares. While some researchers think nightmares may stem from chemical imbalances in the brain, others believe they stem from deep-rooted issues or traumatic experiences. And still, some believe nightmares are simply a sign of vivid imagination.

So why would someone have a recurring nightmare? There are a few potential reasons.

Unmet Psychological Needs

Some researchers believe that recurrent nightmares stem from unmet psychological needs, such as autonomy, competence, and relatedness. These unmet needs can lead to recurring dreams, and in some cases recurring nightmares as an effort at processing and integrating these experiences.

Substances and Medications

Medication, drugs, and alcohol may interfere with brain chemicals and increase the likelihood of nightmares. Studies have found that sedatives, beta-blockers, and amphetamines are especially likely to cause nightmares. In some cases, withdrawing from substances can also lead to recurring nightmares.

PTSD

Nightmares are one of the most common symptoms of PTSD. They often involve re-experiencing the same trauma that was endured in real life (although they may also seem unrelated to a specific real-life trauma as well).

Borderline Personality Disorder

Borderline personality disorder is a mental health disorder that is characterized by self-image issues, difficulty managing emotions and behavior, and a pattern of unstable relationships. About 49% of individuals with borderline personality disorder report nightmares.

Nightmare Disorder

Some individuals with recurring nightmares may qualify for a diagnosis of “nightmare disorder.” Nightmare disorder is a mental health condition that is characterized by:

• Recurrent episodes of well-remembered dreams that typically involve efforts to avoid threats to survival or physical integrity
• Rapid alertness upon waking from the nightmare
• Significant distress or impairment in social, occupational, or other areas of functioning

In order to meet the criteria for a diagnosis, the symptoms cannot be explained by a mood-altering substance.

Common Nightmare Themes

While nightmares can be about anything, researchers have found that there are some common themes to nightmares.

A 2018 study examined common nightmares in children. The researchers discovered that children’s nightmares often involved being chased, physical aggression, or the death or injury of a loved one.

A 2014 study published in SLEEP found that adult nightmares are often similar. After analyzing more than 10,000 dreams, researchers found most nightmares involved physical aggression of some kind. Health issues, death, and threats were also common.

The researchers noted that fear is not always part of nightmares. Sadness, confusion, guilt, and disgust were often present. 

The Toll Recurring Nightmares Can Have on You

Someone who has never had recurring nightmares might think, “It’s just a bad dream. So what?” But anyone who has experienced recurring nightmares knows that they can take a serious toll on your emotional, physical, occupational, and social well-being.

Nightmares may interfere with your romantic relationships. It can be difficult to share a bed with someone if you know you might wake up in a cold sweat screaming.

You might also be tired at work because you woke up several times the night before from nightmares. Consequently, your productivity could be affected.

You may have more difficulty managing your emotions or even your appetite when you’re sleep deprived as well.

These are just a few difficulties you might experience as a result of recurrent nightmares. Here’s what the research says about recurring nightmares and the toll they can take:

• Link to suicide. A 2014 study found a link between recurring nightmares and suicide in war veterans. A 2017 study found that recurring nightmares are associated with non-suicidal self-injury among college students.
• Sleep deprivation. What distinguishes nightmares from bad dreams is the fact that nightmares tend to wake people up. They also tend to make it hard to fall back asleep which can lead to sleep deprivation. Sleep deprivation has been linked to a variety of physical health problems and emotional consequences, ranging from an increased risk of depression to obesity.
• Low mood. Nightmares have also been associated with depression, anxiety, and other mood disturbances. 

Treatments

If you’re experiencing recurring nightmares, talk to your physician. Your doctor may want to conduct a complete physical to rule out any potential medical reasons for the nightmares. Your physician may also recommend referral to a therapist who can assist in improving your sleep, address any underlying mental health issues, and reduce your nightmares.

The treatment for recurring nightmares depends on the cause. Sometimes, a few lifestyle changes can reduce them.

At other times, medication changes may be necessary. A physician might be able to prescribe a medication that can decrease nightmares or change one that is contributing to them.

Therapy can also be helpful. Therapists often use exposure therapy to treat PTSD, and this could decrease recurring nightmares.

Therapists may also use exposure therapy to address nightmares directly. This might involve talking about the nightmares and finding healthy ways to cope with the distress caused by them.

Different types of psychotherapy may be effective in reducing recurring nightmares as well, even when the cause of the nightmares isn’t known. Therapists might ask individuals to write down their dreams, associate to different aspects of them, or they may ask them to look for alternative endings to their nightmares.

A Word From Verywell

If you’re struggling with a recurring nightmare, don’t be afraid to ask for help. Talking to your physician or a therapist could be key to helping you get better rest. A few simple changes in your life or working through a specific issue might help you overcome a nightmare once and for all.