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Nightmares as an Adult? It May Be a Sign of Something Serious

January 23, 2023

If you’ve recently jolted awake in the heart-pounding, shaky aftermath of a nightmare, you know they’re not just for kids — and they’re not just in your head. Nightmares affect your body, and vice versa.

In fact, if you’re regularly having nightmares as an adult, it can be a sign that something is wrong with your health.

So don’t try to white-knuckle your way through it. Here’s what to do instead.

> Schedule an appointment with a primary care provider

Find out what’s causing your nightmares.

Most of us know that nightmares can have psychological causes, like PTSD. But get this: They can also have purely physical causes — like a sleep disorder or the side effects of a new medication.

How to know what’s causing yours? A sleep study is a good place to start.

“A lot of people have recurrent nightmares about being suffocated or chased, and when we do a sleep study, it turns out they have a sleep disorder like sleep apnea or restless leg syndrome,” says Steven Thau, MD, a pulmonologist and sleep specialist with St. Vincent’s Medical Center in Bridgeport. “Once we treat it, the dreams go back to being pleasant.”

If the problem doesn’t have a physical cause, it might be psychological — like stress from a major life change, or a condition like anxiety, depression or PTSD. Talk to your doctor. They can recommend a number of interventions, from therapy to acupuncture and biofeedback.

> Connect with a Sleep Care Center

Meanwhile, cut back on alcohol, cigarettes and screens.

Nightmares tend to occur when something goes wrong during the REM cycle of sleep. Any number of factors can be responsible.

A few usual suspects? Alcohol, cigarettes and video screens.

“Alcohol and smoking directly impair the brain’s ability to sleep and achieve the more natural stages of sleep,” says Dr. Thau.

Meanwhile, the blue light from screens messes with sleep hormones. And often, the content on our screens is literally the stuff of nightmares.

“If you’re watching Law & Order reruns till midnight, it’s not surprising when you have a horrific nightmare — you’ve just been watching something horrific,” says Dr. Thau. “Your brain is not a light switch. It can’t turn on and off. It has to process what happened.”

Ideally, avoid screens for two hours before bedtime (or however long you can manage). Meanwhile, start cutting back on alcohol and cigarettes until you get to zero. Your healthcare team can help.

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For fewer nightmares, get more sleep.

If you’re plagued by nightmares, your pillow may not exactly be beckoning. But don’t avoid it.

“You can have nightmares because you’re not getting enough sleep,” says Dr. Thau.

Why? While you sleep, your brain is blazing through a massive to-do list. It’s sorting through all the day’s information, organizing memories, clearing out toxins and resting major organs. If it can’t get to all this, your systems and sleep cycles get a little… glitchy. Cue any number of health issues, including nightmares.

Think of it this way: To eventually get a pleasant night’s sleep, start by getting a full night’s sleep.

Have a plan for your next nightmare.

First, take a beat. “When you wake up from a nightmare, your heart rate’s going to be elevated, your blood pressure is going to be high,” says Dr. Thau. “Only two things are going to help you fall back asleep: remaining calm and waiting.”

Take the opportunity to make a few notes. What time is it? How many hours has it been since you fell asleep? This can reveal tell-tale patterns to help a doctor get to the bottom of your nightmares.

If you’re still not drowsy, get out of bed and do something calming. “Take slow, deep breaths. Listen to soft music. Read a People magazine or Better Homes & Gardens, something that’s not gripping and just gets you to relax,” says Dr. Thau. “Don’t turn on the TV and certainly – no news! You want to read about light material such as pretty people, pretty places, pretty things.”

Then, the next morning, call your friendly neighborhood sleep expert. They can point the way to sweeter dreams.

Connect with a sleep disorders specialist

Sleep problems are remarkably common – approximately 70 million Americans suffer from some kind of sleep disorder. Our experts are here to help.

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