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Nightmares and Sleep

Many Americans experience sleep disorders that involve dreaming. These include nightmares, sleep terrors, and REM sleep behavior.

Nightmares are dreams with vivid and disturbing content. They are common in children during REM sleep. They usually involve an immediate awakening and good recall of the dream content.

Sleep terrors are often described as extreme nightmares. Like nightmares, they most often occur during childhood, however they typically take place during non-REM (NREM) sleep.

Characteristics of a sleep terror include arousal, agitation, large pupils, sweating, and increased blood pressure. The child appears terrified, screams and is usually inconsolable for several minutes, after which he or she relaxes and returns to sleep. Sleep terrors usually take place early in the night and may be combined with sleepwalking. The child typically does not remember or has only a vague memory of the terrifying events.

Similar to sleep terrors, but more common in adults, is REM sleep behaviors. This involves complex, vigorous, or violent behaviors, sometimes associated with dream-like thoughts and images. Patients with REM sleep behaviors may complain of sleep disruption, violent behavior with injuries to themselves or to their bed partner, or unpleasant and vivid dreams. Patients are usually middle-aged or elderly, and about one third have an associated neurological disease.

If you or someone you know is experiencing distributed sleep or incurring injuries due to any of these problems, they should consult their doctor. Sleep disorders can often be treated.

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