Dream Anxiety Disorder - Meaning, Causes, Symptoms, And Treatments.

Dream Anxiety Disorder - Meaning, Causes, Symptoms, And Treatments.

Do you want to know the meaning of dream anxiety disorder? 

The causes, symptoms, and treatments?

Have you ever had trouble sleeping at night? 

Do you experience frequent disturbing dreams when you sleep?

If you are, you may be living with a form of anxiety called " dream anxiety disorder or nightmare disorder"'.

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What Is The Meaning Of Dream Anxiety Disorder? 

Dream anxiety disorder, also called nightmare disorder, is a mental health condition characterized by excessive or inappropriate fear of miseries.

Nightmare disorder is a distressing pattern of repeated dysphoric and vivid dreams. 

The theme of the disorder tends to consist of threats to survival, security, and physical well-being (Kamron A, 2021).

The third edition of the International Classification of Sleep Disorders (ICSD) has classified dream anxiety disorder as a parasomnia usually associated with rapid eye movement (REM) sleep.

This disorder affects about 4% of adults, as a part of other disorders such as posttraumatic stress disorder (PTSD), and can significantly degrade the quality of life.

This mental health condition is characterized by difficulty maintaining sleep continuity or poor sleep quality. 

A person with a dream anxiety disorder may experience intense feelings of fear or distress during the day because they have had a nightmare the night before.

They may also avoid going to sleep because they are afraid of having monsters and becoming anxious when they wake up.

By Frequency 

  • Acute - nightmare lasts less than a month.
  • Subacute - nightmare lasts more than a month but less than four months.
  • Persistent - nightmare lasts more than three months.

By Severity 

  • Mild - experiences nightmares between 1-2 times a week.
  • Moderate - experiences nightmares between 3-4 times a week
  • Severe - experiences frequent or nightly nightmares.

What Are The Causes Of Dream Anxiety Disorders?

There are different causes of dream anxiety disorders. However, scientists have classified the major causes into medical conditions, psychological conditions, and other factors (Bibek, 2021).

Medical Conditions 

These causes can include

  • Neurologic: headache, stroke, restless leg syndrome, central sleep apnea.
  • Endocrine: menopause, pregnancy, diabetes mellitus.
  • Pulmonary: obstructive sleep apnea, asthma.

Psychological Conditions 

These causes can include

  • Depression: dream anxiety is prevalent among depressed people. They find it difficult to fall asleep and maintain sleep.
  • Anxiety and stress: people living with anxiety also find it difficult to maintain sleep. While sometimes, the ordinary stresses from daily life activities can trigger nightmares.
  • Post Traumatic Stress Disorder (PTSD): past traumatic activities such as accidents, war, rape, and the death of one's beloved can also trigger sleep disorders.
  • Medications: antidepressants such as Benzodiazepines may result in severe parasomnia, especially in the elderly.
  • Substance abuse: excessive consumption of alcohol and drugs can result in frequent nightmares.

Other Factors

These causes include

  • Horror books and movies: for some people, especially children, reading scary books or seeing horror movies at night can trigger dream anxiety.
  • Childhood trauma: childhood trauma, such as a family crisis, can be associated with the cause of nightmares.
  • Aging: almost half of the elderly population find it difficult to maintain sleep, as early adverse events can hunt them.

What Are Common Symptoms Of Dream Anxiety Disorder?

How do you know if you have dream anxiety? A study conducted in 2008 also indicated that the condition might be associated with borderline personality disorder (BPD). The symptoms can be generally brief, but they can cause you to be awake, and returning to sleep might be difficult.

Common symptoms include:

  • Poor concentration at school or the workplace because you can't stop thinking of the images in your dreams
  • Scared of going to sleep at night
  • Your dream often awakes you during the night.
  • You feel afraid, anxious, angry, sad, or disgusted due to your dream.
  • You feel clammy or have a pounding heartbeat while in bed.
  • You can think undoubtedly upon awakening and can reminisce details of your dream.
  • Your dream causes despair that retains you from falling back to sleep fast.
  • Daziness during the daytime.
  • Fatigue or low energy
  • Fear of the dark
  • Impaired interpersonal/social function.

Treatment Approaches 

An occasional dream anxiety disorder does not require treatment. However, doctors can treat chronic nightmare disorder in several ways to constrain the frequent occurrences of disturbing dreams. Two major approaches employed to treat this illness are the behavioral and pharmacological approaches. 

Behavioral Treatment Approach For Dream Anxiety Disorder 

Some of the techniques employed under this section to treat nightmares include:

Image Rehearsal Therapy (IRT)

IRT is a form of modified cognitive-behavioral therapy technique that involves altering the content of a disturbing sleep by creating a new set of positive images. The approach is based on the belief that rewriting the imagery during the day will help influence the dreams at night. 

Cognitive Behavioral Therapy (CBT) 

The CBT technique is used to modify a person's dysfunctional thoughts, emotions, and behaviors. The goal is to adapt your mindset and behavior by treating your distorted feelings or thoughts.

Other behavioral techniques include lucid dreaming, sleep dynamic therapy and self-exposure therapy. 

Pharmacological Treatment Approach For Dream Anxiety Disorder 

To pharmacologically treat nightmare or dream anxiety disorder, the America Academy of Sleep Medicine (AASM) recommends the following medications:

  • Prazosin
  • Nitrazepam
  • Triazolam

Any of the following can be prescribed for the treatment of PSTD-associated nightmares.

  • Olanzapine
  • Risperidone
  • Aripiprazole
  • Clonidine
  • Cyproheptadine
  • Fluvoxamine
  • Gabapentin
  • prazosin
  • Topiramate
  • Trazodone
  • Tricyclic antidepressants
  • Nitrazepam and triazolam
  • Venlafaxine

You can find detailed information on the drugs mentioned above here. 

Conclusion

Dream anxiety disorder is a form of sleep disorder often caused by PTSD. 

The disorder is classified by DMS-5 into frequency and severity and can be treated with various techniques and medications.

Resources 

 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.
https://psychiatry.org/psychiatrists/practice/dsm
Gieselmann A, et al. (2019). Etiology and treatment of nightmare disorder: State of the art and future perspectives.
onlinelibrary.wiley.com/doi/10.1111/jsr.12820
Mayo Clinic. Symptoms and causes https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515?p=1
Morgenthaler TI, et al. (2018). Position paper for the treatment of nightmare disorder in adults: An American Academy of Sleep Medicine position paper.
jcsm.aasm.org/doi/10.5664/jcsm.7178

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