Nightmares Treatment & Management

  • Author: Daniel R Neuspiel, MD, MPH, FAAP; Chief Editor: Caroly Pataki, MD   more...
 
Updated: Mar 9, 2011
 

Medical Care

Reassurance and conservative management is the only treatment required for sporadic nightmares.

Daytime stressors should be identified and resolution attempted.

Bedtime should become a safe and comfortable time when parents read to and talk with the child.

Parents should monitor media exposure as this influences dream content. Television viewing should be avoided for about 2 hours prior to bedtime.

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Consultations

If the nightmare is recurrent, discussing dream content and rescripting may help, and psychiatric intervention may be warranted.

Psychological evaluation is indicated for patients whose nightmares occur more than twice a week over a period of several months, or when the nightmares are of great severity.

Several different cognitive-behavioral methods have been reported to be effective in treating nightmares in children.[9]

Hypnosis has been reported to be effective in treating nightmares and other parasomnias in children and adults.[10]

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Contributor Information and Disclosures
Author

Daniel R Neuspiel, MD, MPH, FAAP  Director of Ambulatory Pediatrics, Levine Children's Hospital, Carolinas Medical Center; Adjunct Clinical Professor of Pediatrics, University of North Carolina School of Medicine

Daniel R Neuspiel, MD, MPH, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Physician Executives, American Public Health Association, New York Academy of Medicine, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Coauthor(s)

Erin Hollingsworth Stubbs, MD  Faculty Physician, Division of General Pediatrics, Levine Children's Hospital, Carolinas Medical Center

Erin Hollingsworth Stubbs, MD is a member of the following medical societies: American Academy of Pediatrics and American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Chet Johnson, MD  Medical Director, Child Development Unit, Department of Pediatrics, Professor, University of Kansas Medical Center

Chet Johnson, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Pharmacy Editor, eMedicine

Disclosure: Nothing to disclose.

Carrie Sylvester, MD, MPH  Director of Education in Child and Adolescent Psychiatry, Professor, Departments of Psychiatry and Pediatrics, Northwestern University Medical School

Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Medical Women's Association, American Psychiatric Association, and American Society for Adolescent Psychiatry

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD  Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Keck School of Medicine of the University of Southern California

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

References

  1. American Academy of Sleep Medicine. International Classification of Sleep Disorders: Diagnostic and coding manual. 2nd. Westchester, IL: American Academy of Sleep Medicine; 2005.

  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th. Washington, DC: American Psychiatric Association; 1994.

  3. Partinen M, Hubin C. Epidemiology of sleep disorders. In: Kryger MH, Roth T, Dement WC. Principles and Practice in Sleep Medicine. Philadelphia: WB Saunders; 2000:pp 558-579.

  4. Petit D, Touchette E, Tremblay RE et al. Dyssomnias and parasomnias in early childhood. Pediatrics. 2007;119:e1016-e1025. [Medline]. [Full Text].

  5. Nielsen TA, Laberge L, Paquet J, et al. Development of disturbing dreams during adolescence and their relation to anxiety symptoms. Sleep. Sep 15 2000;23(6):727-36. [Medline].

  6. Muris P, Merckelbach H, Gadet B, et al. Fears, worries, and scary dreams in 4- to 12-year-old children: their content, developmental pattern, and origins. J Clin Child Psychol. 2000;29:43-52. [Full Text].

  7. Kotagal S. Parasomnias of childhood. Curr Opinion Pediatr. 2008;20:659-665. [Medline].

  8. Bloomfield ER, Shatkin JP. Parasomnias and movement disorders in children and adolescents. Child Adolesc Psychiatr Clin N Am. Oct 2009;18(4):947-65. [Medline].

  9. Sadeh A. Cognitive-behavioral treatment for childhood sleep disorders. Clin Psychol Rev. Jul 2005;25(5):612-28. [Medline].

  10. Hauri PJ, Silber MH, Boeve BF. The treatment of parasomnias with hypnosis: a 5-year follow-up study. J Clin Sleep Med. 2007;3:369-373. [Full Text].

 
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