Nightmare Disorder Treatment & Management
- Author: Daniel R Neuspiel, MD, MPH, FAAP; Chief Editor: Caroly Pataki, MD more...
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.
The most common strategies reported by children for handling their nightmares include ignoring/distraction, talking to parents, or hugging soft toys.
Several different cognitive-behavioral methods have been reported to be effective in treating nightmares in children.
Hypnosis has been reported to be effective in treating nightmares and other parasomnias in children and adults.
If the nightmare is recurrent, discussing dream content and rescripting may help.
Psychiatric intervention may be warranted for various therapies.
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.
Nevsimalova S, Prihodova I, Kemlink D, Skibova J. Childhood parasomnia - A disorder of sleep maturation?. Eur J Paediatr Neurol. 2013 Jun 15. [Medline].
American Academy of Sleep Medicine. International Classification of Sleep Disorders: Diagnostic and Doding Manual. 2nd ed. Westchester, Ill: American Academy of Sleep Medicine; 2005.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 5th ed. Washington, DC: American Psychiatric Association; 2013.
Nielsen TA, Laberge L, Paquet J, et al. Development of disturbing dreams during adolescence and their relation to anxiety symptoms. Sleep. 2000 Sep 15. 23(6):727-36. [Medline].
Partinen M, Hubin C. Epidemiology of Sleep Disorders. Kryger MH, Roth T, Dement WC, eds. Principles and Practice in Sleep Medicine. Philadelphia, Pa: WB Saunders; 2000. pp 558-579.
Muris P, Merckelbach H, Gadet B, Moulaert V. Fears, worries, and scary dreams in 4- to 12-year-old children: their content, developmental pattern, and origins. J Clin Child Psychol. 2000 Mar. 29(1):43-52. [Medline].
Kotagal S. Parasomnias of childhood. Curr Opin Pediatr. 2008 Dec. 20(6):659-65. [Medline].
Bloomfield ER, Shatkin JP. Parasomnias and movement disorders in children and adolescents. Child Adolesc Psychiatr Clin N Am. 2009 Oct. 18(4):947-65. [Medline].
Aurora RN, Zak RS, Auerbach SH, Casey KR, Chowdhuri S, Karippot A, et al. Best practice guide for the treatment of nightmare disorder in adults. J Clin Sleep Med. 2010 Aug 15. 6(4):389-401. [Medline]. [Full Text].
Moore M. Behavioral sleep problems in children and adolescents. J Clin Psychol Med Settings. 2012 Mar. 19(1):77-83. [Medline].
Sadeh A. Cognitive-behavioral treatment for childhood sleep disorders. Clin Psychol Rev. 2005 Jul. 25(5):612-28. [Medline].