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Nightmare Disorder Treatment & Management

  • Author: Daniel R Neuspiel, MD, MPH, FAAP; Chief Editor: Caroly Pataki, MD  more...
 
Updated: May 11, 2015
 

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.[12] Television viewing should be avoided for about 2 hours prior to bedtime.[13]

The most common strategies reported by children for handling their nightmares include ignoring/distraction, talking to parents, or hugging soft toys.[3]

Several different cognitive-behavioral methods have been reported to be effective in treating nightmares in children.[14]

Hypnosis has been reported to be effective in treating nightmares and other parasomnias in children and adults.[13]

If the nightmare is recurrent, discussing dream content and rescripting may help.

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Consultations

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.

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Contributor Information and Disclosures
Author

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

Daniel R Neuspiel, MD, MPH, FAAP is a member of the following medical societies: Academic Pediatric Association, American Academy of Pediatrics, American Association for Physician Leadership, 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, American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD Health Sciences Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine

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

Disclosure: Nothing to disclose.

Additional Contributors

Chet Johnson, MD Professor of Pediatrics, Associate Director and Developmental-Behavioral Pediatrician, KU Center for Child Health and Development, Shiefelbusch Institute for Life Span Studies; Assistant Dean, Faculty Affairs and Development, University of Kansas School of Medicine

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

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Kevin P Connelly, DO, to the development and writing of this article.

References
  1. Nevsimalova S, Prihodova I, Kemlink D, Skibova J. Childhood parasomnia - A disorder of sleep maturation?. Eur J Paediatr Neurol. 2013 Jun 15. [Medline].

  2. American Academy of Sleep Medicine. International Classification of Sleep Disorders: Diagnostic and Doding Manual. 2nd ed. Westchester, Ill: American Academy of Sleep Medicine; 2005.

  3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 5th ed. Washington, DC: American Psychiatric Association; 2013.

  4. 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].

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

  6. 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.

  7. Byars KC, Yolton K, Rausch J, Lanphear B, Beebe DW. Prevalence, patterns, and persistence of sleep problems in the first 3 years of life. Pediatrics. 2012 Feb. 129(2):e276-84. [Medline]. [Full Text].

  8. 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].

  9. Kotagal S. Parasomnias of childhood. Curr Opin Pediatr. 2008 Dec. 20(6):659-65. [Medline].

  10. 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].

  11. 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].

  12. Moore M. Behavioral sleep problems in children and adolescents. J Clin Psychol Med Settings. 2012 Mar. 19(1):77-83. [Medline].

  13. Hauri PJ, Silber MH, Boeve BF. The treatment of parasomnias with hypnosis: a 5-year follow-up study. J Clin Sleep Med. 2007 Jun 15. 3(4):369-73. [Medline]. [Full Text].

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

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