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How To Diagnose Nightmare Disorder & What Is The Best Medicine For It?

Nightmare disorder is a disorder characterized by disturbance in the sleep accompanied by negative emotions such as fear, anxiety or sadness. This disorder is rare but nightmares are common in day to day life. Nightmares affect women more than men. It is more common in young children of 3-6 years. But it can affect anybody at any age. Nightmare disorder affects you in the late stages of sleep, especially in the REM stage. It disrupts your sleep and induces fear and anxiety in the mind that prevents you to get back to normal sleep. It also impacts daytime routine as it may cause fatigue and daytime sleepiness.

How To Diagnose Nightmare Disorder?

How To Diagnose Nightmare Disorder?

There is no test available that can diagnose nightmare disorder on a routine basis. It is diagnosed when your physician evaluates your medical history and your symptoms. It can be done by following points-

Physical Examination- the physician may perform a physical examination to find out the contributing factors of the nightmares. If you have recurrent nightmares and anxiety as its underlying cause, then he may refer you to psychological expert.(1)

Symptoms Discussion- nightmare disorder is diagnosed after a study of your dreams and your experiences. The physician may enquire about your family history of sleep ailments. He may investigate the possibility of other sleep disorders if present. He may also ask your partner about your sleep behaviors.(1)

Polysomnography – Polysomnography is the study of sleep in the night. It is done when your sleep is severely disturbed. Your physician may ask you to keep the record of overnight sleep to judge whether sleep disturbance is related to another sleep disorder. He may place sensors on different parts of the body to record and monitor brain waves, the oxygen level in the blood, heart rate, breathing, eye movement or leg movements during sleep. Your videotaping may be done to understand your behavior during sleep.(1)

What Is The Best Medicine For Nightmare Disorder?

Nightmares do not need treatment in each case. But, treatment is required for those who feel distressed, sleep deprivation or disturbance and interference in the daytime functions. The best medicine for nightmare disorder is the treatment of underlying causes. The treatment options involve the following-

Treatments Of The Cause- nightmares are often associated with an underlying disease. This disease is detected and treated accordingly to have the best results.(1)

Management Of Stress And Anxiety- If stress and anxiety contribute to the nightmares, stress-reduction techniques can help to calm down them. Your physician may also recommend counseling with a psychotherapist or mental health professionals. Management of stress and anxiety is also considered as the best medicine for nightmares.(1) It also involves relaxation training that can reduce tension or anxiety. It helps to get back to sleep after a nightmare.(2)

Image Rehearsal Therapy- nightmares occur in certain people due to PTSD (post-traumatic stress disorder, a mental disorder that develops after a traumatic event in life). Image rehearsal therapy is recommended to reduce PTSD. This therapy helps to change the conclusion of the remembered nightmare so that when the patient awakes, the dream becomes no longer a threatening event. The patient is advised to revise a new ending in the mind. This therapy also reduces the frequency of nightmares.(1)

Medication- medication includes cyproheptadine and prazosin can help in treating nightmare disorder.(3)

Counseling – a therapist can help to find out the cause of the nightmares. He will process the patient’s thoughts and feelings. Intensive counseling is required if the nightmare is induced by a traumatic event.(3)


Nightmare disorder is diagnosed by the physician by evaluation of symptoms, physical examination, and polysomnography. Best medicine for Nightmare disorder is the management of underlying ailments and stress.


Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:October 11, 2019

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