Nightmares and Sleep Apnea

Having the occasional nightmare is quite common, particularly for children under the age of 10 years. While the reason we dream is still subject to research, there is no hiding from the fact that nightmares can be very unsettling. A nightmare can follow an unpleasant theme such as being chased, falling or a sense of being trapped.

Bad dreams are not generally a health concern so long as they are occasional occurrences. However, if a bad dream starts to become recurrent over a prolonged period, you should consult your doctor. Nightmare disorders can affect sleep, mood and the ability to function properly during the day.

If you snore and have morning headaches (symptoms of sleep apnea), a pattern of bad dreams may also point to sleep apnea as the cause.

What Can Cause a Nightmare?

Although there is still a debate about why we dream, there are a number of possible reasons why we may experience nightmares as we sleep. A primary risk factor can be stress and anxiety, with people suffering from chronic stress more prone to nightmare disorders. Further mental health issues such as depression and bipolar disorder can also increase the likelihood of a nightmare.

Potential causes include:

  • Post-traumatic stress disorder
  • Medications affecting the nervous system
  • Illness or fever
  • Alcohol or drug use
  • Eating prior to bedtime

Sleep deprivation and sleep apnea can cause nightmares, specialists say. Genetics may play a role in how often you have a nightmare, with some people being genetically disposed to the problem.

How a Nightmare Impacts Sleep

Restless nights can have a negative impact on the quality of your sleep. A nightmare will often see you awakening in an anxious or agitated state. With a nightmare, you will likely remember your dream and it can take a while to settle down again and accept it was just a dream. This is different to people who suffer with night terrors, as they largely stay asleep and do not recall their dreams when awake.

When you awake from a nightmare, it can be hard to relax your mind and get back to sleep. People with a nightmare disorder may even attempt to avoid sleeping because of how they dream. Unfortunately, the fatigue and sleep deprivation this induces can exacerbate the problem, producing a REM sleep rebound and leading to a more intense nightmare.

This link with sleep deprivation is why a sleep disorder such as obstructive sleep apnea can also make you more prone to a nightmare. Sleep apnea results in frequent awakenings overnight -- gasping for air due to the collapsing of the upper airways as you sleep. Without treatment, sleep apnea results in sleep deprivation and excessive daytime fatigue.

The other side of this issue -- anyone suffering with obstructive sleep apnea can see their disorder negatively affected by a nightmare. Sleep apnea once diagnosed is treated using devices worn overnight to keep the airways open as you sleep. 

Treating a Nightmare Disorder

For most people, the occasional nightmare can be expected and need not be worried about. However, if it is due to an underlying condition such as stress, depression or PTSD, then treating the condition can help prevent more persistent occurrences. 

If you notice an increase in nightmare frequency, try the following lifestyle changes:

  • Increase exercise to at least three times a week
  • Try yoga or meditation to help relax before going to bed
  • Adapt a regular night time routine and consistent sleep schedule
  • Ensure you have a comfortable bedroom environment which encourages sleep
  • Reduce the amount of alcohol and caffeine in your day
  • Avoid tranquilizers
  • Avoid computers and devices before bedtime to avoid any negative imagery

If your nightmare is occurring more than once a week, or it is affecting your sleep and mood, you should consult with your doctor. You will initially be asked about your intake of caffeine and other stimulants, as well as the medications you are taking.

Your doctor may recommend a sleep test. The test will monitor blood oxygen levels, heartbeat, brainwaves, breathing, leg movements and other indicators as you sleep. From this, a specialist can diagnose a sleep disorder like sleep apnea.

If your doctor suspects anxiety or PTSD is the cause, you may need further tests to understand the underlying cause -- so you can get the proper treatment.

For someone with a nightmare disorder, talk therapy may be recommended. The main aim of this approach is to reduce the negative thoughts which could be affecting your sleep and causing your nightmare disorder. 

One form of therapy which may be considered is image reversal therapy, which involves translating a recurring nightmare into a script that is rewritten in a more positive slant. This new script is then rehearsed while awake in order to provide a more positive outcome, which hopefully will ultimately prevent the nightmare.

Hypnosis is another potential approach for people suffering with a nightmare disorder, as is progressive deep muscle relaxation therapy, which aims to aid sleep by relaxing both the mind and the body.

The Bottom Line

The occasional nightmare, while not ideal, should not be a concern for most people. While children are more likely to have a nightmare, a study of college students showed 47% of respondents reporting having at least one nightmare within the preceding two weeks. Stress can be a prime factor in having a nightmare, but some basic lifestyle changes can reduce your risk.

However, a recurring nightmare can lead to sleep deprivation, which in turn can result in a higher risk of health problems. Treating the underlying causes such as sleep apnea is key to combating a nightmare disorder and returning you to proper nights of restorative sleep. If you have a frequently occurring nightmare which is affecting your sleep then you should consult your doctor.

SleepQuest Medical Associate’s sleep specialists are very helpful in diagnosing and treating sleep disorders, including sleep apnea. 

If you’re experiencing sleep deprivation, take a positive first step toward finding answers. Imagine getting a good night’s sleep -- every night.