A nightmare is a dream occuring during rapid eye movement (REM) sleep that brings out feelings of strong fear, terror, distress, or extreme anxiety. Nightmares are usually in the latter part of the night and wake up the sleeper, who is able to remember the content of the dream.

See also:

• Night terror
• Sleep disorders

Nightmares tend to be more common among children and beome less frequent toward adulthood. About 50% of adults have occasional nightmares, women more often than men.

Eating just before going to bed, which raises the body's metabolism and brain activity, may cause nightmares to occur more often. Adults who have repeated nightmares that become a significant problem should seek help.

Anxiety and stress are the most common causes of nightmares. A major life event occurs before the nightmare in most cases.

Other causes of nightmares include:

• Illness with a fever
• Death of a loved one (bereavement)
• Reaction to or side effect of a drug
• Recent withdrawal from a drug, such as sleeping pills
• Excessive alcohol consumption
• Abrupt alcohol withdrawal
• Breathing disorder in sleep (sleep apnea)
• Sleep disorder (narcolepsy, sleep terror disorder)

If you are under severe stress, you should ask for support from friends and relatives. Talking about what is on your mind can really help. Also, follow a regular fitness routine, with aerobic exercise if possible. You will find that you will be able to fall asleep faster, sleep more deeply, and wake up feeling more refreshed. Learn techniques to reduce muscle tension (relaxation therapy), which also will help reduce your anxiety.

Practice good sleep hygiene. Go to bed at the same time each night, and wake up at the same time each morning. Avoid long-term use of tranquilizers, as well as caffeine and other stimulants.

If you noticed that your nightmares started shortly after you began taking a new medication, contact your health care provider. He or she will let you know how to stop taking that medication if necessary, and recommend an alternative.

For nightmares caused by the effects of "street drugs" or regular alcohol use, ask for advice on the best ways to quit. An Alcoholics Anonymous group, for example, might suggest a safe way for you to stop drinking without putting your health at risk. You can also attend their regularly scheduled meetings. See also: Alcoholism - support group.

Also, look at your lifestyle -- friends, work, family -- to find and change factors that encourage substance abuse.